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Abstract
Objective: Compare the inlay butterfly cartilage myringoplasty versus underlay cartilage tympanoplasty mainly in terms of the graft take rate and hearing outcome. Methods: This is a prospective study, forty participants were recruited through patients aging between 15 to 60 years old, with dry central tympanic membrane perforations, presenting at otorhinolaryngology outpatient clinic at faculty of medicine, Cairo University. The 40 patients were then divided into 2 groups. 17 patients underwent inlay butterfly myringoplasty through a trans-canal approach while 23 patients underwent underlay cartilage tympanoplasty through a post-auricular approach. Follow up was done with mean of 3.4 months and audiological assessment by pure tone audiometry was done1 month post-operatively. Results: For inlay group, 64.7% of the patients had a completely healed tympanic membrane postoperatively, 17.6% of the patients had a partially (nearly 50%) healed tympanic membrane. Mean AB gap closure was 4 db. For underlay group, 82.6% of the patients had a completely healed tympanic membrane postoperatively. Mean AB gap closure was 4.7 db. No major complications were reported with both groups.These results show no statistically significant difference between both groups in terms of graft take and hearing improvement (p = 0.149). Conclusion: Inlay butterfly myringoplasty is reliable as an easy and time saving procedure that can be done in cases with eardrum perforations as an alternative to underlay technique. Results are comparable with underlay technique in terms of graft take rate and hearing improvement. Procedure is better in terms of decreasing operative time, postoperative pain and duration before resuming usual activities