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Prevalence of Perforated Graft in Underlay and Pop-in Technique Myringoplasty
Bhuwan Raj Pandey1, Poonam Kc2
1Department of ENT-HNS, Lumbini Medical College, Palpa, Nepal.
Introduction:
Underlay technique myringoplasty is most commonly used technique to repair tympanic membrane perforation by temporalis fascia graft and Trans-tympanic pop-in technique is an another technique that allows temporalis fascia graft placement medial to tympanic membrane remnant through the perforation without the need for tympano-meatal flap elevation. This study was undertaken to find the prevalence of perforated graft in underlay and Pop-in Technique Myringoplasty.
Methods:
This descriptive cross-sectional study was done at Manipal teaching hospital, Pokhara, Nepal and comprises of 86 patients between January 2014 and June 2015. Patients undergoing Underlay Trans-canal approach by tympano-meatal flap elevation and Trans-canal, Trans-tympanic pop-in technique were included. Sample size calculation was done and convenient sampling method was applied. Point estimate at 95% CI was done for binary data along with frequency and proportion. The descriptive statistical analysis was done.
Results:
The prevalence of perforated graft was 15 (17.4%) at 95% Confidence Interval (39.75-60.25%). In underlay technique there were 8 (18.60 %) perforation and 35 (81.39%) were intact while in pop-in technique there were 7 (16.27%) perforation and 36 (83.72%) were intact. The postoperative mean Pure Tone Average (PTA) of underlay was 9.53 and pop-in was 8.31. The mean Pure Tone Average (PTA) gain after underlay technique was 16.095 and pop in technique was 16.87.
Conclusions:
Trans-tympanic pop-in myringoplasty gives similar hearing & graft uptake results when compared with tympano-meatal flap method of underlay myringoplasty done by trans-canal.
Insights
The Trans-tympanic pop-in myringoplasty technique shows comparable graft uptake and hearing results to the underlay myringoplasty method. Both surgical approaches for tympanic membrane perforation repair demonstrate similar efficacy in this study.
Area of Science:
- Otolaryngology
- Surgical Techniques
- Tympanic Membrane Repair
Background:
- Myringoplasty is a surgical procedure to repair tympanic membrane perforations.
- The underlay technique using temporalis fascia is common.
- Trans-tympanic pop-in technique offers an alternative graft placement without flap elevation.
Purpose of the Study:
- To determine the prevalence of graft perforation in myringoplasty.
- To compare the outcomes of the underlay technique versus the Trans-tympanic pop-in technique.
Main Methods:
- A descriptive cross-sectional study involving 86 patients.
- Comparison of underlay myringoplasty (trans-canal, tympano-meatal flap elevation) and Trans-tympanic pop-in technique.
- Analysis of graft perforation rates and postoperative Pure Tone Average (PTA).
Main Results:
- Overall graft perforation prevalence was 17.4%.
- Underlay technique: 18.60% perforation rate; Pop-in technique: 16.27% perforation rate.
- Postoperative PTA gain was 16.095 for underlay and 16.87 for pop-in.
Conclusions:
- Trans-tympanic pop-in myringoplasty yields similar hearing and graft uptake results to the underlay myringoplasty technique.
- Both methods are effective for tympanic membrane repair.
- The pop-in technique may offer advantages by avoiding tympano-meatal flap elevation.
