EFFICACY OF UNDERLAY VERSUS OVERLAY MYRINGOPLASTY IN TERMS OF HEARING IMPROVEMENT
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Keywords
Chronic otitis media, Myringoplasty, Underlay, myringoplasty technique
Abstract
Background: One technique that involves repairing the membrane that covers the tympanic cavity is myringoplasty. The postaural, endaural, or endomeatal routes might be used for this treatment. There are several grafts employed, including perichondrium, vein graft, and temporalis fascia. Based on where the material for the graft is placed, the procedure can be classified as underlay, overlay, interlay, or a mix of these.
Objective: To evaluate the efficacy of underly technique for myringoplasty in terms of hearing improvement.
Methodology: The present descriptive study was conducted in Hayatabad Medical Complex, eshawar, in the time duration of six months from 27/4/2019 to 27/10/2019. Patients of both the gender in age range 18-65 years presenting with dry perforated tympanic membrane with duration more than 6 weeks and with air bone gap of > 20db were included in the study. All the included participants were taken to OT and all operations were performed under general anesthesia. The endaural approach was used to perform the underlay technique. Together with the annulus, a sizable tympanomeatal flap based on the superior vascular pedicle was elevated. Little bits of spongeston were jam-packed into the middle ear. The graft was positioned medial to the annulus, over the malleolus handle. To support the graft, tiny spongeston pieces were layered over it. For one week, a gauze pack saturated in antibiotic ointment was kept inside the meatus. Five consecutive days of prophylaxis antibiotic therapy were administered. All the surgeries were performed under the supervision of CPSP fellow ENT surgeon having at least 5 years experienced in surgery.
Results: According to our analysis, of the 215 patients, 41% were between the ages of 18 and 30, 29% were between the ages of 31 and 40, 16% were between the ages of 41 and 50, and 14% were between the ages of 51 and 65. Of the patients, 44% were female and 56% were male. Furthermore, 88% of patients found the underlay technique to be helpful, whereas 12% did not see any benefit.
Conclusion: Our study concludes that the underly technique was 88% effective in the treatment of myringoplasty in terms of hearing improvement.
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Dr Sahibzada Fakhre Alam
ENT Consultant, DHQ Hospital, Charsadda Pakistan
Dr Ijaz Ahmad
Specialist Registrar, Hayatabad Medical Complex, Peshawar Pakistan
Dr Hamid Mukhtar
Senior Registrar ENT, Northwest General Hospital and Research Center, Peshawar Pakistan
Dr Jawad Badshah
ENT Specialist, Shifa International Hospital, Islamabad Pakistan