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Peer-reviewedCC BY-NC-NDLaryngoscope investigative otolaryngology

Butterfly Cartilage Inlay Technique for Repairing Small to Large Tympanic Membrane Perforations.

  • Ji Min Yun1
  • Eun Jin Son2
  • In Seok Moon3
  • Seong Hoon Bae4
4 affiliations
  1. 1Department of Otorhinolaryngology-Head and Neck Surgery Chung-Ang University College of Medicine Seoul Republic of Korea.
  2. 2Department of Otorhinolaryngology Yongin Severance Hospital, Yonsei University College of Medicine Yongin Republic of Korea.
  3. 3Department of Otorhinolaryngology Severance Hospital, Yonsei University College of Medicine Seoul Republic of Korea.
  4. 4Department of Otorhinolaryngology Gangnam Severance Hospital, Yonsei University College of Medicine Seoul Republic of Korea.
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Abstract

Objective

This study compared the anatomical and functional outcomes of butterfly cartilage inlay tympanoplasty between small and medium-to-large tympanic membrane (TM) perforations.Methods

We retrospectively evaluated 50 patients (50 ears) who underwent butterfly cartilage inlay tympanoplasty between 2017 and 2023. Perforation sizes were quantitatively measured using ImageJ and categorized into small (< 20%, n = 28) and medium-to-large-sized (≥ 20%, n = 22) groups. Graft success, operative time, complications, and preoperative and postoperative hearing thresholds were evaluated.Results

The graft success rate was high and comparable between the small and medium-to-large groups (92.9% vs. 86.4%; p = 0.643), as was the median operative time (32.0 vs. 30.5 min; p = 0.531). Both groups achieved significant postoperative reductions in the air-bone gap (ABG) (p < 0.001). The medium-to-large group demonstrated a significantly greater improvement in ABG (ΔABG) than the small group (-7.5 dB vs. 0 dB; p = 0.002). Perforation size was negatively correlated with ΔABG (r = -0.403, p = 0.003) but not with operative time (p = 0.31).Conclusion

The butterfly cartilage inlay technique achieved high graft success and favorable functional outcomes for both small and medium-to-large TM perforations. It remained surgically efficient and feasible under local anesthesia, regardless of perforation size.Level of evidence

3.

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Cite

BibTeXRIS
BibTeX
@article{yun2026butterfly,
  title = {{Butterfly Cartilage Inlay Technique for Repairing Small to Large Tympanic Membrane Perforations.}},
  author = {Ji Min Yun and Eun Jin Son and In Seok Moon and Seong Hoon Bae},
  journal = {Laryngoscope investigative otolaryngology},
  year = {2026},
  month = oct,
  doi = {10.1002/lio2.70603},
  url = {https://europepmc.org/article/MED/42948288},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Butterfly Cartilage Inlay Technique for Repairing Small to Large Tympanic Membrane Perforations.
AU  - Ji Min Yun
AU  - Eun Jin Son
AU  - In Seok Moon
AU  - Seong Hoon Bae
PY  - 2026
DA  - 2026/10/27
JO  - Laryngoscope investigative otolaryngology
DO  - 10.1002/lio2.70603
UR  - https://europepmc.org/article/MED/42948288
AB  - Objective  This study compared the anatomical and functional outcomes of butterfly cartilage inlay tympanoplasty between small and medium-to-large tympanic membrane (TM) perforations.Methods  We retrospectively evaluated 50 patients (50 ears) who underwent butterfly cartilage inlay tympanoplasty between 2017 and 2023. Perforation sizes were quantitatively measured using ImageJ and categorized into small (< 20%, n = 28) and medium-to-large-sized (≥ 20%, n = 22) groups. Graft success, operative time, complications, and preoperative and postoperative hearing thresholds were evaluated.Results  The graft success rate was high and comparable between the small and medium-to-large groups (92.9% vs. 86.4%; p = 0.643), as was the median operative time (32.0 vs. 30.5 min; p = 0.531). Both groups achieved significant postoperative reductions in the air-bone gap (ABG) (p < 0.001). The medium-to-large group demonstrated a significantly greater improvement in ABG (ΔABG) than the small group (-7.5 dB vs. 0 dB; p = 0.002). Perforation size was negatively correlated with ΔABG (r = -0.403, p = 0.003) but not with operative time (p = 0.31).Conclusion  The butterfly cartilage inlay technique achieved high graft success and favorable functional outcomes for both small and medium-to-large TM perforations. It remained surgically efficient and feasible under local anesthesia, regardless of perforation size.Level of evidence  3.
SN  - 2378-8038
ER  -