Surreal illustration of a healthy ear symbolizing interlay tympanoplasty.

Type 1 Tympanoplasty: Is Interlay the Future of Eardrum Repair?

Reese Marlowe in Health & Wellness December 2025 • 4 min read.

"A Long-Term Study Reveals High Success Rates and Minimal Complications with the Interlay Technique for Tympanic Membrane Repair"

Hearing loss and persistent ear discharge from eardrum perforations can significantly impact quality of life. Chronic Otitis Media (COM), often requiring surgical intervention, affects millions worldwide. Tympanoplasty, a surgical procedure to repair the perforated eardrum, aims to restore hearing and eliminate ear discharge, improving overall well-being.

From the 17th to 19th centuries, early attempts to fix eardrum holes paved the way for modern techniques. In 1887, Blake used a simple paper patch to close perforations. The evolution continued with innovative materials and methods, including skin grafts and temporalis fascia. These efforts led to the classification of tympanoplasty techniques: underlay, overlay, and the increasingly popular interlay.

This article dives into the interlay tympanoplasty technique, a method gaining traction for its promising results. We will explore a detailed longitudinal study assessing its success rate and potential complications, offering insights into why it might be a preferred choice for eardrum repair.

What is Interlay Tympanoplasty and How Does it Work?

Surreal illustration of a healthy ear symbolizing interlay tympanoplasty.

Interlay tympanoplasty involves placing a graft between the fibro-squamous and mucosal layers of the tympanic membrane. This strategic placement provides excellent support and promotes successful healing. Unlike underlay or overlay techniques, interlay aims to minimize common complications such as graft lateralization, medialization, and anterior blunting.

A prospective study conducted at Era's Lucknow Medical College, India, from 2012 to 2015, closely examined the outcomes of interlay tympanoplasty. The study included 50 patients aged 10 to 50 years with chronic otitis media of the mucosal type and dry ears. Each participant underwent a thorough evaluation, including otomicroscopy, tuning fork tests, and pure tone audiometry (PTA) before undergoing the interlay procedure performed by a single surgeon.

Pre-operative Assessment: Comprehensive hearing tests and ear examinations were performed to document the extent of the perforation and hearing loss.
Surgical Technique: A post-auricular approach was used, with temporalis fascia harvested for the graft material. The tympanomeatal flap was carefully elevated, and the graft was positioned between the layers of the eardrum.
Post-operative Care: Patients received antibiotics, antihistamines, and nasal drops to prevent infection and reduce inflammation. Regular follow-up appointments were scheduled to monitor graft uptake and hearing improvement.

The study meticulously tracked graft uptake and hearing outcomes, with follow-up visits at 1, 2, and 3 weeks, then at 3, 6, 12, and 18 months. Microscopic examinations assessed graft integrity and any complications. Hearing levels were recorded using air conduction and bone conduction tests to determine the air-bone gap (ABG), a key indicator of hearing improvement.

Interlay Tympanoplasty: A Promising Path to Eardrum Restoration

The study's findings strongly support interlay tympanoplasty as a highly effective technique for repairing eardrum perforations. With its high success rate, minimal complications, and potential for excellent hearing outcomes, interlay tympanoplasty offers a promising path to restoring hearing and improving the quality of life for individuals with chronic otitis media.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1007/s12070-017-1185-3, Alternate LINK

Title: Longitudinal Study Of Type I Interlay Tympanoplasty

Subject: Otorhinolaryngology

Journal: Indian Journal of Otolaryngology and Head & Neck Surgery

Publisher: Springer Science and Business Media LLC

Authors: Manish Chandra, Satveer Singh Jassal

Published: 2017-08-20

Everything You Need To Know

What is Interlay tympanoplasty?

Interlay tympanoplasty is a surgical procedure to repair a perforated eardrum. It involves placing a graft, often made from temporalis fascia, between the fibro-squamous and mucosal layers of the tympanic membrane. This technique aims to promote healing and reduce complications associated with other methods.

Why is Interlay tympanoplasty considered important?

The Interlay technique is important because it offers high success rates in repairing eardrum perforations and minimizes complications like graft lateralization, medialization, and anterior blunting. These complications can affect hearing outcomes and the overall effectiveness of the surgery. The study described demonstrates the Interlay technique's effectiveness in restoring hearing and improving the quality of life for patients with Chronic Otitis Media.

What are the implications of using the Interlay technique?

The implications of using the Interlay technique are significant. By effectively repairing the eardrum, the Interlay method can restore hearing and prevent recurrent ear infections. The study results showed high graft uptake and positive hearing outcomes. The use of Interlay can lead to improved patient well-being and a reduction in the impact of hearing loss and ear discharge associated with Chronic Otitis Media.

What steps are involved in the Interlay tympanoplasty procedure and patient care?

The study's approach included a pre-operative assessment involving comprehensive hearing tests and ear examinations. The Surgical technique utilized a post-auricular approach and temporalis fascia was harvested for the graft material. The graft was positioned between the layers of the eardrum. Post-operative care included antibiotics, antihistamines, and nasal drops. Follow-up appointments were scheduled to monitor graft uptake and hearing improvement.

How does Interlay tympanoplasty relate to Chronic Otitis Media (COM)?

Chronic Otitis Media (COM) is a persistent inflammation of the middle ear, often resulting in eardrum perforations, hearing loss, and ear discharge. Tympanoplasty, specifically the Interlay technique, is a surgical solution for patients with COM. By repairing the eardrum, tympanoplasty aims to eliminate discharge and restore hearing, improving the overall quality of life for individuals suffering from COM.