Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-26T08:05:29.460Z Has data issue: false hasContentIssue false
  • English
  • Français

Total annulus excision tympanoplasty – a solution to recurrent myringitis: double blind randomised trial

Published online by Cambridge University Press:  27 October 2021

N Verma ,
P Singhal ,
K P Surendra Prabhu ,
R Sehra ,
R Yadav ,
B Singh Aeron ,
S Munjal ,
A Hussain ,
S Agarwal  and
M Prakash Sharma
N Verma
Affiliation:
Department of Otorhinolaryngology, SMS Medical College, Jaipur, India
P Singhal*
Affiliation:
Department of Otorhinolaryngology, SMS Medical College, Jaipur, India
K P Surendra Prabhu
Affiliation:
Department of Otorhinolaryngology, SM Hospital, Kannur, India
R Sehra
Affiliation:
Department of Otorhinolaryngology, SMS Medical College, Jaipur, India
R Yadav
Affiliation:
Department of Preventive and Social Medicine & Biostats, SMS Medical College, Jaipur, India
B Singh Aeron
Affiliation:
Department of Otorhinolaryngology, Meenakshi Hospital, Hanumangarh, India
S Munjal
Affiliation:
Department of Otorhinolaryngology, Shri Balaji Hospital, Sirsa, India
A Hussain
Affiliation:
Department of Otorhinolaryngology, Bangalore Medical & Surgical Centre, Bengaluru, India
S Agarwal
Affiliation:
Department of Otorhinolaryngology, SMS Medical College, Jaipur, India
M Prakash Sharma
Affiliation:
Department of Otorhinolaryngology, SMS Medical College, Jaipur, India
*
Author for correspondence: Dr P Singhal, 78 A, Lipi Clinics, Vishnupuri, Durgapura, Jaipur302018, Rajasthan, India E-mail: drps.ent@gmail.com Fax: +91 141 255 2745
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

In spite of continuous refinements in tympanoplasty techniques, results are variable, and it is not uncommon to see a discharging eardrum even after a good graft uptake. This study aimed to evaluate the efficacy of total annulus excision tympanoplasty in comparison with conventional underlay tympanoplasty.

Method

This was a double blinded, randomised, controlled trial performed at a tertiary care centre. After inclusion and exclusion criteria were met, 56 patients were enrolled and randomised, and 28 patients were allocated to each group (group A (conventional tympanoplasty) and group B (total annulus excision)). Patients and evaluators were blind to the procedure performed.

Results

Patients in group B (total annulus excision) showed better graft uptake and no discharge with better gains in air conduction thresholds (p < 0.05) when compared with group A (conventional tympanoplasty).

Conclusion

In view of the advantages it offers, total annulus excision tympanoplasty may be preferred over the conventional techniques in patients with central perforations.

Keywords

TympanoplastyMyringoplastyOtitis media
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 3 , March 2022 , pp. 223 - 228
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr P Singhal takes responsibility for the integrity of the content of the paper

Presented at 105th Annual Clinical Congress of American College of Surgeons, 27–31 October 2019, San Francisco, California, USA and 32nd Politzer Society Meeting and 2nd World Congress of Otology, 28 May–1 June 2019, Warsaw, Poland.

References

Kawatra, R, Maheshwari, P, Kumar, G. A comparative study of the techniques of myringoplasty – overlay, underlay & interlay. IOSR J Dent Med Sci 2014;13:12–1610.9790/0853-131251216CrossRefGoogle Scholar
Pannu, KK, Chadha, S, Kumar, D. Evaluation of hearing loss in tympanic membrane perforation. Ind J Otolaryngol Head Neck Surg 2011;63:208–1310.1007/s12070-011-0129-6CrossRefGoogle ScholarPubMed
Mudry, A. History of tympanoplasty. Otol Neurotol 2005;26:554–5Google ScholarPubMed
Berthold, E. Ueber myringoplastik. Wier Med Bull 1878;1:627Google Scholar
Wullstein, H. The restoration of the function of the middle ear in chronic otitis media. Ann Otol Rhinol Laryngol 1971;80:210–17Google Scholar
Zollner, F. The principles of plastic surgery of the sound – conducting apparatus. J Laryngol Otol 1955;69:637CrossRefGoogle ScholarPubMed
Palva, T, Ramsay, H. Myringoplasty and tympanoplasty – results related to training and experience. Clin Otolaryngol Allied Sci 1995;20:329–35CrossRefGoogle ScholarPubMed
Sarkar, S. A review on the history of tympanoplasty. Ind J Otolaryngol Head Neck Surg 2013;65:455–6010.1007/s12070-012-0534-5CrossRefGoogle ScholarPubMed
World Health Organization. Chronic suppurative otitis media, burden of illness and management options. Geneva: WHO Child and Adolescent Health Department, Prevention of Blindness and Deafness, 2004Google Scholar
Primrose, WJ, Kerr, AG. The anterior marginal perforation. Clin Otolaryngol Allied Sci 1986;11:175–6CrossRefGoogle ScholarPubMed
Patil, BC, Misale, PR, Mane, RS, Mohite, AA. Outcome of interlay grafting in type 1 tympanoplasty for large central perforation. Ind J Otolaryngol Head Neck Surg 2014;66:418–24CrossRefGoogle ScholarPubMed
Jain, S, Gupta, N, Gupta, R, Roy, A. Interlay type I tympanoplasty in large central perforations: analysis of 500 cases. Ind J Otol 2017;23:32–5Google Scholar
Sharma, N, Sharma, P, Goyal, VP, Sharma, KG. Interlay versus underlay type 1 tympanoplasty: a comparative study of the techniques in 100 cases. Int J Otorhinolaryngol Head Neck Surg 2019;5:64–8CrossRefGoogle Scholar
Singh, M, Rai, A, Bandyopadhyay, S, Gupta, SC. Comparative study of underlay and overlay techniques of myringoplasty in large and subtotal perforations of the tympanic membrane. J Laryngol Otol 2003;117:444–8CrossRefGoogle ScholarPubMed
Sergi, B, Galli, J, De Corso, E, Parrilla, C, Paludetti, G. Overlay versus underlay myringoplasty: report of outcomes considering closure of perforation and hearing function. Acta Otorhinolaryngol Ital 2011;31:366–71Google ScholarPubMed
Kalsotra, P, Gupta, R, Gupta, N, Kotwal, S, Suri, A, Kanotra, S. Overlay versus underlay myringoplasty: a comparative study. Ind J Otol 2014;20:183–8Google Scholar
Cameron, CW, Demetri, A, Vivian, FK, Brandon, I. Endoscopic lateral cartilage graft tympanoplasty. Otolaryngol Head Neck Surg 2017;157:683–9Google Scholar