{
    "abstract": "Surgical repair of the tympanic membrane, termed a type one tympanoplasty is a tried and tested treatment modality. Overlay or underlay technique of tympanoplasty is common. Sandwich tympanoplasty is the combined overlay and underlay grafting of tympanic membrane.\nTo describe and evaluate the modified sandwich graft (mediolateral graft) tympanoplasty using temporalis fascia and areolar fascia. To compare the clinical and audiological outcome of modified sandwich tympanoplasty with underlay tympanoplasty.\nA total of 88 patients of chronic otitis media were studied. 48 patients (Group A) underwent type one tympanoplasty with modified sandwich graft. Temporalis fascia was underlaid and the areolar fascia was overlaid. 48 patients (Group B) underwent type one tympanoplasty with underlay technique. We assessed the healing and hearing results.\nSuccessful graft take up was accomplished in 47 patients (97.9%) in Group A and in 40 patients (83.3%) Group B. The average Air-Bone gap closure achieved in Group A was 24.4\u00b11.7dB while in Group B; it was 22.5\u00b13.5dB. Statistically significant difference was found in graft healing rate. Difference in hearing improvement was not statistically significant.\nDouble layered graft with drum-malleus as a 'meat' of sandwich maintains a perfect balance between sufficient stability and adequate acoustic sensitivity.\nO reparo cir\u00fargico da membrana timp\u00e2nica, denominado timpanoplastia tipo 1, \u00e9 uma modalidade de tratamento j\u00e1 bem estabelecida. As t\u00e9cnicas \nDescrever e avaliar a timpanoplastia com a t\u00e9cnica \u201csandu\u00edche\u201d modificada (timpanoplastia mediolateral) utilizando f\u00e1scia temporal e f\u00e1scia aureolar. Comparar o desfecho cl\u00ednico e audiol\u00f3gico da timpanoplastia com a t\u00e9cnica \u201csandu\u00edche\u201d modificada com o da timpanoplastia com a t\u00e9cnica \nForam estudados 88 pacientes com otite m\u00e9dia cr\u00f4nica. 48 pacientes (Grupo A) foram submetidos \u00e0 timpanoplastia tipo 1 com enxerto \u201csandu\u00edche\u201d modificado. A f\u00e1scia temporal foi utilizada na t\u00e9cnica \nO sucesso do enxerto ocorreu em 47 pacientes (97,9%) no Grupo A e em 40 pacientes (83,3%) do Grupo B. O fechamento m\u00e9dio do gap a\u00e9reo-\u00f3sseo no Grupo A foi de 24,4 \u00b1 1,7\u00a0dB, enquanto no Grupo B foi de 22,5 \u00b1 3,5 dB. Houve diferen\u00e7a estatisticamente significativa na taxa de cicatriza\u00e7\u00e3o do enxerto. A diferen\u00e7a na melhora auditiva n\u00e3o foi estatisticamente significante.\nO enxerto de camada dupla e o t\u00edmpano-martelo posicionados como o \u201crecheio\u201d do sandu\u00edche mant\u00e9m um equil\u00edbrio perfeito entre a estabilidade necess\u00e1ria e adequada sensibilidade ac\u00fastica.",
    "authors": [
        {
            "affiliation": "Smt. Kashibai Navale Medical College and General Hospital, Pune Maharashtra, India. Electronic address: drsanjana31@yahoo.in.",
            "firstname": "Sanjana Vijay",
            "initials": "SV",
            "lastname": "Nemade"
        },
        {
            "affiliation": "Smt. Kashibai Navale Medical College and General Hospital, Pune Maharashtra, India.",
            "firstname": "Kiran Jaywant",
            "initials": "KJ",
            "lastname": "Shinde"
        },
        {
            "affiliation": "Smt. Kashibai Navale Medical College and General Hospital, Pune Maharashtra, India.",
            "firstname": "Chetana Shivadas",
            "initials": "CS",
            "lastname": "Naik"
        },
        {
            "affiliation": "Smt. Kashibai Navale Medical College and General Hospital, Pune Maharashtra, India.",
            "firstname": "Haris",
            "initials": "H",
            "lastname": "Qadri"
        }
    ],
    "conclusions": "Double layered graft with drum-malleus as a 'meat' of sandwich maintains a perfect balance between sufficient stability and adequate acoustic sensitivity.",
    "copyrights": "Copyright \u00a9 2017 Associa\u00e7\u00e3o Brasileira de Otorrinolaringologia e Cirurgia C\u00e9rvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.\nCopyright \u00a9 2017 Associa\u00e7\u00e3o Brasileira de Otorrinolaringologia e Cirurgia C\u00e9rvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.",
    "doi": "10.1016/j.bjorl.2017.03.009",
    "journal": "Brazilian journal of otorhinolaryngology",
    "keywords": [
        "Areolar fascia graft",
        "Enxerto de f\u00e1scia aureolar",
        "Enxerto de f\u00e1scia temporal",
        "Ganho auditivo p\u00f3s-operat\u00f3rio",
        "Post operative hearing gain",
        "Sandwich technique",
        "Temporalis fascia graft",
        "Timpanoplastia",
        "Tympanoplasty",
        "T\u00e9cnica \u201csandu\u00edche\u201d"
    ],
    "methods": null,
    "publication_date": "2017-05-10",
    "pubmed_id": "28476655\n24103745\n22323847\n1541881\n6877022\n10829103\n10393778\n8246654\n12150610\n1555321\n18720879\n15368066\n16398967",
    "results": "Successful graft take up was accomplished in 47 patients (97.9%) in Group A and in 40 patients (83.3%) Group B. The average Air-Bone gap closure achieved in Group A was 24.4\u00b11.7dB while in Group B; it was 22.5\u00b13.5dB. Statistically significant difference was found in graft healing rate. Difference in hearing improvement was not statistically significant.",
    "title": "Comparison between clinical and audiological results of tympanoplasty with modified sandwich technique and underlay technique.",
    "xml": "<Element 'PubmedArticle' at 0x7885030b1b20>"
}