Filippo Ricciardiello1, Davide Pisani2, Gerardo Petruzzi3, Pasquale Viola4, Remo Palladino5, Giulio Sequino6, Aldo Falco Raucci7, Giovanni Motta8, Ciro Coppola9, Michele Cavaliere10, Alessia Astorina11, Claudio Di Nola12, Flavia Oliva13, Alfonso Scarpa14, Giuseppe Chiarella15. 1. Ear Nose Throt Departement AORN Cardarelli, 80100 Napoli, Italy; . filipporicciardiello@virgilio.it. 2. Unit of Audiology, Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy; . davidepisani@gmail.com. 3. Department of Otolaryngology and Head and Neck Surgery, IRCCS ''Regina Elena'' National Cancer Institute, Rome, Italy. petruzzigerardo@gmail.com. 4. Unit of Audiology, Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy; . pasqualeviola@unicz.it. 5. Otolaryngology, P.O. Umberto I, Nocera Inferiore, Salerno, Italy. remo.palladino@tiscali.it. 6. Ear Nose Throt Departement AORN Cardarelli, 80100 Napoli, Italy;. giuseq@gmail.com. 7. Ear Nose and Throat Unit, Santa Maria delle Grazie Hospital, Pozzuoli, Naples, Italy. falcoraucci@libero.it. 8. Ear Nose Throt Departement AORN Cardarelli, 80100 Napoli, Italy;. pasqualeviol@libero.it. 9. health management AORN Cardarelli, 80100 Napoli, Italy;. ciro.coppola@aocardarelli.it. 10. Department of Neurosciences, Reproductives and Odontostomatologic Sciences, Unit Ear, Nose and Throat Section, University of Naples "Federico II", Naples, Italy. michele.cavaliere@unina.it. 11. Unit of Audiology, Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy; . alessiaastorina7@gmail.com. 12. Unit of Otorhinolaryngology, Department of Neuroscience, Federico II University Hospital, Napoli, Italy;. claudio.dinola@yahoo.it. 13. Ear Nose Throt Departement AORN Cardarelli, 80100 Napoli, Italy;. flaviaoliva311@gmail.com. 14. Department of Medicine and Surgery, University of Salerno, Salerno, Italy. alfonsoscarpa@yahoo.it. 15. Unit of Audiology, Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy; . chiarella@unicz.it.
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.
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.