Technical note: A graft modification in butterfly cartilage myringoplasty using a triangular excision.

Area of Science:

• Otolaryngology
• Surgical Innovation
• Tympanic Membrane Repair

Background:

• Butterfly myringoplasty is a standard procedure for tympanic membrane perforations.
• Thin residual tympanic membranes pose a risk of tearing during conventional graft placement.
• Existing graft modifications aim to improve surgical success rates.

Purpose of the Study:

• To introduce a novel modification to the cartilage graft used in butterfly myringoplasty.
• To enhance the safety and ease of graft insertion, particularly in challenging cases.
• To minimize trauma to the residual tympanic membrane during the procedure.

Main Methods:

• A small triangular excision was created on the medial wing of the cartilage graft.
• This modification was inspired by the design of the Paparella type 2 ventilation tube.
• The modified graft allows for controlled rotational insertion through the tympanic membrane perforation.

Main Results:

• The modification facilitates controlled insertion of the graft.
• It preserves the integrity of the residual tympanic membrane during placement.
• The technique is particularly beneficial for thin or atrophic tympanic membranes.

Conclusions:

• This graft modification offers a potentially safer method for butterfly myringoplasty.
• It may reduce the incidence of intraoperative trauma to the residual tympanic membrane.
• Further research is warranted to validate the clinical efficacy of this technique.