Double medial and lateral graft in myringoplasty

A surgical technique for a double medial and lateral overlay autologous fascia graft myringoplasty is described in this paper along with its indications and results.

The presurgical and one year post surgery characteristics are analyzed for 100 cases with the double medial and lateral overlay autologous fascia graft technique. The anatomical and functional results are analyzed.

The results are analyzed one year post surgery. The probabilities of obtaining a graft take using this methodology are 95%. The incidence of persistence of the perforations is 12.5% in children under 10 and 2.5% in children over ten years of age and adults. The complications are 4% of epithelial pearls with blunting of the neo-tympanum, 1% of retractions and 3% of epithelitis which is resolved with a topical medical treatment. The average residual air/bone gap is less than 20dB in 85% of the cases. Less than 10dB in 38%, and between 10 and 20dB in 47%. The causes for incomplete closure of the gap are analyzed; possibly related to fibrosis and sclerosis of the tympanic remnants and/or the ossicular chain.

It is concluded that this methodology provides the best results in comparison with other methods we have used and have set aside for very specific situations related to the size and location of the perforation.