{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T18:10:54Z","timestamp":1790791854143,"version":"4.1.0"},"reference-count":25,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Otol Rhinol Laryngol"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>This study compared the functional and anatomical outcomes of medial versus lateral graft placement techniques in type I tympanoplasty, focusing on hearing improvement and residual perforation rates. Tympanoplasty is a common surgical intervention for tympanic membrane (TM) perforations aimed at improving hearing and achieving tympanic closure. Debate continues regarding the optimal graft placement\u2014medial or lateral to the handle of the malleus\u2014for superior postoperative outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective comparative study was conducted on 48 patients aged 15 to 50\u2009years with central TM perforations and preoperative air-bone gap (ABG) &gt;\u200925\u2009dB. Group 1 (n\u2009=\u200923) underwent medial graft placement, and Group 2 (n\u2009=\u200925) underwent lateral placement. ABG changes at 3\u2009months post-surgery were assessed using audiometry. Statistical analysis included independent and paired t-tests, Fisher\u2019s Exact Test, 2-way ANOVAs, and Cohen\u2019s d for effect size estimation. Ethical approval was obtained from the Institutional Ethical Committee (ECR\/467\/Inst\/AP\/2013\/RR-19).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Both groups exhibited significant postoperative hearing improvement. Mean ABG gain was 21.6\u2009dB in Group 1 and 20.1\u2009dB in Group 2 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.567). No statistically significant difference was found in pre- or postoperative ABG values or residual perforation rates (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u20091.0). Effect sizes for all comparisons were negligible (Cohen\u2019s\n                      <jats:italic toggle=\"yes\">d<\/jats:italic>\n                      \u2009&lt;\u20090.2). Demographics, including age and gender, showed no interaction effects on outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Medial and lateral graft placements in tympanoplasty yield comparable functional and anatomical results. Given the negligible differences, graft positioning should be tailored to intraoperative findings and individual anatomical considerations. Larger, multicenter studies with varied graft materials and longer follow-up are warranted for definitive guidance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00034894261437484","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:41:42Z","timestamp":1775781702000},"page":"666-672","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Functional Outcomes of Tympanoplasty Based on Graft Position: Medial Versus Lateral to the Malleus Handle"],"prefix":"10.1177","volume":"135","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9205-0763","authenticated-orcid":false,"given":"Tabish","family":"Maqbool","sequence":"first","affiliation":[{"name":"Government Medical College Srinagar, Srinagar, Jammu and Kashmir, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Showkat Ahmed","family":"Showkat","sequence":"additional","affiliation":[{"name":"Government Medical College Srinagar, Srinagar, Jammu and Kashmir, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ihsan","family":"Ali","sequence":"additional","affiliation":[{"name":"Government Medical College Srinagar, Srinagar, Jammu and Kashmir, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waqar ul","family":"Hamid","sequence":"additional","affiliation":[{"name":"Government Medical College Srinagar, Srinagar, Jammu and Kashmir, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danish","family":"Andrabi","sequence":"additional","affiliation":[{"name":"Paras Hospital, Sonwar, Srinagar, Jammu and Kashmir, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,9]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.4103\/indianjotol.INDIANJOTOL_121_20"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjorl.2019.06.011"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.18203\/issn.2454-5929.ijohns20193857"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s44197-025-00396-9"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12070-023-03487-w"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/00034894241257103"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-023-08305-1"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.5152\/iao.2018.5570"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.joto.2020.01.001"},{"key":"e_1_3_2_11_2","article-title":"Cartilage graft and temporal muscle fascia graft in revision myringoplasty: a comparison of anatomical and functional results with an innovative surgical technique","volume":"15","author":"Canale A","year":"2024","unstructured":"Canale A, Boldreghini M, Abboud I, et al. Cartilage graft and temporal muscle fascia graft in revision myringoplasty: a comparison of anatomical and functional results with an innovative surgical technique. 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Comparison between overlay and underlay primary myringoplasty: retrospective analysis on anatomical and functional results in 497 adult patients. Acta Bio\u2009Med. 2022;93(4):e2022072.","journal-title":"Acta Bio\u2009Med"},{"issue":"6","key":"e_1_3_2_20_2","first-page":"366","article-title":"Overlay versus underlay myringoplasty: report of outcomes considering closure of perforation and hearing function","volume":"31","author":"Sergi B","year":"2011","unstructured":"Sergi B, Galli J, De Corso E, et al. Overlay versus underlay myringoplasty: report of outcomes considering closure of perforation and hearing function. 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