Objective: To determine the outcomes between underlay and onlay techniques underwent myringoplasty.

Study Design: Quasi-experimental study.

Place and Duration of Study: Department of ENT, Nowshera medical College/Qazi Hussain Ahmad Medical

Complex, Nowshera from 1st July 2018 to 30th June 2020.

Methodology: One hundred patients with age ranges 12-55 years were enrolled. Patients details demographics

age, sex and body mass index were recorded after taking informed written consent. Patients suffered with

tympanic membrane perforation related to chronic otitis media and/or trauma were included. They were divided

into two groups, I and II. Group I had 50 patients and received underlay myringoplasty and group II had 50

patients underwent for onlay myringoplasty. Outcomes among both groups were assessed in terms of graft

success rate. Complete follow-up among both groups was taken in duration of 4 months.

Results: There were 35 (70%) males and 15 (30%) females in group I while in group II 30 (60%) males and 20

(40%) females. Mean age in group I was 24.15±8.41 years with mean BMI 25.17±6.53 kg/m2 and in group II mean

age was 25.15±8.41 years with mean BMI 25.21±6.14 kg/m2. In group I graft success rate was 48 (96%) and in

group II 45 (90%) graft success found. Medialization in group I was 2 (4%) and in group II was 4 (8%) and no any

lateralization was found in both groups. Hearing was improved in group I, mean air bone gap closure was

9.8±6.45dB and in group II 11.8±4.54 dB.

Conclusion: The underlay technique for myringoplasty was more effective in terms of graft success and hearing

improvement. Overall success rate among both groups was 93% among both groups.

Keywords: Underlay technique, Overlay technique, Myringoplasty