Outcome of Interlay Type 1 Tympanoplasty for Large Central Perforation

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

Comparative study of Crescentic Cartilage and Anterior Tucking Tympanoplasty

Introduction: This study was undertaken to know the better technique of two methods i.e. cresentric cartilage tympanoplasty (CCT) and anterior tucking tympanoplasty (ATT) operated by single handed endoscopically. Material and Methods: This study was conducted on hundred patients at Shyam Shah Medical College, Rewa, MP. Hundred patients were selected using certain criteria and fifty patients each were operated by cresentric cartilage supported tympanoplasty(CCT) and anterior tucking technique(ATT). Audiometrically results were analysed preoperatively and postoperatively. Results: Maximum patients affected were teens and males. Maximum patients had large central perforation followed by subtotal and then total perforations in both the groups of cresentric cartilage tympanoplasty (CCT) and anterior tucking tympanoplasty (ATT). We operated under local anaesthesia and some under general anaesthesia in both the groups. Discussion: Hearing being special sense organ needs restoration for normal development and personality grooming. Newer method with evolution of medical sciences have devised techniques of reconstruction of hearing mechanism to give better results. Comparative study using cresentric cartilage tympanoplasty (CCT) and anterior tucking tympanoplasty (ATT) was done to know the better outcome and method. Conclusion: Cresentric cartilage tympanoplasty (CCT) is better of the two methods as it doesn’t shrink or change the shape.

Outcome of underlay versus interlay tympanoplasty in patients with inactive mucosal chronic otitis media with large central perforation: a retrospective comparative study

<p class="abstract"><strong>Background:</strong> Aim and objective were to study the outcome of underlay versus interlay tympanoplasty in patients with inactive mucosal chronic otitis media with large central perforations in terms of graft uptake rate and hearing improvement. </p><p class="abstract"><strong>Methods:</strong> The present study was conducted retrospectively on 110 patients of inactive mucosal chronic otitis media with large central perforation, 55 patients selected from each group undergoing underlay or interlay technique in a tertiary referral hospital, Department of ENT, ESIC Kalaburagi, Karnataka, from February 1 2018 to January 31, 2020. </p><p class="abstract"><strong>Results:</strong> Total 110 patients were included in the study. Male:female ratio was 1:2.2. The age group in this study ranged from 13-50 years of age. Preoperative mean air bone gap in groups A and B was 30.28±6.62, and 30.18±6.87 dB and postoperative mean air bone gap was 19.44±7.66 and 15.13±6.3 dB. In both the groups a significant mean reduction in air bone gap was observed. Mean reduction was maximum in group B. Statistically, intergroup difference in reduction in air bone gap was highly significant (p&lt;0.001). Graft success rate being 89.09% and 94.54% in underlay (group A) and interlay (group B) respectively.</p><p class="abstract"><strong>Conclusions:</strong> Interlay is a better technique than underlay in chronic otitis media inactive mucosal disease with large central perforation in terms of hearing improvement and graft uptake. </p>

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

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.