[Tips & tricks--collar button technique: safe and patient friendly myringoplasty technique]

Background: The inlay cartilage butterfly myringoplasty is a simple technique with few complications for closure of tympanic membrane defects introduced by Eavey 1998, but still not often used. Its advantages consist in avoiding of exposure the tympanic cavity and possible blunting, option to operate both ears at once, safe local anaesthesia, reduction of operation time and cost, minimal postoperative care and patient comfort. Patients and Methods: We operated 10 patients using a to date not described simple cartilage transplant without perichondrium. Reason, localisation, extent and duration of the defect as well as complications, patient assessment and pure tone audiogram were analysed. Results: All defects were closed six months postoperative. Seven patients rated hearing as improved, two as non-changed and one patient showed deafness in the pure tone audiogram pre- and postoperative. The average air-bone gap of the thresholds at frequencies 0.5, 1, 2 and 3 kHz was 8.6 dB postoperative as compared to 16.3 dB preoperative. It could be shown that pure cartilage transplants without perichondrium used for defects up to 6mm in diameter were enwrapped by the tympanic membrane and covered by capillaries. Conclusion: The inlay cartilage butterfly myringoplasty is a safe and gentle technique for tympanic membrane defect closure.