A Randomized Prospective Study on Interlay Vs Underlay of Type I Tympanoplasty in Remote Tertiary Center
Interlay Vs Underlay of 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.
Galdstone HB, Jackler RK, Varav K. Tympanic Membrane Wound Healing. An Overview. Otolaryngol Clin North Am. 1995;28(5):913–945.
Berthold E. Overlay myringoplasty. Wier Med Bull. 1878;1:627–627.
WULLSTEIN H. THEORY AND PRACTICE OF TYM- PANOPLASTY. Laryngoscope. 1956;66(8):1076???1093– 1076???1093. Available from: https://dx.doi.org/10.1288/00005537-195608000-00008.
Zollner F. The principles of plastic surgery of the sound- conducting apparatus. J Laryngol Otol. 1955;69:637–52.
Aslam MA, Aslam MJ. Comparison of Over- Underlay and Underlay Techniques of Myringoplasty. Pak Armed Forces Med J. 2009;59(2):155–161.
Shea JJ. Vein Graft Closure Of Eardrum Perforations. J Laryngol Otol. 1960;74(6):358–362. Available from: https://dx.doi.org/10.1017/s002221510005670x.
Gupta R, Jain S, Gupta N, Roy A. Interlay Type I tym- panoplasty in large central perforations: Analysis of 500 cases. Indian J Otol. 2017;23(1):32–32. Available from: https://dx.doi.org/10.4103/0971-7749.199503.
Kawatra R, Maheshwari P, Kumar G. A Comparative study of the techniques of Myringoplasty - Overlay Underlay & Interlay. IOSR J Dent Med Sci. 2014;13(12):12–16. Available from: https://dx.doi.org/10.9790/0853-131251216.
House WF. Myringoplasty. Archives Otolaryngol Head Neck Surg. 1960;71(3):399–404. Available from: https://dx.doi.org/10.1001/archotol.1960.03770030041009.
Karlan MS. Gelatin Film Sandwich in Tympanoplasty. Otolaryngol Head Neck Surg. 1979;87(1):84–86. Available from: https://dx.doi.org/10.1177/019459987908700120.
Juvekar MR, Jurekar RV. The double breasting technique of tympanoplasty: A study of 200 cases. Indian J Otol. 1999;5:145–153.
Kartush JM, Michaelides EM, Becvarovski Z, LaRouere MJ. Over-Under Tympanoplasty. Laryngoscope. 2002;112(5):802– 807. Available from: https://dx.doi.org/10.1097/00005537-200205000-00007.
Singh M, Rai A, Bandyopadhyay S, Gupta SC. Comparative study of the underlay and overlay techniques of myringoplastyin large and subtotal perforations of the tympanic membrane. J Laryngol Otol. 2003;117(6):444–448. Available from: https://dx.doi.org/10.1258/002221503321892262.
Komune S, Wakizono S, Hisashi K, Uemura T. Interlay Method for Myringoplasty. Auris Nasus Larynx. 1992;19(1):17–22. Available from: https://dx.doi.org/10.1016/s0385-8146(12)80197-0.
Guo M, Huang Y, Wang J. Report of Myringoplasty with interlay method in 53 ears perforation of tympani. Lin Chuang Er Bi Yan Hou Ke Za Zhi. 1999;13(4):147–156.
Sengupta A, Basak B, Ghosh D, Basu D, Adhikari D, Maity K. A Study on Outcome of Underlay, Overlay and Combined Techniques of Myringoplasty. Indian J Otolaryngol Head Neck Surg. 2012;64(1):63–66. Available from: https://dx.doi.org/10.1007/s12070-011-0257-z.
Hay A, Blanshard J. The anterior interlay myringoplasty: Outcome and hearing results in anterior and subtotal tympanic membrane perforations. Otol Neurotol. 2014;35(9):1569–76.
Patil BC, Misale PR, Mane RS, Mohite AA. Outcome of Interlay Grafting in Type 1 Tympanoplasty for Large Central Perforation. Indian J Otolaryngol Head Neck Surg. 2014;66(4):418–424. Available from: https://dx.doi.org/10.1007/s12070-014-0741-3.
Nardone M, Sommerville R, Bowman J, Danesi G. Myringo- plasty in simple chronic otitis media: critical analysis of long- term results in a 1,000-adult patient series. Otol Neurotol. 2012;33(1):48–53.
Hussain A, Yousaf N, Khan AR. Outcome of Myringoplasty. J Postgrad Med Inst. 2004;18:693–699.
Copyright (c) 2020 Author
This work is licensed under a Creative Commons Attribution 4.0 International License.