title: Inlay butterfly cartilage tympanoplasty in children.
abstract: OBJECTIVE
  To assess the results of inlay butterfly cartilage tympanoplasty in children.
  
  
  METHODS
  Before-and-after trial; follow-up duration, 26.6 +/- 19.9 months (mean +/- standard deviation).
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  Fifty-nine pediatric cases of tympanic membrane perforation.
  
  
  METHODS
  Inlay butterfly cartilage tympanoplasty was performed under general anesthesia according to the technique originally described by Eavey and modified by Lubianca-Neto (i.e., without any associated split-thickness skin graft).
  
  
  METHODS
  Percentage of perforation closures, surgical complications, preoperative and postoperative puretone hearing thresholds; the results of inlay butterfly cartilage tympanoplasty were compared with those obtained in a retrospective series of 29 underlay fascia temporalis myringoplasties.
  
  
  RESULTS
  The 71% "take rate" of inlay butterfly cartilage tympanoplasty was not significantly different from the 83% take rate obtained with underlay fascia temporalis tympanoplasty (p = 0.23, chi test). The anatomic results were improved when the graft diameter was at least 2 mm larger than the size of the perforation (81% take rate) (p = 0.009, chi test). No iatrogenic cholesteatoma was observed. Pure-tone hearing thresholds were improved at 0.5, 1, and 2 kHz, and stable at 4 kHz. Hearing levels were not different from those obtained with underlay fascia temporalis tympanoplasty.
  
  
  CONCLUSIONS
  Inlay butterfly cartilage tympanoplasty is a safe, efficient, time-saving, and easy technique of tympanoplasty in children. Anatomic results may be improved by associating a split-thickness skin graft and/or by trimming a tragal graft much larger than the size of the perforation.
authors.affiliation: Department of Pediatric Otolaryngology and Head and Neck Surgery, Hôpital Robert Debré, AP-HP, Paris, France. vincent.couloigner@rbh.ap-hop-paris.fr
authors.forename: Vincent
authors.initials: V
authors.lastname: Couloigner
authors.forename: Florence
authors.initials: F
authors.lastname: Baculard
authors.forename: Wissame
authors.initials: W
authors.lastname: El Bakkouri
authors.forename: Paul
authors.initials: P
authors.lastname: Viala
authors.forename: Martine
authors.initials: M
authors.lastname: François
authors.forename: P
authors.initials: P
authors.lastname: Narcy
authors.forename: T
authors.initials: T
authors.lastname: Van Den Abbeele
mesh_terms: D000293:Adolescent; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D002356:Cartilage / Q000637:transplantation*; D002648:Child; D002675:Child, Preschool; D005205:Fascia / Q000637:transplantation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009225:Myringoplasty / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology; D012008:Recurrence; D012086:Reoperation; D018058:Tympanic Membrane Perforation / Q000601:surgery*; D014433:Tympanoplasty / Q000379:methods*