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abstract nr.: O101
RESULTS OF INTERLAY TECHNIQUE TYMPANOPLASTY
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Author:
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N.B. Prahlada, Karnataka ENT Institute & Research Centr, Chitradurga, India |
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Co-author(s):
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Topic:
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Surgery |
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Keywords:
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Tympanoplasty, tri-layer neo-tympanum, Interlay technique, Epithelial pearls |
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OBJECTIVES: In-growth of Squamous epithelium along the margins of tympanic membrane (TM) perforation or outgrowth of mucous membrane are potential risks, if not addressed appropriately during tympanoplasty. Squamous epithelium can form epithelial pearls. The out-grown mucous layer secretes mucous which can trouble the patient with life long itching ear. An advantage of Interlay technique tympanoplasty which helps in overcoming these problems is presented here.
METHODS: In this Randomized prospective study, 52 patients were included. Post-aural approach and temporalis fascia graft were used in all cases. Posterior bony canal wall skin flap was raised. Anteriorly, the annulus was elevated inside-out far about 3 mm. The remnant tympanic membrane was excised along with fibrous annulus all around. Interlay grafting done.
RESULTS: 47 patients were regularly followed with Mean follow up of 1.9 years. None had re-perforation, epithelial pearls formation or itching ears. Residual air-bone gap was about 15 dB, better than in other techniques. Histopathological examination (HPE) of neo-tympanic membrane showed that it consists of tri-layer as in normal TM.
CONCLUSIONS: As such the remnants of tympanic membrane and annulus are excised; risks of epithelial pearls and mucous secretion are eliminated. This technique also provides anatomical neo-tympanum with epithelial growth outside and mucous layer growth inside of the graft, while the graft itself forms the middle fibrous layer. This tri-layer neo-tympanum helps in obtaining hearing results better than in other techniques.
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Presentation preference:
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