Overlay and underlay tympanoplasty revisited: a review

Myringoplasty conventionally is the reconstitution of the perforated tympanic membrane with placement of the graft either on the external or internal side of the residual eardrum The first recorded attempt to close tympanic membrane perforation was by Banzer in 1640; with a pig’s bladder membrane stretched over an ivory tube. Paper patching, perforation margin cauterization, the overlay or underlay, skin, fascia, perichondrium, cartilage or dural grafting were the developments in the repair of the ear drum. The temporalis fascia is superior to other grafts as it has a better uptake because of a low basal metabolic rate and, minimal shrinkage due to its low elasticity. Lateralization or medialization are the likely issues respectively of either technique. The technique and its development historically have been elaborated upon