A Comparative Study of Type-I Underlay Tympanoplasty with Temporalis Fascia Graft Alone and with Conchal Cartilage

Microscopic Over-under Versus Medial Tympanoplasty for Larger Tympanic Membrane Perforations

OBJECTIVES

To identify the differences in hearing, anatomical success rate, functional success rate, and complications between over-under tympanoplasty and medial tympanoplasty procedures.

METHODS

The clinical data of patients with tympanic membrane perforation repaired by medial tympanoplasty between January 2011 and December 2016 and by over-under tympanoplasty between January 2017 and December 2020 were retrospectively analyzed. We evaluated the differences between medial tympanoplasty and over-under tympanoplasty.

RESULTS

The overall success rate of over-under tympanoplasty was higher than that of medial tympanoplasty (90.76% vs 81.31%). In large perforations, the success rate of over-under tympanoplasty was higher than that of medial tympanoplasty (89.80% vs 71.43%). There was no statistically significant difference in the success rate between the two treatment groups for moderate perforations. Furthermore, there was no statistically significant difference in the incidence of complications between the two groups (P = .2637).

CONCLUSIONS

Over-under tympanoplasty is more suitable for large perforations of the tympanic membrane and has a higher success rate as compared to medial tympanoplasty.