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Updated: May 22, 2025

Author Spotlight: Advancing Endoscopic Ossiculoplasty – Techniques, Innovations, and Practical Guidance for Clinical Integration
Published on: January 26, 2024
Endoscopic Butterfly Myringoplasty: Comparison of Tragal Cartilage Graft and Dermal Allograft
Seok-Hyun Kim1, Hyun-Taek Jeong2, In-Seok Moon2
1Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.
Objectives:
Tympanic membrane perforation (TMP) is a common reason for visits to otolaryngology clinics. For decades, various surgical methods and grafts have been employed to treat TMP. This study aimed to compare the efficacy of tragal cartilage grafts (TCG) and dermal allografts (DAG) in myringoplasty for treating TMP.
Methods:
We retrospectively analyzed 80 patients who underwent endoscopic butterfly inlay myringoplasty between 2019 and 2022. The patients were divided into two groups based on the graft material used: TCG (n = 40) and DAG (n = 40). We compared preoperative and postoperative hearing results and surgical outcomes between the two groups.
Results:
Both the TCG and DAG groups demonstrated significant postoperative improvements in hearing. The air-bone gap decreased from 11.87 to 7.74 dB in the TCG group (p = 0.01) and from 13.6 to 8.96 dB in the DAG group (p = 0.013). Similarly, the low-tone average improved significantly: from 40.49 to 25.26 dB in the TCG group (p < 0.001) and from 38.33 to 25.15 dB in the DAG group (p < 0.001). The graft closure rates were comparable at 97.5% for TCG and 92.5% for DAG, indicating that both procedures are effective and similar in efficacy. However, the TCG group required more follow-up visits (average of 4 vs. 2.6 for DAG).
Conclusions:
Both TCG and DAG techniques demonstrated comparable efficacy in terms of graft success rates and hearing improvement, with no significant differences in postoperative complications.

