Clinical efficacy of fat-graft myringoplasty for perforations of different sizes and locations

Abstract

Conclusion: Fat-graft myringoplasty (FGM) has a reliable tympanic closure rate for small to large perforations, but yields poor hearing improvement in the latter case. A topographic evaluation of FGM showed that the procedure resulted in a reliable perforation closure rate and audiologic outcome, regardless of perforation location. Objectives: This study assessed the utility of FGM in treating perforations of different sizes and locations. Methods: This retrospective study involved 45 patients (46 ears) who underwent FGM at St Mary's Hospital (Seoul, Korea) between August 2007 and February 2010. Results: The total perforation closure rate after FGM was 87% (40 cases), with no statistical difference among perforation size groups, even though the mean closure rates of the 10–20% and >30% perforation groups were lower than other groups. The difference in the closure rates of patients with anteriorly located perforations and those with perforations in other sites was not significant. The mean postoperative air–bone gap (ABG) was 14.3 (±7.5) dB. Mean postoperative ABG improved significantly after FGM; however, on a per-group basis, the >30% perforation group had the poorest results and the difference was statistically significant. The difference in mean postoperative ABGs of the two groups depending on the location of the perforation (anterior and other) was not significant.