Interlay versus underlay type 1 tympanoplasty: a comparative study of the techniques in 100 cases

Background: Type 1 tympanoplasty is a surgical technique used to restore the integrity of tympanic membrane as well as to improve hearing level in patients with large central perforations (inactive mucosal chronic otitis media).Methods: This is a randomized prospective study of 12 month duration from January 2017 to December 2017 in 100 patients of chronic otitis media inactive mucosal type with large central perforation admitted in the E.N.T department at Geetanjali Medical College and Hospital, Udaipur. Results: The graft uptake rate in the present study was found to be 96% and 90% respectively in interlay and underlay techniques. Post operatively after 12 weeks mean air bone gap was maximum reduced in Interlay tympanoplasty.Conclusions: The present study showed that Interlay technique had a better graft take rate as well as hearing improvement in large central perforation of chronic otitis media than the underlay technique.

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Outcome of Interlay Type 1 Tympanoplasty for Large Central Perforation

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v27i1.53212 ◽

2021 ◽

Vol 27 (1) ◽

pp. 86-91

Author(s):

Md Mahmudul Huq ◽

SM Mostofa Qaiyoum ◽

Md Saifullah Ibne Mannan ◽

Md Kamruzzaman

Keyword(s):

Prospective Study ◽

Uptake Rate ◽

Chronic Otitis Media ◽

Hearing Improvement ◽

Effective Technique ◽

Medical College ◽

Type 1 Tympanoplasty ◽

Central Perforation ◽

A Prospective Study

Background: Perforation of the tympanic membrane may occur from various reasons. Most of these perforations heal spontaneously, whereas the remaining long-standing perforations that lead to recurrent ear discharge need tympanoplasty. Interlay Type 1 Tympanoplasty,a newer technique has shown promising results with higher success ratein terms of hearing gain and graft uptake. Objective: To analyze the results of interlay Type 1 Tympanoplasty in terms of graft uptake and hearing improvement in cases of inactive mucosal chronic otitis media (COM) with large central perforation. Methods: This is a prospective study of 24 months (January 2018 to December 2019) duration conducted in department of E.N.T, Khulna medical college, Khulna and data was collected from the 60 patients admitted for tympanoplasty. Results were calculated in terms of graft accepted or rejected and decrease in air bone gap. Result: The graft uptake rate in the present study was found to be 91.67% and the patients reported an improvement in terms of hearing. Pre operatively mean air bone gap was 26.5dBand post operatively after 12 weeks mean air bone gap improved to 17.58dB. Conclusion: Interlay Type 1 Tympanoplasty is an effective technique over conventional methods in terms of both graft uptake as well as hearing improvement in large central perforation. Bangladesh J Otorhinolaryngol; April 2021; 27(1): 86-91

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A Randomized Prospective Study on Interlay Vs Underlay of Type I Tympanoplasty in Remote Tertiary Center

Academia Journal of Surgery ◽

10.47008/ajs/2020.3.1.6 ◽

2020 ◽

Vol 3 (1) ◽

pp. 26-30

Author(s):

Md Sharif Alam ◽

Om Prakash ◽

R P Thakur

Keyword(s):

Prospective Study ◽

Otitis Media ◽

Uptake Rate ◽

Chronic Otitis Media ◽

Type I ◽

Hearing Improvement ◽

Medical College ◽

Central Perforation ◽

Tertiary Center ◽

Type I Tympanoplasty

Background: Type I tympanoplasty is a surgical technique used to restore the integrity of tympanic membrane as well as improve the hearing in inactive mucosal chronic otitis media. There are two main methods that are underlay and overlay in between both is interlay. The aim of the present study is to analyse and compare the results of the two most commonly used type I tympanoplasty techniques, underlay and the interlay technique in chronic otitis media with mucosal disease in large central perforation, in terms of graft uptake and hearing improvement. Subjects and Methods: This is a randomized prospective study of 100 cases of inactive mucosal chronic otitis media with total or large anterior central perforation between October2017 to September 2019 in Anugarah Narayan Magadh Medical College & Hospital, Gaya. Half had gone through Interlay and half by Underlay technique of Type I Tympanoplasy surgery. Results: The graft uptake rate in this study was 96% and 90% for Interlay and Underlay technique respectively. Postoperatively mean air bone gap maximally reduced in the Interlay technique. Conclusion: The present study showed that Interlay method had better graft uptake rate as well as hearing improvement in total and large anterior central perforation of inactive mucosal chronic otitis media than the Underlay technique.

