Butterfly cartilage tympanoplasty: An alternative approach for management of small- and medium-sized perforations

Maurya, Ashish Kumar; Jadia, Shalini; Qureshi, Sadat; Jain, Leena

doi:10.4103/0971-7749.182283

Cited by 4 publications

(8 citation statements)

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“…A total of 15 studies fulfilled the selection criteria and were included. These included one RCT, 23 6 prospective studies, 9,12,13,[15][16][17] and 8 retrospective studies. 10,11,14,[18][19][20][21][22] These eligible studies were published between 2001 and 2020, with a minimum follow-up period of 3 months.…”

Section: Resultsmentioning

confidence: 99%

“…Previous studies also supported these results that BCT achieves satisfactory graft uptake rates for TM repair. [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Furthermore, cartilage grafts were preferred in patients with retraction pockets, Eustachian tube dysfunction, chronic mucosal dysfunction, and residual or reperforation. 34,35 Although the auditory gains may theoretically be influenced by the thickness and rigidity of the cartilage, 36 the results with short-term follow-up suggest identical ABG closure between cartilage and fascia grafts, 37,38 which coincides with our qualitative analysis.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6][7] Since its introduction in 1998, 8 butterfly cartilage tympanoplasty (BCT) has been a popular technique to repair TM perforations. [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] The name ''butterfly'' originated from the cartilage graft which is shaped like butterfly wings prior to insertion into the TM to close the perforations, much like an ear tube. 8 Though this technique is simple, practical, and effective, there is a lack of higher-level evidence investigating the efficacy of BCT in the literature.…”

Section: Introductionmentioning

confidence: 99%

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Butterfly Cartilage Tympanoplasty as an Alternative to Conventional Surgery for Tympanic Membrane Perforations: A Systematic Review and Meta-Analysis

2021

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Objective: To compare the effectiveness of butterfly cartilage tympanoplasty (BCT) with that of conventional surgical approaches in the treatment of tympanic membrane perforations. Methods: A systematic search was performed by screening the PubMed, Embase, and Cochrane Library databases up to October 31, 2020. Two coauthors independently identified studies in accordance with the selection criteria. Data were pooled and analyzed via Review Manager version 5.3 and Stata version 12.0 software. The postoperative outcomes were measured and expressed as odds ratios (ORs) and standardized mean differences (SMDs). Additionally, heterogeneity was assessed through the I2 statistic. Results: A total of 15 articles were eligible for final inclusion. The OR values for the graft uptake rate, compared to conventional tympanoplasty, were 1.12 (95%CI: 0.56-2.22, I2 = 52%, P = .75) and 1.22 (95%CI: 0.58-2.59, I2 = 0%, P = .60), and the OR compared to fat plug myringoplasty was 3.02 (95%CI: 1.04-8.77, I2 = 0%, P = .04). The qualitative analysis of the hearing results reflected significant postoperative auditory gains with no significant differences between the BCT and control groups, indicating satisfactory and similar postoperative hearing improvement. Moreover, the operation time was shortened (SMD = −2.19, 95%CI: −2.79 to −1.59, I2 = 82%, P < .05), and the postoperative pain was less with the BCT approach. Conclusion: Butterfly cartilage tympanoplasty has satisfactory efficacy in terms of anatomical and functional results in small to medium perforations. It reduces operation time and postoperative pain. However, the effectiveness on large perforation requires further assessment by well-designed studies.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Butterfly Cartilage Tympanoplasty as an Alternative to Conventional Surgery for Tympanic Membrane Perforations: A Systematic Review and Meta-Analysis

