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Technical note: A graft modification in butterfly cartilage myringoplasty using a triangular excision
Meliksah Cakir1, Hakan Bayraktar2, Fatih Ozdogan3
1Department of the Ear Nose Throat/Head & Neck Surgery, Kocaeli City Hospital, Izmit, Turkey. drmeliksahcakir@gmail.com.
Background:
Butterfly myringoplasty is a simple and effective technique for small-to-moderate, non-marginal tympanic membrane perforations. Various modifications of the graft have been described. However, when the residual tympanic membrane is thin, it may tear during graft placement.
Methods:
Inspired by the Paparella type 2 ventilation tube, we applied a minor modification to the cartilage graft in butterfly myringoplasty. A small triangular excision was made on the medial wing of the graft, allowing controlled rotational insertion through the perforation while preserving the integrity of the residual tympanic membrane.
Conclusion:
This modification may facilitate safer graft placement, particularly in atrophic membranes, by reducing the risk of trauma to the residual membrane. Further studies are needed to assess its effectiveness.
