Transcanal endoscopic myringoplasty with butterfly dermal allograft

Am J Otolaryngol. 2023 Mar-Apr;44(2):103760. doi: 10.1016/j.amjoto.2022.103760. Epub 2023 Jan 16.

Abstract

Objective: Tympanic membrane perforation (TMP) is a common cause of visits to the otolaryngology clinic. For decades, various surgical methods and various grafts have been used to treat TMP. This study aimed to compare the efficacy of butterfly dermal allograft (BDA) and fat myringoplasty for the treatment of TMP.

Study design: A retrospective case-control study.

Setting: Tertiary referral center.

Methods: We retrospectively analyzed 40 patients who underwent BDA (n = 20) and fat myringoplasty (n = 20) for TMP performed by a single surgeon between January 2019 and December 2021. The hearing outcomes, graft success rate, complications, operation time, and hospital stay were recorded and compared between the two groups. Hearing outcomes were determined by pure-tone audiometry.

Results: There was no significant difference between the BDA and fat groups regarding demographic characteristics. There was no significant difference in the pre and postoperative air conduction and bone conduction thresholds, or air-bone gap values between the two groups. A significant audiologic improvement was observed in both groups (p < 0.05), but there was no significant difference in the degree of hearing gain between the two groups. In terms of recurrence of tympanic membrane perforation, postoperative otorrhea, and discomfort symptoms; however, there was no significant difference between the groups (p > 0.05). The operation time and hospital stay were shorter in the BDA group than in the fat group (p < 0.05).

Conclusion: BDA myringoplasty is as safe and medically efficacious as fat myringoplasty and shortens the operation time and hospital stay.

Keywords: Acellular allograft dermal matrix; Endoscopy; Myringoplasty; Tympanic membrane perforation.

MeSH terms

  • Allografts
  • Animals
  • Audiometry, Pure-Tone
  • Butterflies*
  • Case-Control Studies
  • Humans
  • Myringoplasty / methods
  • Retrospective Studies
  • Treatment Outcome
  • Tympanic Membrane Perforation* / diagnosis
  • Tympanic Membrane Perforation* / surgery