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Comparative study of outcomes of type-1 tympanoplasty with and without anterior tucking

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20201277 ◽

2020 ◽

Vol 6 (4) ◽

pp. 657

Author(s):

Kiran Gangadar S. ◽

G. Priyadarshini

Keyword(s):

Tympanic Membrane ◽

Otitis Media ◽

Chronic Otitis Media ◽

Pure Tone Audiometry ◽

Tympanic Membrane Perforation ◽

Hearing Improvement ◽

Type 1 Tympanoplasty ◽

Membrane Perforation ◽

Group 2

Background: Tympanoplasty is a surgical procedure for closing the tympanic membrane perforation and reconstructing the tympanic membrane and hearing, commonly after trauma and chronic otitis media. The aim of the study was to compare the clinical and audiological outcomes of tympanoplasty with or without anterior tucking.Methods: In this prospective study, 50 patients with chronic otitis media (COM) were divided into two groups. Group 1 underwent type 1 tympanoplasty with anterior tucking method, and group 2 underwent type 1 tympanoplasty without anterior tucking. The result was measured on graft uptake and hearing outcome at 6 months postoperatively by performing pure tone audiometry. Results: The hearing improvement was almost the same in both the groups. Graft uptake was good in type 1 tympanoplasty with tucking (96%) when compared to without tucking tympanoplasty (92%). Complications like residual perforation were seen in both groups equally. Anterior marginal blunting was noted (8%) in type 1 tympanoplasty with tucking.Conclusions: The hearing improvement of type-1 tympanoplasty with anterior tucking and without anterior tucking is the same. Type-1 tympanoplasty with anterior tucking has a better graft acceptance. The only disadvantage of type-1 tympanoplasty with anterior tucking is anterior marginal blunting.

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Outcome of ear surgeries in dry and wet ear

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20172103 ◽

2017 ◽

Vol 3 (3) ◽

pp. 562 ◽

Cited By ~ 1

Author(s):

Shreyash C. S. ◽

Rajneesh . ◽

Rahul S.

Keyword(s):

Success Rate ◽

Otitis Media ◽

Chronic Otitis Media ◽

Success Rates ◽

Hearing Improvement ◽

Suppurative Otitis Media ◽

Time Of Surgery ◽

Type 1 Tympanoplasty ◽

Cortical Mastoidectomy

Background: Chronic suppurative otitis media (CSOM) can present with dry and wet ear (discharging ear). It’s an accepted fact that an actively draining central perforation is not a contraindication for ear surgery. The discharging ear presents the otologists with the dilemma of operating on it or not, this is due to widespread belief that the success rate while doing ear surgeries on wet ears is decidedly inferior. Hence the present dissertation is intended to find the outcome of ear surgeries in dry and wet ear.Methods: The present study comprises of 60 patients who have undergone type 1 tympanoplasty with cortical mastoidectomy, at Fr Muller’s Medical College, Mangalore. These patients were divided into two groups- Wet and Dry, based on the presence or absence of ear discharge at the time of surgery respectively. Inclusion Criteria: Patients of age group 16-60 years and both sexes, with mucosal type of chronic otitis media who underwent type 1 tympanoplasty with cortical mastoidectomy. Exclusion criteria: Patients with squamosal type of chronic otitis media or with ossicular chain erosion. A comparative analysis was done on the hearing improvement and incidence of the graft uptake postoperatively between the two groups.Results: In dry group, complete graft uptake was seen in 90% cases, whereas in wet group, a graft uptake rate of 86.7% was achieved. The graft take up rate is better in high x socio-economic status. Higher take up rates were seen in small and medium perforation compared to subtotal perforations. Hearing improvement, assessed by mean gain of PTA at the end of 6th month postoperatively, was achieved in 86% cases in Wet group and 90% cases in Dry group. There was an average hearing improvement of 13.08 db in speech frequencies in 88.3% cases. The difference between the two groups was statistically insignificant.Conclusions: In our study, we found no statistically significant differences between the success rates of Wet and Dry group, either in terms of graft uptake or the hearing improvement. Thus, from our study, we conclude that the presence of ear discharge at the time of surgery does not affect the success rate of type 1 tympanoplasty.

