技術ノート:三角切除を用いたバタフライ軟骨鼓室形成術における移植片の改良
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.