2021

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“…Twenty studies (60.6%) were undertaken in India, three studies (9.1%) in China, two studies (6.1%) each in Thailand and Bangladesh, and one study (3.0%) each in Korea, Nepal, Iraq, Italy, Egypt, and Pakistan. In terms of study design, 13 studies (11,19,20,(24)(25)(26)(27)(28)(29)(30)(31)(32)(33) were randomized and 20 (7)(8)(9)(10)12,13,18,21,22,(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44) were nonrandomized. The inclusion and exclusion criteria of all studies are summarized in Supplementary Content 3, http://links.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…23 studies recruited patients with dry ear status (11,(18)(19)(20)(21)(22)(24)(25)(26)(27)(28)(29)(31)(32)(33)35,36,(38)(39)(40)(42)(43)(44), three studies with wet ear status (30,34,37), and 7 studies with both dry and wet ear status (7)(8)(9)(10)12,13,41). Some studies only included microscopic myringoplasty (7-10, 12,13,18-21,24,26,31-33,35,37,40-42), some only endoscopic myringoplasty (27,28,30,34,38,44) and some included both types (11,19,20,(24)(25)(26)(27)(28)(29)…”

Section: Patient Characteristicsmentioning

confidence: 99%

Postoperative Outcomes After Tympanoplasty for Active Versus Inactive Otitis Media Patients With Tympanic Membrane Perforation: A Systematic Review and Meta-Analysis

2023

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Objectives To compare postoperative tympanoplasty outcomes between active versus inactive otitis media (OM) patients with tympanic membrane perforation. Databases Reviewed Medline via PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, and Google Scholar for studies published from inception to March 1, 2023. Methods Studies of 15- to 60-year-old patients undergoing microscopic/endoscopic myringoplasty using underlay/overlay technique with reported postoperative mean hearing gain and graft uptake were included. Studies requiring simultaneous surgical procedures, reporting patients with comorbidities and with non-English full text articles were excluded. Articles were independently screened by two researchers with data extracted according to a predetermined proforma in Microsoft Excel. Cochrane risk-of-bias assessment was used for risk of bias evaluation of randomized studies and Risk of Bias in Nonrandomized Studies of Interventions for nonrandomized studies. Similar studies were pooled for meta-analysis using the inverse variance random effects model to calculate the mean difference and corresponding 95% confidence interval (CI) for mean hearing gain and DerSimonian and Laird random effects model for graft uptake. Results Thirty-three studies comprising 2,373 patients met the inclusion/exclusion criteria, seven were pooled for meta-analysis. Included articles showed inactive OM patients have higher average postoperative mean hearing gain of 10.84 dB and graft uptake of 88.7% compared to active OM patients (9.15 dB and 84.2%). Meta-analysis of mean hearing gain (MD, –0.76 dB; 95% CI, −2.11 to 0.60; p = 0.27, moderate certainty) and graft uptake (OD, 0.61; 95% CI, 0.34–1.09; p = 0.10, moderate certainty) have an overall p value >0.05. Conclusion There were no statistically significant differences in postoperative mean hearing gain and graft uptake between active and inactive OM patients undergoing tympanoplasty. Hence, tympanoplasty procedures should not be postponed solely because of patients' preoperative ear discharge status.

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Comparative Study of Inlay and Overlay Cartilage Perichondrium Composite Graft Myringoplasty

Vashisth

Yadav

Kumar

et al. 2023

Indian J Otolaryngol Head Neck Surg

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Butterfly cartilage tympanoplasty: An alternative approach for management of small- and medium-sized perforations

Cited by 4 publications

References 1 publication

Butterfly Cartilage Tympanoplasty as an Alternative to Conventional Surgery for Tympanic Membrane Perforations: A Systematic Review and Meta-Analysis

Butterfly Cartilage Tympanoplasty as an Alternative to Conventional Surgery for Tympanic Membrane Perforations: A Systematic Review and Meta-Analysis

Postoperative Outcomes After Tympanoplasty for Active Versus Inactive Otitis Media Patients With Tympanic Membrane Perforation: A Systematic Review and Meta-Analysis

Comparative Study of Inlay and Overlay Cartilage Perichondrium Composite Graft Myringoplasty

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