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Underlay Myringoplasty Versus Overlay Myringoplasty: A Systematic Review and Meta-Analysis of Randomized Controlled
Ebraheem Albazee1, Marzouqi Salamah2, Mubarak Althaidy1
1Kuwait Institute for Medical Specializations (KIMS), Kuwait City, Kuwait.
Summary
The underlay myringoplasty technique shows higher success rates for surgical and hearing outcomes compared to the overlay method in perforated tympanic membrane patients. Further research is needed to confirm these findings.
Area of Science:
- Otolaryngology
- Surgical Innovation
- Evidence-Based Medicine
Background:
- Myringoplasty is a common otological surgery for perforated tympanic membranes.
- The optimal surgical approach (underlay vs. overlay) remains debated.
Purpose of the Study:
- To compare surgical and audiological outcomes of underlay and overlay myringoplasty.
- Synthesize evidence from randomized controlled trials (RCTs).
Main Methods:
- Systematic review and meta-analysis of RCTs.
- Searched Web of Science, SCOPUS, PubMed, and Google Scholar.
- Pooled dichotomous outcomes using risk ratio (RR) and 95% confidence intervals (CI).
Main Results:
- Included 8 RCTs with 656 patients.
- Underlay technique showed significantly higher surgical success rates (RR: 1.21, P=0.03).
- Underlay technique demonstrated significantly higher audiological success rates (RR: 1.31, P<0.00001).
Conclusions:
- The underlay technique may be superior for managing tympanic membrane perforations.
- Results have implications for surgical and audiological outcomes.
- Additional research is recommended to validate these findings.
