Compare the Outcomes of Underlay and Onlay Myringoplasty


  • Muhammad Habib, Bakht Zada, Zafar Iqbal, Muhammad Naseem Khan, Kamran Chaudhry, Muhammad Nadeem



Myringoplasty, Overlay technique, Underlay technique, Graft success


Objective: The purpose of this study is to compare the outcomes of myringoplasty patients who had underlay and onlay procedures in order to establish whether approach is superior.

Study Design: Quasi-experimental study

Place and Duration: The study was conducted at the department of ENT, Head &Neck Surgery, Lady Reading Hospital MTI Peshawar and Chaudhary Muhammad Akram Teaching and Research Hospital Lahore for the period from May 2021 to October 2021.

Methods: This study included a total of 114 patients ranging in age from 14 to 60 years. After obtaining informed written consent, patients' full details including age, gender and BMI were recorded. Chronic otitis media and/or trauma-related tympanic membrane perforation was included. M and N were the designations given to the two sets of patients. 57 patients in Group M received underlay myringoplasty and 57 patients in Group N underwent for onlay myringoplasty respectively. The success rate of grafts was evaluated for both groups. A three-month period was allotted for complete follow-up in both groups. SPSS 24.0 was used to analyze all of the data.

Results: Group M had 38 (66.7%) males, but group N had 42 (71.9%) males. There were 26.13±5.39 years and 27.10±3.42 years were the mean ages of the two groups, respectively, for group M and group N. There were 53 (93%) graft successes in group M and 49 (86%) in group N. Group M's medialization was 5.3%, but group N's medialization was 10.5%, with no evidence of lateralization in either group. Mean air bone gap closure was 8.1±4.33 dB in group M and 10.9±7.61 dB in group N.

Conclusion: After doing this research, we came to the conclusion that the underlay technique for myringoplasty was more beneficial in terms of graft success and hearing restoration. Overall, both groups had accepted success rate, which is comparable to the national average.