The Results of Myringoplasty Using Cartilage Butterfly Technique(Inlay Tympanoplasty)

Kim, Sok Chon; Park, Soo Hong; Kim, Young Chul; Kim, Young Soo; Chang, Chol; Lee, Song Won; Kim, Eun Seo; Hong, Seok Chan

Abstract

BACKGROUND AND OBJECTIVES: Popular myringoplasty techniques include either an underlay or an onlay approach using tissues such as temporalis fascia or perichondrium as grafting materials. The "cartilage butterfly technique" using a tragal cartilage graft that resembled butterfly wings without incising canal skin was described by Eavey in 1998. This study describes the results of using this technique and analyzes the postoperative hearings.
MATERIALS AND METHODS
Cartilage butterfly inlay tympanoplasty was carried out in 28 patients to close small-to-medium tympanic membrane perforations from October 1998 to December 2000. We excluded one patient due to accidental removal of graft at another clinic. We evaluated the success rate and postoperative hearing results.
RESULTS
The graft take rate was 96.3% (26/27) at the end of the follow-up period (mean follow-up was 6.0 months). All of successful cases had cartilage grafts that were intact and dry at the last visit. One patient failed due to otorrhea and extruding graft. Two patients were not evaluated, because one had profound preoperative hearing loss and the other was a cerebral palsy patient. Mean air-bone gap (A-B gap) was improved from 16.3 dB to 9.8 dB. Ten patients had an A-B gap average between 0 and 10 dB, 14 patients between 11 and 20 dB, and no patient greater than 20 dB.
CONCLUSION
The cartilage butterfly technique was effective to close tympanic membrane perforations in selected patients. It could provide advantages in high success rate, ease, speed and patient comfort.