Butterfly-cartilage tympanoplasty in children: A 28-case series and literature review

Abstract

ObjectiveThis study presents results for a pediatric series of tympanoplasty using the butterfly-cartilage technique, with comparison to literature reports. MethodsA retrospective study included patients aged between 2 and 12 years receiving tympanoplasty performed by a single senior surgeon in our department between 2003 and 2012, for whom pre- and postoperative tympanum imaging was complete. Results were analyzed at a minimum 10 months’ follow-up in terms of graft healing and auditory data, with pre- and postoperative audiograms and calculation of mean hearing loss. ResultsTwenty-eight tympanoplasties were performed in 27 children: 16 males, 11 females; in 1 case, perforation was bilateral. Perforation location was inferior or antero-inferior in 14 cases (50%), antero-superior in 9 (32.1%) and anterior in 5 (17.9%). Perforation size on otoscopy ranged from 11.1% to 36.4% of tympanum area (mean, 26.3%). Mean follow-up was 25 months. Closure of the perforation was achieved in 87.7% of cases. Mean hearing loss was 20.2dB (range, 10–31.25dB) preoperatively and 14dB (range, 5–31.25dB) postoperatively. DiscussionWe analyze our results and compare them with the international literature to refine indications for this technique of tympanic repair. ConclusionTympanoplasty using the butterfly-cartilage technique was reliable and easy to perform. It should be included in the therapeutic armamentarium for moderate non-marginal tympanic perforation. In the present series, the technique was reserved to perforations involving less than 40% of tympanum area.