“HEARING IMPROVEMENT IN PATIENTS UNDERGOING UNDERLAY TECHNIQUE OF MYRINGOPLASTY”

Abstract

Introduction: The quite common otologic disease that causes conductive hearing loss and repeated infections is the perforation of the Tympanic membrane. Type I tympanoplasty, also known as myringoplasty, aims to repair the eardrum and improve hearing. The underlay method is a popular surgical approach due to its technical simplicity, reduced operative time, and positive hearing results, among other benefits.

Objective: To establish the height and rate of hearing restoration in patients with dry tympanum membrane perforation undergoing underlay myringoplasty.

Materials and Methods: The case series presented was performed in the Department of E.N.T., Allied Hospital, Faisalabad, between January, 2020 and December, 2024. It included 90 patients aged 15–40 years, dry tympanic membrane perforations that lasted over 12 weeks, and air-bone gap ≤40 dB. Patients who had active ear disease, mastoiditis, sensorineural deafness, systemic comorbidities, or eustachian tube dysfunction were excluded. Myringoplasty was carried out underlay and temporalis fascia grafts, and hearing was evaluated by pure tone audiometry, which was done before and 8 weeks after the surgery.

Results: The average age was 29.6 ± 5.7 years, 66.7 percent men and 33.3 percent women. In 56.7%, the etiology of perforation was infective, and in 43.3%, the etiology was traumatic. Small holes were the major (60%) ones. The postoperative outcome showed that 51 patients (56.7%) had significant hearing improvement of 10 dB or more gap between air and bones, and 39 patients (43.39%) did not have any improvement.

Conclusion: It was demonstrated that underlay myringoplasty was effective in producing significant hearing benefits in more than fifty percent of patients, demonstrating its presence as a safe surgical procedure in everyday otologic surgery.