Comparative Study of the Underlay and Over-Underlay Techniques of Tympanoplasty in Perforations of the Tympanic Membrane

Abstract Tympanoplasty is defined as a surgical procedure to eradicate disease in the middle ear and to reconstruct the hearing mechanism, with or without mastoid surgery and with or without tympanic membrane grafting. In this study the results of underlay and over-underlay tympanoplasty techniques in tympanic membrane perforations were compared. This randomised prospective study was conducted for a period of 1year [from March 2013 to February 2014]. It included 50 patients who presented to the Otorhinolaryngology department and they were randomly allocated into two groups. In group A, the temporalis fascia graft was placed medial to the handle of malleus (underlay technique), in group B the graft was placed lateral to the handle of malleus but medial to the remnants of the tympanic membrane or fibrous annulus (over-underlay technique). The two groups were followed up for 6 months post operatively. Pre-operative and post operative air-bone gap of the 2 groups were compared. In this study, short-term results of the two tympanoplasty techniques were compared and there was no significant difference found between the two techniques.