Comparative Study of Inlay and Overlay Cartilage Perichondrium Composite Graft Myringoplasty

Area of Science:

• Otorhinolaryngology
• Surgical Innovation
• Regenerative Medicine

Background:

• Chronic otitis media with dry ear is a common condition requiring surgical intervention.
• Myringoplasty aims to repair tympanic membrane perforations and restore hearing.
• Cartilage-perichondrium composite grafts offer a viable option for tympanic membrane reconstruction.

Purpose of the Study:

• To compare the efficacy of inlay versus overlay cartilage-perichondrium composite graft myringoplasty.
• To evaluate graft take-up rates and hearing outcomes for both techniques.
• To determine the optimal technique for office-based myringoplasty.

Main Methods:

• A comparative study involving 40 patients with chronic otitis media.
• Patients were divided into two groups: inlay and overlay cartilage-perichondrium graft myringoplasty.
• Outcomes assessed included graft success rate and hearing improvement at 6 and 24 months post-operatively.

Main Results:

• The inlay technique demonstrated a higher graft take-up rate (95% at 6 months, statistically significant long-term) compared to the overlay technique (85% at 6 months).
• 100% graft uptake was achieved with the inlay technique for large perforations (4-5 mm), while the overlay technique was successful only for small perforations (2 mm).
• Mean hearing gain was greater with the inlay technique (16.50 dB) versus the overlay technique (13.03 dB).

Conclusions:

• Inlay cartilage-perichondrium composite graft myringoplasty offers superior long-term graft success and hearing outcomes compared to the overlay technique.
• The inlay technique is effective for various perforation sizes, including large ones.
• The high success rate and ease of performance under local anesthesia make the inlay technique an optimal choice for office-based myringoplasty.