Endoscopic Butterfly Myringoplasty: Comparison of Tragal Cartilage Graft and Dermal Allograft

OBJECTIVES

Tympanic membrane perforation (TMP) is a common reason for visits to otolaryngology clinics. For decades, various surgical methods and grafts have been employed to treat TMP. This study aimed to compare the efficacy of tragal cartilage grafts (TCG) and dermal allografts (DAG) in myringoplasty for treating TMP.

METHODS

We retrospectively analyzed 80 patients who underwent endoscopic butterfly inlay myringoplasty between 2019 and 2022. The patients were divided into two groups based on the graft material used: TCG (n = 40) and DAG (n = 40). We compared preoperative and postoperative hearing results and surgical outcomes between the two groups.

RESULTS

Both the TCG and DAG groups demonstrated significant postoperative improvements in hearing. The air-bone gap decreased from 11.87 to 7.74 dB in the TCG group (p = 0.01) and from 13.6 to 8.96 dB in the DAG group (p = 0.013). Similarly, the low-tone average improved significantly: from 40.49 to 25.26 dB in the TCG group (p < 0.001) and from 38.33 to 25.15 dB in the DAG group (p < 0.001). The graft closure rates were comparable at 97.5% for TCG and 92.5% for DAG, indicating that both procedures are effective and similar in efficacy. However, the TCG group required more follow-up visits (average of 4 vs. 2.6 for DAG).

CONCLUSIONS

Both TCG and DAG techniques demonstrated comparable efficacy in terms of graft success rates and hearing improvement, with no significant differences in postoperative complications.

LEVEL OF EVIDENCE: 3

Allogeneic composite amniotic membrane in tympanic membrane repair: a randomized parallel controlled study

BACKGROUNDS

Composite amniotic membranes have been widely used in ophthalmology and orthopedics. For the repair of tympanic membrane perforation, the introduction of amniotic membrane is still under study.

OBJECTIVES

To analyse the effectiveness of a homograft composite amniotic membrane in tympanic membrane repair.

METHODS

A total of 76 patients were recruited and randomly assigned to the experimental group (n = 39) and the control group (n = 37). The test group employed a composite amniotic membrane for the repair of the tympanic membrane, while the control group utilized cartilage from the auricular for the same purpose. The efficacy of composite amniotic membrane was evaluated through a comparative analysis of postoperative tympanic membrane healing, complications, and hearing recovery.

RESULTS

Hearing improved significantly in both groups, but there was no significant difference between the two groups. The results of the postoperative pain scores demonstrated that the majority of patients were experiencing mild pain, with a notable discrepancy between the test group and the control group. Intraoperative bleeding time was also significantly lower in the test group than in the control group.

CONCLUSION

Allogeneic composite amniotic membrane can be used as a material for repairing tympanic membrane perforation, which can effectively improve postoperative hearing of patients.