Ep. 265 Pediatric Tympanoplasty: Butterfly Cartilage Technique with Dr. Sean Evans

What makes butterfly cartilage tympanoplasty such an elegant solution for pediatric eardrum perforations? In this episode of the BackTable ENT Podcast, Dr. Sean Evans of Children’s Healthcare of Atlanta joins hosts Dr. Ashley Agan and Dr. Gopi Shah to discuss the evaluation and management of pediatric tympanic membrane perforations, with a focus on the butterfly cartilage tympanoplasty technique --- SYNPOSIS Dr. Evans describes his practice and reviews common etiologies of tympanic membrane perforations. He outlines his approach to the clinical workup and patient counseling, including the role of audiograms, careful otoscopic examination, and selective use of laboratory studies and CT imaging in patients with chronic otorrhea or suspected cholesteatoma. The discussion also addresses timing and age considerations for repair, as well as strategies for managing chronic drainage. Dr. Evans also discusses his evaluation of patient selection criteria and operative technique for butterfly cartilage tympanoplasty. He shares practical insights on surgical steps, technical pearls and pitfalls, postoperative care, recovery expectations, potential risks, coding considerations, and approaches to revision surgery. --- TIMESTAMPS 00:00 - Introduction 02:35 - When to Repair Perforations 10:36 - Physical Exam, Audiogram, & Treatment Decisions18:06 - Butterfly Graft Candidacy20:42 - Step by Step Butterfly Technique25:52 - Butterfly Technique Pearls and Pitfalls29:16 - Example Case Video and Indications35:12 - Restrictions, Pain, & Recovery37:10 - Risk Factors and Complications40:09 - Revision Timing and Failure Modes42:37 - Final Pearls and Wrap Up --- RESOURCES Dr. Sean Evans https://med.emory.edu/directory/profile/?u=SSEVAN3