A comparative study between modified underlay myringoplasty with graft over the handle of malleus and classical underlay technique with graft under the handle of malleus.

Karthikeyan, V A (2013) A comparative study between modified underlay myringoplasty with graft over the handle of malleus and classical underlay technique with graft under the handle of malleus. Masters thesis, Stanley Medical College, Chennai.

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Abstract

Chronic otitis media (COM) is defined as chronic inflammation of mucoperiosteal lining of part or whole of the middle ear cleft. It has been recognized since prehistoric times. It is classified into two types, mucosal and squamous, of which mucosal type is characterized by intermittent mucoid or mucopurulent discharge through a perforated tympanic membrane. Although the introduction of antibiotics has reduced the mortality in COM, still surgery remains the definitive treatment modality for closure of tympanic membrane perforation. From seventeenth to nineteenth century several attempts at closing tympanic membrane perforations were made using prosthetic materials like paper patch and cauterising agents. Surgical repair of tympanic membrane was first attempted by Banzer (1640) with pig’sbladder. In1878 Berthold devised the term myringoplasty. In 1952,Wullstein formally announced, a technique of closing perforation. That time he used split thickness skin graft. In 1958 Heerman began to use temporalis fascia. First Shea performed underlay tympanoplasty. He performed stapedectomy and he accidentally tore the ear drum. That time he successfully repaired the ear drum perforation with medial vein graft. He placed the graft medial to the ear drum perforation. The use of fascia as an underlay graft was first reported by Storrs in 1961.In their classic underlay myringoplasty they placed the graft medial to the handle of malleus. In our study we compare the results of two techniques of underlay myringoplasty graftunder the handle of malleus and the graft over the handle of malleus in terms of graft uptake and hearing outcome. Conclusion: Modified underlay technique, placing the graft lateral to the handle of malleus is a good alternative technique to classical underlay myringoplasty for anterior and subtotal perforations. There is no statistically significant difference in hearing outcome between these two groups.

Item Type: Thesis (Masters)
Uncontrolled Keywords: myringoplasty; graft over the handle of malleus; classical underlay technique; graft under the handle of malleus; comparative study
Subjects: MEDICAL > Otorhinolaryngology
Depositing User: Devi S
Date Deposited: 05 Jul 2017 07:22
Last Modified: 05 Jul 2017 07:22
URI: http://repository-tnmgrmu.ac.in/id/eprint/1004

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