Over-under myringoplasty.

OBJECTIVE: To determine the success rate of over-under technique of myringoplasty regarding rate of graft take, complications and hearing improvement. DESIGN: Quasi-experimental study. PLACE AND DURATION OF STUDY: Department of Otorhinolaryngology and Head and Neck Surgery, Fauji Foundation Hospital, Rawalpindi from March 2003 to January 2005. PATIENTS AND METHODS: A total of 68 patients having dry central tympanic membrane perforations of various sizes secondary to chronic tubotympanic suppurative otitis media were included in the study. Over-under technique of myringoplasty was used to repair the tympanic membrane perforation. Outcome measures were graft success i.e., full or partial take, no perforation, atelactasis or lateralization within 6 months of operation and improvement in hearing. RESULTS: Sixtysix patients (97%) out of 68 had full graft take at six months of follow-up. Only one (1.5%) met with graft failure and another one (1.5%) had partial graft take. Delayed perforation was noted in two patients (3%), both of these were 10 months after surgery. Atelactasis was seen in only one patient (1.5%) eight months after operation. Lateralization did not occur in any patient. Hearing improvement was noticed in 67 (98.5%) patients. Average air bone gap decreased by 12.65 dB. CONCLUSION: Over-under myringoplasty is an effective technique of repairing the tympanic membrane perforation due to high rate of graft take, few complications and marked hearing improvement.