Abstract
To evaluate the success rate and the surgical procedure of two different transcanal myringoplasty techniques using the Tutopatch® (Tutogen Medical, Inc., Alachua, FL, USA), a xenograft produced from bovine pericardium or the butterfly, an inlay tragal cartilage autograft. This is a retrospective study. We studied all cases of transcanal myringoplasty with Tutopatch and butterfly, performed by the same surgeon between April 2005 and May 2013. Perforations were secondary to chronic otitis media without cholesteatoma, perforation post ventilation tube or trauma. They were not exceeding one-third of the tympanic membrane surface for the Tutopatch and one quarter for the butterfly. We evaluated the anatomical success rate, complications and postoperative hearing results in both techniques. A total of 106 myringoplasties were performed: 66 with Tutopatch and 40 with butterfly with a mean follow-up of 16.5 and 5.2 months, respectively. Successful closure rates of Tutopatch and butterfly were 75.8 % (P < 0.0001) and 85.0 % (P < 0.0001), respectively. Myringitis controlled with topical antibiotics treatment occurred in 8 (12.1 %) and 5 (12.5 %) cases. Eighty percent of patients with Tutopatch had a mean residual air-bone gap within 10 dB, compared to 85.0 % in patients with butterfly. When anatomically feasible, a transcanal approach myringoplasty with a Tutopatch® graft or butterfly appears to provide good anatomical and functional results. We show that both techniques provide good anatomical and functional results. The butterfly has the advantage to use an autograft, which is surgically easier because it does not require tympanomeatal flap elevation. We recommend the butterfly technique for non-marginal perforation not exceeding one quarter of the tympanic membrane after excision of the perforation edge and Tutopatch for bigger perforation or when standard autografts are not available. Myringitis is the only described complication without specific incidence.
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References
(1994) Viral inactivation study during the Tutoplast allografts manufacturing process. Institut Pasteur texcel. Paris, France
Filippi R, Schwarz M, Voth D, Reisch R, Grunert P, Perneczky A (2001) Bovine pericardium for duraplasty: clinical results in 32 patients. Neurosurg Rev 24(2–3):103–107
Baharuddin A, Go BT, Firdaus MN, Abdullah J (2002) Bovine pericardium for dural graft: clinical results in 22 patients. Clin Neurol Neurosurg 104(4):342–344
Gupta M, Lyon F, Singh AD, Rundle PA, Rennie IG (2007) Bovine pericardium (Tutopatch) wrap for hydroxyapatite implants. Eye 21:476–479
Eavey RD (1998) Inlay tympanoplasty: cartilage butterfly technique. Laryngoscope 108(5):657–661
Mauri M, Neto JF, Fuchs SD (2001) Evaluation of inlay butterfly cartilage tympanoplasty: a randomized clinical trial. Laryngoscope 111:1479–1485
Fiorino F, Barbieri F (2007) Fat graft myringoplasty after unsuccessful tympanic membrane repair. Eur Arch Otorhinolaryngol 264(10):1125–1128
Thomassin JM, Facon F, Gabert K (2004) The effectiveness of otoendoscopy in myringoplasty using adipose graft. Ann Otolaryngol Chir Cervicofac 121(6):346–349
Saadat D, Ng M, Vadapalli S, Sinsha UK (2001) Office myringoplasty with Alloderm. Laryngoscope 111:181–183
Gérard JM, Thill MP, Gersdorff M (2003) The art of the tympanoplasty and its clinical illustration. Ann Otolaryngol Chir Cervicofac 120(2):83–93
Albera R, Dagna F, Lacilla M, Canale A (2009) Equine versus bovine pericardium in transmeatal underlay myringoplasty. Ann Otol Rhinol Laryngol 104(4):287–291
Gérard JM, Gersdorff M (2006) The Tutopatch graft for transcanal myringoplasty. B-ENT 2(4):177–179
Yetiser S, Tosun F, Satar B (2001) Revision myringoplasty with solvent-dehydrated human dura mater (Tutoplast). Otolaryngol Head Neck Surg 124(5):518–521
Haid CT (1993) Clinical experiences with dehydrated temporalis fascia in tympanoplasty. Early and late results. HNO 41(4):185–191
Sarac S, Gursel B (2002) Use of homograft dehydrated temporal fascia in tympanoplasty. Otol Neurotol 23(4):416–421
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None of the authors or any relatives have any financial interest in Tutogen Medical, Inc., Alachua, FL, USA.
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de Dorlodot, C., De Bie, G., Deggouj, N. et al. Are bovine pericardium underlay xenograft and butterfly inlay autograft efficient for transcanal tympanoplasty?. Eur Arch Otorhinolaryngol 272, 327–331 (2015). https://doi.org/10.1007/s00405-013-2855-8
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DOI: https://doi.org/10.1007/s00405-013-2855-8