Endoscopic butterfly inlay myringoplasty: new technique extended perichondrium butterfly

Abstract

Background: Various graft materials and surgical methods are used in the treatment of tympanic membrane perforations.

Aims/Objectives: The aim of this study was to evaluate the operation method and graft success of extended perichondrial butterfly myringoplasty performed by an endoscopic method and the hearing gain of patients.

Material and Method: This was a retrospective study evaluating the hearing tests of 54 ears of 48 patients (28 male, 20 female) who underwent surgery between February 2017 and March 2019. Pure-tone audiometric results were analyzed preoperatively and six months postoperatively by recording the perforation size, the duration of surgery, and graft success.

Results: The graft success rate was 98.1% (53/54 ears). The perforations were most frequently located in the anterior quadrant and were small-sized. The mean preoperative air-bone gap (ABG) was 17.4 ± 5.24 dB. The mean ABG was 9.2 ± 2.13 dB 1 month postoperatively and 8.5 ± 2.26 dB 6 months postoperatively (p < .005).

Conclusions: The endoscopic inlay extended perichondrial butterfly myringoplasty method is safe and doesn’t require tympanomeatal flap elevation. Moreover, it shortens hospitalization time, facilitates anatomical closure of the membrane, and sometimes closes perforations in the anterior part, which cannot be clearly evaluated after graft placement.

Chinese abstract

背景：多种移植材料和手术方法被用于鼓膜穿孔的治疗。

目的：探讨使用鼻内镜行软骨膜蝶形扩张鼓膜成形术的手术方法、移植成功率及患者听力的提高。

材料与方法：对2017年2月至2019年3月48例（男28例, 女20例）手术患者的54个耳的听力测试进行回顾性研究。术前和术后6个月通过记录穿孔大小、手术时间和移植成功率来分析纯音测听结果。

结果：移植成功率为98.1%（53/54个耳）。穿孔最常见于前象限, 且比较小。术前平均气骨间隙（ABG）为17.4±5.24 dB。术后1个月平均ABG为9.2±2.13 dB, 术后6个月平均ABG为8.5±2.26 dB（p<0.005）。

结论：内窥镜下扩大软骨膜蝶形鼓膜成形术是一种安全、无需鼓室管瓣抬高的方法。此外, 它缩短了住院时间, 有助于鼓膜的解剖闭合, 有时会闭合前部的穿孔, 这在移植后无法清楚评估。

Keywords:

• Tympanoplasty
• butterfly
• extended perichondrium
• myringoplasty

Ethical approval

Informed consent was obtained from all individual participants included in the study. This article does not contain any studies performed with animals by any of the authors. The work was approved by the Institutional Review Board (approval no. 140-18/2019) on 1 October 2019.

Acknowledgments

The authors thank Dr. Vaner Köksal for Figure 1.

Disclosure statement

No potential conflict of interest was reported by the author(s).