Double fascia graft for subtotal dry perforations Sandwich Graft Tympanoplasty

Surgical closure of subtotal perforations can present a problem. The lack of anterior support frequently leads to graft failure if an underlay technique is used, whereas, anterior blunting and lateralization are complications of only techniques. Sandwich graft tympanoplasy was found to be reliable in closing 23 subtotal perforations. It uses both an internal and external areolar fascia grafts plus an immediate epithelial coverage. This method gave 95.7% closure rate with no significant blunting or lateralization and a mean auditory threshold gain of 19.1 dB. One patient [4.3%] had epithelial pearl and no one had significant thickening of the new drum