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Inlay butterfly cartilage tympanoplasty in children
Vincent Couloigner1, Florence Baculard, Wissame El Bakkouri
1Department of Pediatric Otolaryngology and Head and Neck Surgery, Hôpital Robert Debré, AP-HP, Paris, France. vincent.couloigner@rbh.ap-hop-paris.fr
Summary
Inlay butterfly cartilage tympanoplasty is a safe and effective surgical technique for children with tympanic membrane perforations. This method offers good hearing outcomes and is technically straightforward, making it a valuable option for pediatric ear surgery.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Surgical Techniques
Background:
- Tympanic membrane perforations are common in children.
- Cartilage tympanoplasty offers an alternative to traditional graft materials.
- The inlay butterfly technique is a specific method for cartilage grafting.
Purpose of the Study:
- To evaluate the efficacy and outcomes of inlay butterfly cartilage tympanoplasty in pediatric patients.
- To compare the results of this technique with underlay fascia temporalis myringoplasty.
Main Methods:
- A before-and-after trial was conducted with 59 pediatric cases.
- Inlay butterfly cartilage tympanoplasty was performed without a split-thickness skin graft.
- Outcomes measured included perforation closure rates, complications, and hearing thresholds.
Main Results:
- The inlay butterfly cartilage tympanoplasty achieved a 71% closure rate, comparable to underlay fascia temporalis tympanoplasty (83%).
- Graft success improved when the graft was at least 2 mm larger than the perforation (81% success).
- Hearing thresholds improved postoperatively, with no significant difference compared to the underlay technique.
Conclusions:
- Inlay butterfly cartilage tympanoplasty is a safe, efficient, and easy surgical option for children.
- The technique demonstrates good anatomical and audiological results.
- Optimizing graft size and potentially using a split-thickness skin graft can further enhance outcomes.