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Butterfly Cartilage Inlay Technique for Repairing Medium-to-Large-Sized Tympanic Membrane Perforations.

Ji Min Yun1, Dachan Kim2, Ju Yun Nam2

  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, Korea.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|December 31, 2024
PubMed
Summary

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The butterfly cartilage inlay technique is effective for repairing medium-to-large tympanic membrane perforations, showing comparable success rates to the underlay technique but with shorter operating times and local anesthesia use.

Area of Science:

  • Otolaryngology
  • Surgical Innovation
  • Tympanic Membrane Repair

Background:

  • The butterfly cartilage inlay technique, initially for small tympanic membrane (TM) perforations, is now used for larger defects.
  • Limited comparative studies exist for butterfly tympanoplasty versus conventional underlay techniques for medium-to-large TM perforations.

Purpose of the Study:

  • To compare the effectiveness of butterfly tympanoplasty with the conventional underlay cartilage technique for medium-to-large TM perforations.
  • Evaluate graft success, hearing outcomes, complications, and operating time.

Main Methods:

  • Retrospective chart review of 52 patients with medium-to-large TM perforations (January 2017 - July 2024).
  • Compared butterfly tympanoplasty (n=28) with underlay tympanoplasty (n=24).
Keywords:
conductivehearing losstympanic membrane perforationtympanoplasty

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  • Precisely measured TM perforation sizes using ImageJ software.

    • Main Results:

    • Comparable graft success rates: butterfly (92.9%) vs. underlay (83.3%).
    • Butterfly technique demonstrated significantly shorter operating time and was performed under local anesthesia.
    • Both techniques achieved significant postoperative air-bone gap reduction with no significant difference in improvement.

    Conclusions:

    • Butterfly tympanoplasty is an effective option for medium-to-large TM perforations.
    • Offers comparable outcomes to the underlay technique.
    • Advantages include reduced operating time and suitability for local anesthesia.