Comparison between overlay and underlay primary myringoplasty: retrospective analysis on anatomical and functional results in 497 adult patients

Comparison between overlay and underlay primary myringoplasty: retrospective analysis on anatomical and functional results in 497 adult patients

Authors

  • Filippo Ricciardiello Ear Nose Throt Departement AORN Cardarelli, 80100 Napoli, Italy;
  • Davide Pisani Unit of Audiology, Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy; https://orcid.org/0000-0001-7486-0140
  • Gerardo Petruzzi Department of Otolaryngology and Head and Neck Surgery, IRCCS ‘‘Regina Elena’’ National Cancer Institute, Rome, Italy https://orcid.org/0000-0003-0371-7667
  • Pasquale Viola Unit of Audiology, Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy; https://orcid.org/0000-0002-2352-1146
  • Remo Palladino Otolaryngology, P.O. Umberto I, Nocera Inferiore, Salerno, Italy
  • Giulio Sequino Ear Nose Throt Departement AORN Cardarelli, 80100 Napoli, Italy;
  • Aldo Falco Raucci Ear Nose and Throat Unit, Santa Maria delle Grazie Hospital, Pozzuoli, Naples, Italy
  • Giovanni Motta Ear Nose Throt Departement AORN Cardarelli, 80100 Napoli, Italy;
  • Ciro Coppola health management AORN Cardarelli, 80100 Napoli, Italy;
  • Michele Cavaliere Department of Neurosciences, Reproductives and Odontostomatologic Sciences, Unit Ear, Nose and Throat Section, University of Naples "Federico II", Naples, Italy
  • Alessia Astorina Unit of Audiology, Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy;
  • Claudio Di Nola Unit of Otorhinolaryngology, Department of Neuroscience, Federico II University Hospital, Napoli, Italy;
  • Flavia Oliva Ear Nose Throt Departement AORN Cardarelli, 80100 Napoli, Italy;
  • Alfonso Scarpa Department of Medicine and Surgery, University of Salerno, Salerno, Italy
  • Giuseppe Chiarella Unit of Audiology, Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy; https://orcid.org/0000-0002-9829-2229

Keywords:

Myringoplasty; Graft; Tympanic membrane perforation; Surgery; Healing; Hearing function

Abstract

Purpose: Retro-auricular approach using an autologous graft is the main surgical method for myringoplasty (MPL). Endaural and transcanal or endoscopic approaches are also used. There is no definitive consensus on the best MPL surgical technique. The aim of this study is to compare the two most used technique, over and underlay MPL, to evaluate the difference in anatomical and functional outcomes. Materials and methods: We made a retrospective analysis of 497 adult patients who underwent underlay or overlay primary MPL, between 2010 and 2018, and evaluated the difference in anatomical and functional outcomes. Results: Successful functional results, evaluated 18 months after surgery, were obtained in 380 patients (76,4%); the underlay MPL obtained a successful result in 85% of patients, while the overlay technique in the 68%. We observed anatomical failure in 13.4% patients, in detail 9,8% of underlay MPL and 17,2% of overlay MPL had an anatomical failure. Conclusion: Our results show less complications related to the underlay technique. We believe that this remains the technique to prefer, except in subtotal or wide anterior perforations that could be better managed using the overlay technique.

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Published

31-08-2022

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ORIGINAL ARTICLES

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1.
Comparison between overlay and underlay primary myringoplasty: retrospective analysis on anatomical and functional results in 497 adult patients. Acta Biomed [Internet]. 2022 Aug. 31 [cited 2024 Mar. 29];93(4):e2022072. Available from: https://mattioli1885journals.com/index.php/actabiomedica/article/view/12393