Interlay technique type 1 tympanoplasty, an alternative for closing large central tympanic membrane perforation
Authors: Darmawan Anton Budhi 
Published: March 2021

Background: Type 1 tympanoplasty or myringoplasty is the most frequently performed procedure in the field of otology. Type 1 tympanoplasty is a surgical procedure to repair and only involves the restoration of the perforated tympanic membrane. There are three most accepted methods often used universally, namely underlay, overlay, and interlay. The interlay method is a relatively new method developed in 1992 for closing tympanic membrane perforation. This method has a high success rate of 96%. Objective: To report the success of type 1 tympanoplasty with an interlay method to close large central tympanic membrane perforations at Margono Soekarjo District Hospital. Case Report: Reporting 3 cases of chronic tubotympanic suppurative otitis media with large central tympanic membrane perforation which were repaired by type 1 tympanoplasty using interlay method. Clinical Question: Does interlay method type 1 tympanoplasty performed on large central tympanic membrane perforation provide better result compared with other methods of type 1 tympanoplasty? Review Method: Studying the evidence-based literatures on type 1 tympanoplasty interlay methods through Cochrane, Pubmed, and Google Scholar databases. Based on the inclusion and exclusion criteria, three journals were relevant with the reported cases. Result: All three journals stated that interlay method type 1 tympanoplasty had high success rate in terms of closing the tympanic membrane perforation and diminishing air-bone gap. Conclusion: Type 1 Tympanoplasty interlay method could be used as an alternative for the closure of a large central tympanic membrane perforation.Keywords: Chronic Tubotympanic Suppurative Otitis Media, large central tympanic membrane perforation, interlay tympanoplasty ABSTRAK Latar belakang: Timpanoplasti tipe 1 atau miringoplasti merupakan prosedur di bidang otologi yang paling sering dilakukan. Timpanoplasti tipe 1 merupakan metode pembedahan yang bertujuan untuk memperbaiki, dan terbatas hanya di membran timpani. Terdapat tiga metode yang paling diterima dan sering digunakan secara universal, yaitu underlay, overlay, dan interlay. Metode interlay merupakan metode penambalan perforasi membran timpani yang relatif baru, dikembangkan pada tahun 1992. Metode ini mempunyai keberhasilan yang tinggi yaitu mencapai 96%. Tujuan: Melaporkan keberhasilan timpanoplasti tipe 1 dengan metode interlay untuk penutupan perforasi membran timpani sentral besar di RSUD Margono Soekarjo. Laporan kasus: Dilaporkan 3 kasus otitis media supuratif kronik tipe tubotimpani dengan perforasi sentral besar, yang dilakukan timpanoplasti tipe 1 dengan metode interlay. Pertanyaan klinis: Apakah metode interlay timpanoplasti tipe 1 yang dilakukan pada perforasi membran timpani yang besar, dapat memberikan hasil yang lebih baik daripada metode lain timpanoplasti tipe 1? Telaah literatur: Telaah berbasis bukti mengenai timpanoplasti tipe 1 metode interlay melalui database Cochrane, Pubmed, dan Google Scholar. Berdasarkan kriteria inklusi dan ekslusi didapatkan tiga jurnal yang relevan dengan kasus yang dilaporkan. Hasil: Ketiga jurnal tersebut menyatakan bahwa timpanoplasti tipe 1 metode interlay mempunyai angka keberhasilan yang tinggi dalam hal penutupan perforasi membran timpani maupun mengurangi air-bone gap. Kesimpulan: Timpanoplasti tipe 1 metode interlay dapat digunakan sebagai alternatif untuk penutupan perforasi membran timpani sentral yang besar