A Study of Interlay Grafting in Type 1 Tympanoplasty for Large Central Perforation
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ORIGINAL ARTICLE
A Study of Interlay Grafting in Type 1 Tympanoplasty for Large Central Perforation Manit M. Mandal1 • Ajay J. Panchal1 Vipul V. Valiya1
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Rakesh Kumar1 • Mithram Z. Wadia1
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Received: 2 September 2020 / Accepted: 14 September 2020 Association of Otolaryngologists of India 2020
Abstract The objective of the study was to study the outcomes of interlay type 1 tympanoplasty in large central perforations in terms of graft uptake, hearing improvement and complications. Study included 150 symptomatic patients having large central perforation in tympanic membrane willing for surgery who later underwent tympanoplasty with or without cortical mastoidectomy. All the patients selected for study, were assessed for subjective and objective evaluation pre-operatively and then post-operatively after 4 months. The study was conducted at tertiary health care hospital. Type I tympanoplasty with Interlay technique for large central perforations is superior. The Interlay technique in Type I tympanoplasty has high success both in terms of graft uptake as well as ABG closure. In the view of the advantages it offers, it should be preferred over the other conventional techniques in patients with large central perforations for better results. Keywords Interlay tympanoplasty Mucosal chronic otitis media Central perforation Abbreviations ABG Air bone gap AC Air conduction BC Bone conduction COM Chronic otitis media CSOM Chronic suppurative otitis media EAC External auditory canal & Ajay J. Panchal [email protected] 1
Department of Otorhinolaryngology, Surat Municipal Institute of Medical Education and Research, Sahara Darwaja, Surat, Gujarat 395001, India
TFG TM
Temporalis fascia graft Tympanic membrane
Introduction Ear discharge and decreased hearing are the most common complaints that bring the patient to an otorhinolaryngologist. Otitis media is defined as inflammation or infection of middle ear cleft. Chronic Suppurative Otitis Media is defined as a persistent disease, insidious in onset, often capable of causing severe destruction of middle ear structure and irreversible sequel, which is clinically manifested with deafness and discharge for more than 3 months which is further subdivided into Tubo-tympanic (safe) and Atticoantral (unsafe). The mucosal type chronic otitis media is characterized by central perforation in tympanic membrane and it can be surgically repaired by tympanoplasty with or without mastoidectomy. Tympanoplasty is a procedure to repair the tympanic membrane after eradicating disease from middle ear cleft with or without ossicular chain reconstruction. Central perforation in tympanic membrane can be repaired by using graft material like temporalis fascia or fascia lata, which can be placed by different techniques i.e. overlay, underlay or interlay. In Interlay technique, graft is placed between the fibrous layer and mucosal layer of the remnant drum. So, the graft is supported medially as well as laterally and therefore it overcomes the disadvantages of overlay and underlay technique (Fig.
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