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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.

European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
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PubMed
Summary

A modified butterfly myringoplasty technique improves tympanic membrane graft placement. This technique reduces tearing risk in thin or atrophic eardrums, enhancing surgical outcomes.

Keywords:
Butterfly techniqueCartilage graftMyringoplastyNovel techniqueOtologic surgeryTympanic membrane perforation

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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.