{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T23:59:20Z","timestamp":1784764760324,"version":"3.55.0"},"reference-count":45,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2021,11,5]],"date-time":"2021-11-05T00:00:00Z","timestamp":1636070400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec>\n            <jats:title>Objective:<\/jats:title>\n            <jats:p>Evaluate whether elevating the tympanic membrane from the malleus during endoscopic tympanoplasty may negatively affect postoperative hearing outcomes or perforation rates by comparing 2 similar endoscopic tympanoplasty techniques.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Study Design:<\/jats:title>\n            <jats:p>Retrospective cohort.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Setting:<\/jats:title>\n            <jats:p>Tertiary care center.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patients:<\/jats:title>\n            <jats:p>Endoscopic over-under cartilage tympanoplasties age and gender matched to endoscopic underlay cartilage tympanoplasties between January 2015 and January 2019. Exclusion criteria included preoperative or intraoperative cholesteatoma, performance of mastoidectomy or ossicular chain reconstruction, and lack of postoperative audiogram.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Interventions:<\/jats:title>\n            <jats:p>Endoscopic cartilage tympanoplasty via over-under or underlay technique.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Main Outcome Measures:<\/jats:title>\n            <jats:p>Pre- and postoperative pure-tone average and word recognition score, graft success.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>A total of 52 patients were evaluated: 26 endoscopic over-under cartilage tympanoplasties were matched to endoscopic underlay cartilage tympanoplasties. Both groups demonstrated a statistically significant improvement in air conduction hearing (9 dB [<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001] and 6 dB [<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.01], respectively), and bone pure-tone average did not worsen in either group (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001 and <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.05, respectively). Postoperative air conduction pure-tone average was statistically noninferior in the over-under group compared with the underlay group (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.05). Reperforation was present in 3 patients (12%) in the underlay group and none in the over-under group, but this difference was not statistically significant (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.24).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Endoscopic over-under cartilage tympanoplasty effectively closes tympanic membrane perforations and improves hearing, without greater risk than underlay tympanoplasty. Elevating the tympanic membrane from the malleus does not confer worsen hearing outcomes.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/ono.0000000000000005","type":"journal-article","created":{"date-parts":[[2022,8,5]],"date-time":"2022-08-05T20:02:39Z","timestamp":1659729759000},"page":"e005","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Endoscopic Over Under Cartilage Tympanoplasty Is Not Inferior to Underlay Cartilage Tympanoplasty"],"prefix":"10.1097","volume":"1","author":[{"given":"Isaac D.","family":"Erbele","sequence":"first","affiliation":[{"name":"Division of Neurotology, Department of Otolaryngology, Louisiana State University Health Sciences Center, Baton Rouge and New Orleans, Louisiana"},{"name":"Department of Otolaryngology, Brooke Army Medical Center, Fort Sam Houston, Texas"},{"name":"Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madelinn R.","family":"Fink","sequence":"additional","affiliation":[{"name":"Louisiana State University Health Sciences Center, New Orleans, Louisiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gauri","family":"Mankekar","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie S.","family":"Son","sequence":"additional","affiliation":[{"name":"Division of Neurotology, Department of Otolaryngology, Louisiana State University Health Sciences Center, Baton Rouge and New Orleans, Louisiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mois\u00e9s A.","family":"Arriaga","sequence":"additional","affiliation":[{"name":"Division of Neurotology, Department of Otolaryngology, Louisiana State University Health Sciences Center, Baton Rouge and New Orleans, Louisiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul","family":"Mehta","sequence":"additional","affiliation":[{"name":"Division of Neurotology, Department of Otolaryngology, Louisiana State University Health Sciences Center, Baton Rouge and New Orleans, Louisiana"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,11,5]]},"reference":[{"key":"R1-20241014","doi-asserted-by":"crossref","first-page":"1206","DOI":"10.1002\/lary.27599","article-title":"Over-under versus medial tympanoplasty: comparison of benefit, success, and hearing results.","volume":"129","author":"Babu","year":"2019","journal-title":"Laryngoscope"},{"key":"R2-20241014","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1007\/s00405-018-5262-3","article-title":"Does cartilage tympanoplasty impair hearing in patients with normal preoperative hearing? 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