Endoscopic Butterfly Cartilage Tympanoplasty in Children

By June 7, 2019

Tzelnick, Sharon 1,2; Hilly, Ohad1,2; Hod, Roy 1,2
1 Department of Otolaryngology – Head and Neck Surgery Rabin Medical Center and Schneider Children’s Medical Center, Petah Tikva, Israel;
2 Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Endoscopic cartilage tympanoplasty has been previously described mainly in the adult population and is known as an effective, safe and short procedure. The aim of our study was to analyze the operative outcomes of children that underwent endoscopic butterfly cartilage tympanoplasty.

A retrospective case control study was conducted in a tertiary university-affiliated pediatric medical center. Included were children under the age of 18 who underwent endoscopic cartilage tympanoplasty between the years 2014-2016. Outcome measures were operative and hospitalization time, tympanic membrane closure rate and complications.

A total of 139 children were included in the study with a mean follow-up duration of 22 months (±9.8). Thirty-six children underwent an endoscopic procedure and 103 children underwent retro-auricular approach tympanoplasty. Mean age was 12.45 years (±2.6). The endoscopic procedure was shorter (67±22 vs. 113±32 minutes, P<0.001), and all surgeries were performed in a day care setting as compared with overnight stay in the open approach. Post-operative myringitis events were equal between groups (p=0.411). Audiometric analysis, in the endoscopic group, revealed 26 patients (72.2%) with hearing gain. Mean PTA-ABG decrease was 12 dB in average in the long term follow up. Closure rates were 86% in the endoscopic group and 90% in the retro-auricular group at 12 months of follow up.

The endoscopic butterfly cartilage tympanoplasty procedure in children is an effective and safe procedure with a shorter operative and hospitalization time. We think it might be a good alternative for selected patients.