Inlay versus underlay cartilage myringoplasty

Introduction:

Grafting the tympanic membrane is the most common ontological surgeries.

Many controversies were discussed for many years about the best graft material and best placement technique.

Shea 1960 first described underlay tympanoplasty.

Inlay cartilage tympanolasty was first described by Roland Eavey in 1998 through transcanal approach by fashioning the graft like butterfly or grommet tube. It has good take rate and hearing outcome.

Methods:

This is a prospective study. It included 40 patients with chronic inactive mucosal type of chronic suppurative otitis media with dry central perforation.

They were divided into two groups; Group A contained 17 patients who had inlay cartilage tympanoplasty, and group B contained 23 patients who had underlay cartilage tympanoplasty. All patients were preoperative asessed by full history taking, full ENT examination and histograms. And followed up postoperative for about 4 month.

Results:

11 patients in group A (65%) had healed tympanic membrane, while 19 patients in group B (83%) had healed tympanic membrane.

3 cases in group A (18%) had partial closure of the perforation.

The difference was not statistically significant.

Regarding hearing outcome, the mean AB gap closure in group A was 4 dB. While the mean AB gap closure in group B was 4.5 dB. This was also statistically not significant. However inlay butterfly cartilage myringoplasty is superior to the underlay cartilage tympanoplasty regarding operative time, postoperative pain score and duration to return to work.

Conclusion:

Inlay cartilage myringoplasty is an easy, rapid reliable alternative of underlay techniquefor grafting tympanic membrane. It has advantages of shorter operative time, less postoperative pain and rapid getting back to work.

Publication History

Publication Date:
18 April 2018 (online)