Medio-Lateral Myringoplasty versus Medial Myringoplasty: A Comparative Study

Objectives: One of the most important factors in the success of myringoplasty is the size of the perforation. The repair of subtotal and large central perforation is less likely to be successful compared with the repair of small perforations. Moreover anterior tympanic membrane is less vascular and the re-peroration rates are higher in this part. Medio-lateral myringoplasty offers an advantage in both of these situations and can be a viable alternative to conventional underlay myringoplasty. Methods: A prospective controlled study was undertaken from January 2008 to December 2010. Disease/ condition studied: Inactive (mucosal) chronic otitis media with large central, subtotal and anterior perforations. Subjects Forty cases of either sex in the age group of 18-40 years. Setting: Pt. B.D.S Post graduate Institute Medical Sciences Rohtak, a tertiary care center. Patients were randomly divided into two groups of twenty each. Group A underwent medial myringoplasty and group B underwent medio-lateral myringoplasty. The graft uptake rate and the preoperative and postoperative hearing thresholds in each group were analyzed. Independent variables: Size and location of the perforation, preoperative air bone gap and technique of myringoplasty used. Results: The overall graft uptake in group A was 80% as compared to graft uptake of 95% in group B. Further, the average postoperative gain in group A was 14 dB as compared to 17.5 dB of group B. Conclusions: Medio-lateral myringoplasty is better than medial myringoplasty in subtotal and large central perforations.