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Comparative study of anterior tucking and cartilage support tympanoplasty with respect to graft uptake and hearing outcome

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20184709 ◽

2018 ◽

Vol 5 (1) ◽

pp. 69

Author(s):

Raghunath Shanbag ◽

J. S. Arunkumar ◽

M. Sarath Chand ◽

Santosh S. Garag

Keyword(s):

Tympanic Membrane ◽

Otitis Media ◽

Middle Ear ◽

Surgical Techniques ◽

Chronic Otitis Media ◽

Hearing Improvement ◽

Hearing Outcome ◽

Type 1 Tympanoplasty ◽

And Cartilage

Background: Tympanic membrane perforation in chronic otitis media exposes the middle ear mucosa to exogenous source of infection and also produces conductive hearing loss. To overcome this problem various surgical techniques of tympanoplasty using different graft materials have been tried with varying degrees of success rate. The purpose of this study was to compare anterior tucking and cartilage support tympanoplasty with respect to graft uptake and hearing outcome.Methods: This prospective study comprised of 50 consecutive patients with chronic otitis media of tubo tympanic type during October 2015 to September 2017, which were divided into two groups. Group A (25 patients) underwent type 1 tympanoplasty with anterior tucking method, Group B (25 patients) underwent type 1 tympanoplasty with cartilage support. The primary result was measured in view of graft uptake & hearing capacity outcome at 6 months post operatively by performing pure tone audiometry. Results: In anterior tucking tympanoplasty group out of 25 patients, the graft uptake was good in 22 patients and 23 patients showed good improvement in hearing, while in cartilage support tympanoplasty group all the 25 patients the graft uptake was good and all showed good hearing improvement postoperatively. In our study both the groups have significant hearing improvement and in cartilage support tympanoplasty results were better.Conclusions: The aim of tympanoplasty is to treat middle ear and tympanic membrane defects. In this study we subjected the patients for anterior tucking and cartilage support tympanoplasty for two different groups respectively and both methods showed significant hearing improvement.

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Modification of Surgical Procedures of Type 1 Tympanoplasty for Non-Cholesteatomatous Chronic Otitis Media

ORL ◽

10.1159/000265124 ◽

2009 ◽

Vol 71 (1) ◽

pp. 71-73 ◽

Cited By ~ 3

Author(s):

Akinobu Kakigi ◽

Taizo Takeda ◽

Hiroaki Nakatani ◽

Kenichi Kozakura ◽

Shoichi Sawada ◽

...

Keyword(s):

Otitis Media ◽

Surgical Procedures ◽

Chronic Otitis Media ◽

Type 1 Tympanoplasty

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Type 1 tympanoplasty: does the status of contralateral ear affect the outcome?

