Endoscopic Type One Tympanoplasty with Butterfly Technique: Pediatric Case Series

By June 7, 2019

Levorato, Maurizio1; Bartell, Ricardo 1; Adroher, Marti1; Cardelus, Sara1; Wienberg, Peter1; Veneri, Antonio1; Vazquez, Cristina1; Haag, Oliver1
1 Department of Pediatric Otolaryngology, Sant Joan de Deu Children’s Hospital Barcelona, Spain

We present our early experience with  endoscopic type I tympanoplasty in pediatric patients using butterfly technique.

Thirty (30) pediatric patients have been operated between january and december 2018 with butterfly technique (donor site the tragal cartilage). We used 3 mm rigid endoscope of 0 or 30 degree. We consider 23 patients in this study, aged between 7 and 16 years (average 9,9 yy),  that have a follow up of at least 3 moths (min 3, max. 11, average 4,9).

Discussion and Results:
Subjective evaluation of the percentage of the area of perforation was assesed: average 32%, minimum 10 %, maximim 60%. Eighteen patients (78%) had a complete tympanic membrane closure, two (9%) did not closed and three (13%) had a residual microperforation. Preoperative Pure Tone Average (PTA) for Air Conduction (AC) was 22 dB and for Bone Conduction (BC) was 9 dB: the preoperative Air Bone Gap (ABG) was 13 dB. Postoperative (measured only in 16 patients) PTA for AC was 15 dB, for BC was 8 dB and the ABG was 7 dB.

No mayor complications were observed with this technique in this pediatric series and we observed an early recovery. Technical aspect of the surgery are described. All the patients were dismissed the same day of the surgery. We suggest that butterly endoscopic type I tympanoplasty can be considered as a safe and effective procedure in pediatricn patients if compared with other techiques but if we need a more extended study and follow up.