Overlay versus underlay myringoplasty: report of outcomes considering closure of perforation and hearing function

Bruno Sergi, Jacopo Galli, Gaetano Paludetti, Eugenio De Corso, Claudio Parrilla

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

In this series of patients, the underlay or overlay positioning of a graft achieves successful outcome for both repair of perforation and hearing function, with better hearing gain in the underlay group. In myringoplasty, the two most common techniques for positioning the graft relative to the remnant of both the tympanic membrane and the annulus are the "overlay" and the "underlay" techniques. 115 patients who underwent myringoplasty for tympanic membrane perforation secondary to chronic otitis media and/or trauma were included, and hearing function was evaluated. We prefer an overlay technique in subtotal perforations, in those involving the anterior and antero-inferior parts of the ear drum with respect to the handle of the malleus and in revision surgery. We reserve an underlay technique for smaller perforations and for those limited to the posterior part of the tympanic membrane. Of 115 cases, 63 underwent an overlay myringoplasty and 52 underlay myringoplasty. In the former group, five cases were anatomically unsuccessful, whereas in the second group there were three failures. The air bone gap improved significantly in both groups with a better hearing gain in the underlay group.
Original languageEnglish
Pages (from-to)366-371
Number of pages6
JournalActa Otorhinolaryngologica Italica
Volume31
Publication statusPublished - 2011

Keywords

  • healing
  • hearing function
  • surgery
  • tympanic membrane perforation

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