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20191738 ◽

2019 ◽

Vol 5 (3) ◽

pp. 722

Author(s):

Arindam Das ◽

Sandipta Mitra ◽

Debasish Ghosh ◽

Arunabha Sengupta

Keyword(s):

Success Rate ◽

Otitis Media ◽

Prospective Observational Study ◽

Tertiary Care ◽

Chronic Otitis Media ◽

Care Hospital ◽

Type 1 Tympanoplasty ◽

The Status ◽

Contralateral Ear

Background: The objective of the study was to investigate the effect of contralateral ear status on the success rate (anatomical closure) of type 1 tympanoplasty.Methods: The study is a prospective observational study comprising of 60 patients diagnosed with chronic otitis media, who underwent type 1 tympanoplasty during 2016-2018 in a tertiary care hospital. Results: In our study, contralateral ear was normal in 40 (66.7%) cases & diseased in 20 (33.3%) cases. Success rate of type 1 tympanoplasty in patients with normal contralateral ear was 90% (n=36) but success rate was only 60% (n=12) in diseased contralateral ear. This was statistically significant (p=0.006).Conclusions: Our study revealed that the status of the opposite ear is an individual prognostic factor for type 1 tympanoplasty. In other words, graft-healing rates are poorer in individuals whose opposite ears are atelectatic or perforated because of chronic otitis media.

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A Comparative Study of Endoscopic and Microscopic Approach Type 1 Tympanoplasty for Simple Chronic Otitis Media

The Journal of International Advanced Otology ◽

10.5152/iao.2015.1011 ◽

2016 ◽

Vol 12 (1) ◽

pp. 28-31 ◽

Cited By ~ 29

Author(s):

Tzu-Yen Huang ◽

Kuen-Yao Ho ◽

Ling-Feng Wang ◽

Chen-Yu Chien ◽

Hsun-Mo Wang

Keyword(s):

Comparative Study ◽

Otitis Media ◽

Chronic Otitis Media ◽

Microscopic Approach ◽

Type 1 Tympanoplasty

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ROLE OF MASTOIDECTOMY IN TYPE 1 TYMPANOPLASTY OF SAFE TYPE CHRONIC SUPPURATIVE OTITIS MEDIA- A PROSPECTIVE STUDY

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2016/1167 ◽

2016 ◽

Vol 3 (102) ◽

pp. 5645-5649

Author(s):

Sami Ullah ◽

Faiz S. M ◽

Mohd Shakeel ◽

Saurabh Srivastav ◽

Satveer Singh Jassal ◽

...

Keyword(s):

Prospective Study ◽

Otitis Media ◽

Chronic Suppurative Otitis Media ◽

Suppurative Otitis Media ◽

Type 1 Tympanoplasty ◽

A Prospective Study

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Myringoplasty in wet and dry ears: an observational study in a tertiary care center

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20212785 ◽

2021 ◽

Author(s):

S. Umamaheswara Rao ◽

K. Samatha Reddy ◽

Siva Subba Rao Pakanati ◽

S. Chandramouli

Keyword(s):

Observational Study ◽

Otitis Media ◽

Care Center ◽

Tertiary Care ◽

Hearing Threshold ◽

Chronic Otitis Media ◽

Hearing Improvement ◽

Female Ratio ◽

Medical College ◽

Maximum Improvement

Background: Chronic otitis media is the most common cause of hearing impairment in the developing countries with serious effects. The aim of the study was to compare the outcome of myringoplasty in dry and wet ears in tubo-tympanic type of chronic otitis media (COM) with respect to graft uptake and hearing improvement.Methods: This is an observational study done in the department of ENT, Mamata medical college, Khammam, during the study period of September 2019 to February 2021 on 40 patients of tubo-tympanic type COM. On simple random basis selected patients underwent myringoplasty by underlay technique. All patients were evaluated during post-operative follow-up.Results: In our study, majority of patients were in the age group of 26 to 45 years with slight female preponderance, with male to female ratio (0.73:1). In our study, the successful graft uptake was seen 90% in dry ears and 85% in wet ears, which seems to be not significant in difference. With respect to hearing improvement, post-operatively there was significant improvement in both the groups, when compared to pre-operative hearing. The maximum improvement in average hearing threshold after surgery, in dry ears with large perforation (12.66dB) and in wet ears with small central perforation (12.44dB) was almost equal.Conclusions: In this study, the success rate of graft uptake and hearing improvement is found almost equal in dry and wet ears by using underlay technique of myringoplasty.

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