Comparative study of anatomical and functional results of butterfly myringoplasty versus temporalis fascia underlay myringoplasty

Abstract

Background: Myringoplasty is traditionally been done by using temporalis fascia graft material. But in recent years understanding of physiology and pathology of middle ear cleft is drastically improved with technical advancement in surgical methods. Various grafts have been tried for myringoplasty time to time with varying results. Methods: A case control study was conducted; where 52 patients underwent myringoplasty with butterfly graft and second group of 52 patients underwent myringoplasty with temporalis fascia graft under general anesthesia in major OT. All the patients were followed up for 3 months. The results of the procedure were assessed, with respect to closure of tympanic membrane perforations and improvement in the air bone gap post operatively. Results: Butterfly group had statistically significant number of healed patients and hearing improvement compared to temporalis fascia group at the end of one month and with no statistical significance at the end of three months. The age group less than 18 years showed better uptake with butterfly graft. The difference of mean pre-operative, 1 month and 3 months post-operative air bone gaps in butterfly graft were 35.57±2.87 dB, 27.86±2.53 dB, 24.65±2.66dB and in temporalis fascia were 35.97±2.6dB, 29.36±1.54dB, 25.12±1.73 dB respectively. Conclusions: Butterfly group had statistically significant hearing improvement in patients compared to temporalis fascia group at one month and with no statistical significance at three months post procedure. The age group less than 18 years showed better uptake with butterfly graft.