Inlay butterfly cartilage tympanoplasty in children.
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.
Couloigner
Vincent
V
Department of Pediatric Otolaryngology and Head and Neck Surgery, Hôpital Robert Debré, AP-HP, Paris, France. vincent.couloigner@rbh.ap-hop-paris.fr
Baculard
Florence
F
El Bakkouri
Wissame
W
Viala
Paul
P
François
Martine
M
Narcy
P
P
Van Den Abbeele
T
T
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*