Evidence map›Paper›PMID 40699222›Full record

Trial reportEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2025

Clinical outcomes of type I endoscopic tympanoplasty: Over-Underlay vs. Overlay techniques in a randomized controlled trial.

Pornsek Tananuchittikul, Phatthiraporn Yuangram

Abstract readRandomized Controlled TrialComparative Study
PubMed Publisher
In one paragraph

Trial report in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Endoscopic three-layer graft myringoplasty without tympanomeatal flap elevation for repairing subtotal and total perforations.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Pornsek TananuchittikulDepartment of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Thammasat University, Thammasat University Hospital, 99 Moo. 8, Phaholyotin Road, Khlong Luang, Pathum Thani, 12120, Thailand. saketann@gmail.com.ORCID http://orcid.org/0000-0003-3972-8632
Phatthiraporn YuangramDepartment of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Thammasat University, Thammasat University Hospital, 99 Moo. 8, Phaholyotin Road, Khlong Luang, Pathum Thani, 12120, Thailand.ORCID http://orcid.org/0009-0009-4485-110X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeCompare clinical outcomes between type I endoscopic over-underlay tympanoplasty (EOUT) and type I endoscopic overlay tympanoplasty (EOT) for repairing medium-to-large-sized tympanic membrane perforations.

methodsA prospective, single-blind, randomized controlled trial was conducted at a single tertiary university hospital involving 46 patients (aged 18-75 years) between September 2023 and July 2024. All patients had a persistent dry middle ear status for more than three months and underwent endoscopic tympanoplasty. The primary outcomes were graft success rate and hearing improvement, while the secondary outcomes included operative time and postoperative complications.

resultsA total of 43 patients were analyzed (EOUT, 22; EOT, 21). The overall graft success rate was 95.3%, with no significant intergroup differences (EOUT, 95.5% vs. EOT, 95.2%; p = 0.999). Postoperative pure-tone average air conduction threshold improved significantly in both groups (EOUT: from 39.03 ± 13.62 dB to 27.84 ± 11.72 dB; EOT: from 36.13 ± 14.26 dB to 25.00 ± 12.53 dB; p < 0.001). Similarly, the air-bone gap improved (EOUT: from 13.47 ± 7.20 dB to 4.26 ± 3.33 dB; EOT: from 12.32 ± 8.33 dB to 3.87 ± 3.93 dB; p < 0.001). Mean operative times were comparable (EOUT: 102.45 ± 13.04 min vs. EOT: 104.29 ± 15.43 min; p = 0.676), without postoperative hearing deterioration.

conclusionEOUT and EOT appear to be effective techniques for repairing medium-to-large-sized tympanic membrane perforations, showing high graft success rates and significant audiological improvements, with no statistically significant differences observed between the techniques. These findings are promising and may support future studies with larger sample sizes and longer follow-up periods. CLINICAL

trial registrationProspectively registered- Thai Clinical Trials Registry (TCTR) under TCTR20230911001 on 11 September 2023.

Indexed as

EndoscopyTympanic Membrane PerforationTympanoplastyAdolescentAdultAgedFemaleHumansMaleMiddle AgedOperative TimePostoperative ComplicationsProspective StudiesSingle-Blind MethodTreatment OutcomeYoung AdultEndoscopyOverlayOver-underlayTympanic membrane perforationTympanoplasty

Identifiers

PMID40699222

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.