BUTTERFLY CARTILAGE TYMPANOPLASTY

Purpose. To review the literature to evaluate the effectiveness of using the “butterfly” technique for tympanoplasty in patients with chronic suppurative otitis media (CSOM). Materials and methods. The research studies in which patients with CSOM (tubotympanic form) underwent tympanic membrane reconstruction using a butterfly cartilage graft were included. The following inclusion criteria were applied: the patients in the study had chronic tubotympanic otitis without signs of exacerbation, tympanoplasty using this technique, postoperative follow-up for at least six months, participation of the patients who underwent traditional tympanoplasty using the temporal fascia, cartilage or fat “patch” in the control groups. The exclusion criteria were CSOM with cholesteatoma, destruction of the auditory ossicles, other tympanoplasty methods than those mentioned above, the use of xenogeneic, allogeneic or other biomaterials as a graft. Results and discussion. The technique shows high efficiency (86-96%), comparable to tympanoplasty of the temporal fascia using the “underlay” technique, has technical advantages in the form of no need for an intra-auricular or post-auricular incision, mobilization of the meatotympanic flap, additional tissue separation forthe temporal fascia graft, which affects the speed of the surgery, the need for tamponade of the ear canal and the duration of the patient’s disability. The technique cannot be used if the patient has cholesteatoma and a ruptured auditory ossicular chain; the cartilage graft is technically difficult to produce for small tympanic membrane perforations without the aid of a microscope; the selection and shaping of the graft requires considerable experience and time. Conclusion. Butterfly cartilage tympanoplasty is highly effective in terms of anatomical and functional results for the treatment of small and medium tympanic membrane perforations in patients with chronic tubotympanic suppurative otitis media. Endoscopic modification of the surgery has obvious technical and economic advantages. The effectiveness of the technique for large perforations of the tympanic membrane, residual and recurrent perforations requires further comprehensive studying.