Endoscope-assisted inlay butterfly cartilage myringoplasty

ABSTRACT

Myringoplasty is one of the most common forms of surgery in otology. It yields very satisfying results for both to the patient and the surgeon. Popular myringoplasty techniques include either an underlay or an onlay approach using tissues such as temporalis fascia or perichondrium as grafts. In 1998, Eavey described an inlay tympanoplasty technique in children using a cartilage graft which resembled butterfly wings. This technique was effective for closure of tympanic membrane perforations, while being more rapid for the surgeon and more comfortable for the patient. The aim of this study was to evaluate the results of using middle ear endoscopy for doing inlay butterfly cartilage myringoplasty. Between December 2008 and December 2010, Twenty one consecutive patients between age group of 16-50 years with persistent tympanic membrane perforation were included in this study. All patients underwent Endoscope-assisted Inlay Butterfly Cartilage [Eavey Technique] myringoplasty [EAIBCM]. The overall success rate of the graft uptake and improvement in conductive deafness as air-bone gap closure was achieved in above 80 percent of cases. tympanoscopy, with its visualisation of hidden corners, justifies Butterfly inlay myringoplasty via a tympanic membrane perforation. Furthermore, the cost of the endoscope is much less than the operating microscope and the endoscope is portable tool thus it is more cost-effective, especially in developing countries. Combining butterfly inlay tympanoplasty technique with the middle ear endoscopy as a tool carries definitive advantages of less operative time, day care surgery, minimal scarring and hence can be accepted as a routine procedure in day-to-day practice.