Butterfly Tympanoplasty Research Articles

Endoskopik modifiye kelebek timpanoplasti ile incudostapedial rekonstrüksiyon sonuçları

Purpose: The aim of this study was to evaluate the results of endoscopic butterfly tympanoplasty in perforations that involve the ossicular chain pathologies.
 Materials and Methods: We assessed the outcome of endoscopic modified butterfly tympanoplasty in 29 patients. The study included those with large tympanic membrane perforations covering the manubrium of malleus and has ossicular chain pathologies, operated via endoscopic transcanal tympanoplasty. 
 Results: The tympanic membrane closure rate was 89.7% (26 of 29 ears). The mean air conduction in the pre- and postoperative period was 37.75±5.20 dB and 18.96±6.52 dB, respectively, with a statistically significant decrease of 18.79±7.33. The mean pre- and the postoperative air-bone gap was 27.82±4.74 dB and 9.17±4.89 dB, respectively, with a statistically significant decrease of 18.62±7.11 
 Conclusion: The endoscopic modified butterfly tympanoplasty technique is a minimally invasive technique that can provide successful results in large perforations with defective incudostapedial joint.

Endoscopic Cartilage Butterfly Tympanoplasty: A Two-Handed Technique with Endoscope Holder.

The aim of the study was to evaluate and report the short-term results of two-handed endoscopic cartilage butterfly tympanoplasty using endoscope holders. The efficacy of the operative technique was evaluated and assessed by comparing the air-bone-gap on pure tone audiometry preoperatively and on follow-up at 6months and 1-year post operatively. Patients with uncomplicated otitis media and healthy middle ear status with no ossicular involvement underwent endoscopic transcanal cartilage butterfly tympanoplasty. Small and medium sized tympanic membrane perforations were included in the study. Pre- and postoperative air-bone gaps and presence for any residual perforation was noted. A total 69 patients consisting of 45 males and 24 females with a mean age of 24.45years were included in the study group. Small perforations involving only one quadrant were 39 in number while the medium sized perforations involving two quadrants were 26 in number and the ones involving three quadrants were 4 in number. At the end of the follow-up period of 6months and 1year, successful closure occurred in 67 of 69 patients with a success rate of 97.1%. The mean preoperative Air-Bone gap was 34 ± 3.45dB which showed a steady decline on follow-up at 6months 13 ± 4.53 and 15.34 ± 3.39dB at 1year following surgery. Recurrent perforation was noted in two patients involving three quadrants of the tympanic membrane. Endoscopic two-handed butterfly cartilage tympanoplasty can be safely performed in small and medium sized perforations with no middle ear disease/ossicular involvement. The hearing outcomes and successful closure rate are similar to those of other surgical methods. Our study uses the endoscope which provides superior image quality and the use of an endoscope holder makes the technique a two handed one, thereby making the manoeuvring of the microear instruments easier. Moreover, it can be performed under local anaesthesia with low complication rates and quick recovery. Level of Evidence Level 4.

Evaluating butterfly inlay tympanoplasty

ObjectiveTo compare closure rate, reduction in air-bone-gap, and operative time of butterfly tympanoplasty (BT) to underlay tympanoplasty (UT). MethodsRetrospective cohort study of children (age <18y) undergoing Type I tympanoplasty between 2009 and 2017. Patients were excluded if they had <6 months of follow up, mastoidectomy, fat graft or cholesteatoma. ResultsTwenty-one patients (mean age 13.4) underwent BT while forty-one patients (mean age 13.5) underwent UT. The mean size of perforation in 30.6% in BT patients and 43.6% in UT patients (p = 0.01). Preoperative audiogram showed a similar air-bone-gap between the two groups of 31.7, 22.7, and 17.9 dB in BT vs 29.6, 24.8, and 17.6 dB in UT at 500, 1000, and 2000 Hz, respectively (p = 0.65, 0.63, and 0.94). Operative time was reduced in BT as compared to UT (94.0 min vs. 150.9, p = 0.01). Closure rate was similar at 85.7% in BT vs 75.6% in UT patients (p = 0.40). Average reductions in air-bone gap were similar with 19.2, 11.7, and 13.2 dB for BT vs 16.6, 12.1, and 10.3 dB for UT at 500, 1000, and 2000 hz, respectively (p = 0.66, 0.93, 0.40). ConclusionBT has become a reliable tool for the pediatric otolaryngologist. This retrospective study shows that pediatric BT results in similar outcomes with reduced operative time.

Inlay butterfly cartilage tympanoplasty for large central perforations

Objective. The aim of this study is to evaluate the results of inlay butterfly tympanoplasty technique in large central tympanic membrane perforations. Methods . The files of the patients who underwent inlay butterfly cartilage tympanoplasty for large central tympanic membrane perforations were reviewed. Patients were followed with otoscopy and audiometry. Preoperative and postoperative pure-tone audiometry results were calculated and analyzed to evaluate the hearing gain. The grafting procedure was considered successful if no perforations were observed during postoperative microscopic or endoscopic evaluation during the follow-up period. Results . Twenty-nine patients with large central tympanic membrane perforation who were operated by inlay butterfly tympanoplasty technique were included in the study. Twenty-one (72.4%) ears were operated with endoscope and 8 (27.6%) under microscope. The mean duration of surgery was 30.5±3.77 minutes. The mean follow-up time was 69.6±21.6 (range; 24-112 weeks). Graft take rate was 89.7% (26/29). Conclusion. Inlay butterfly cartilage tympanoplasty is a minimal invasive and effective technique for repairing large central tympanic membrane perforations.

Endoscopic cartilage butterfly myringoplasty in children.

The present study evaluated the results of the graft success rate and hearing gain of children who underwent endoscopic inlay butterfly myringoplasty due to chronic otitis media. The study included 32 pediatric patients aged between 8 and 17, who had endoscopic inlay butterfly myringoplasty with the diagnosis of chronic otitis media between September 2012 and January 2015 in Elazig Training and Research Hospital Otorhinolaryngology Clinic and Firat University Otorhinolaryngology Clinic. All patients' demographics, perforation size, and hearing status were examined. Tympanic membrane perforation was ≤3mm in 12 patients and between 3 and 6mm in 20 patients. The air-bone gap (ABG) of the patients was 18.5±6.29dB preoperatively, 8.81±3.53dB postoperatively second month, 8.09±3.55dB postoperatively sixth month, and 7.96±3.32dB postoperatively 12th month. Two (6.3%) of the patients had postoperative myringitis. Two (6.3%) patients had recurrent perforation in the postoperative follow-ups. In children, endoscopic inlay butterfly tympanoplasty is a surgical technique with short duration, high graft success, effective hearing reconstruction, and high levels of postoperative patient comfort.