Prevalence of Perforated Graft in Underlay and Pop-in Technique Myringoplasty

  • Bhuwan Raj Pandey Department of ENT-HNS, Lumbini Medical College, Palpa, Nepal
  • Poonam KC Department of ENT-HNS, Ganeshman Singh Memorial Hospital and Research Center, Lalitpur, Nepal
Keywords: myringoplasty; pop-in; trans-tympanic; underlay.


Introduction: Underlay technique myringoplasty is most commonly used technique to repair tympanic membrane perforation by temporalis fascia graft and Trans-tympanic pop-in technique is an another technique that allows temporalis fascia graft placement medial to tympanic membrane remnant through the perforation without the need for tympano-meatal flap elevation. This study was undertaken to find the prevalence of perforated graft in underlay and Pop-in Technique Myringoplasty.

Methods: This descriptive cross-sectional study was done at Manipal teaching hospital, Pokhara, Nepal and comprises of 86 patients between January 2014 and June 2015. Patients undergoing Underlay Trans-canal approach by tympano-meatal flap elevation and Trans-canal, Trans-tympanic pop-in technique were included. Sample size calculation was done and convenient sampling method was applied. Point estimate at 95% CI was done for binary data along with frequency and proportion. The descriptive statistical analysis was done.

Results: The prevalence of perforated graft was 15 (17.4%) at 95% Confidence Interval (39.75-60.25%).
In underlay technique there were 8 (18.60 %) perforation and 35 (81.39%) were intact while in pop-in
technique there were 7 (16.27%) perforation and 36 (83.72%) were intact. The postoperative mean
Pure Tone Average (PTA) of underlay was 9.53 and pop-in was 8.31. The mean Pure Tone Average
(PTA) gain after underlay technique was 16.095 and pop in technique was 16.87.

Conclusions: Trans-tympanic pop-in myringoplasty gives similar hearing & graft uptake results when compared with tympano-meatal flap method of underlay myringoplasty done by trans-canal.

How to Cite
Pandey, B. R., & KC, P. (2019). Prevalence of Perforated Graft in Underlay and Pop-in Technique Myringoplasty. Journal of Nepal Medical Association, 57(220).
Original Article