Inlay butterfly cartilage tympanoplasty in the treatment of dry central perforated chronic otitis media as an effective and time-saving procedure

Abstract

The aim of this study is to compare the inlay butterfly transcanal cartilage tympanoplasty with the conventional underlay tympanoplasty. Operation time, pre- and postoperative hearing levels, successful closure rate of tympanic membrane (take rate) and long-term re-perforation in dry perforated chronic otitis media were evaluated. The study design consists of case series with a chart review. The study settings are tertiary referral center. Of the 72 patients (age range 14-57years) with dry perforated chronic otitis media, 29 patients underwent inlay butterfly transcanal cartilage tympanoplasty (group 1) and 43 patients underwent conventional underlay tympanoplasty without mastoidectomy (group 2) between January 2010 and June 2012. The outcome measures were the duration of surgery, "take rate" at the 30th postoperative day and the audiometric results at the 45th postoperative day. Long-term re-perforation was evaluated at least postoperative 1year. The graft take rate was 96.5% in group 1 and 90.7% in group 2 at the 30th postoperative day (p>0.05). Mean air-bone gap was improved from 18.8±8.09 to 11.9±7.12dB in group 1 and from 21.9±7.32 to 11.6±8.43dB in group 2. The improvement of air-bone gap in both groups was statistically significant (p<0.05) but the improvement between the groups was not statistically significant (p>0.05). The average duration of the surgery was 29.9±5.38min for inlay tympanoplasty group and 58.9±12.1min for underlay tympanoplasty group (p<0.05). Two patients in group 2 had re-perforations after an initial take of the graft in 1-year follow-up period. Inlay butterfly transcanal cartilage tympanoplasty is a good choice in selected cases. Although this technique has the similar take rate and audiological results with conventional underlay tympanoplasty, it is a time-saving procedure.