Fat graft myringoplasty – A prospective clinical study

Abstract

A prospective clinical study for reporting the efficacy of fat grafting for small tympanic membrane perforations due to: trauma, infection, post-tympanostomy tube extraction and post myringoplasty residual perforations. Also, to emphasize upon the clinical criteria and technical operative points needed for the success of this procedure.Sixty patients aged between 4 to 44 years; with fat graft myringoplasty were operated for closure of tympanic membrane perforation due to the above causes. Follow up visits for tympanic membrane evaluation, were in the 1st, 4, 6 and 12th post-operative months. Failure cases were counted at the end of the 1st month post-operatively. Hearing evaluation was done pre-operatively and in the 4th postoperative month. Closure of the air bone gap was the parameter of hearing improvement. The outcome measures were the post-operative state of tympanic membrane, hearing improvement in closure of the air-bone gap and incidence of failures and complications.The Mean operative time was 20 minutes. No side effects or operative complication occurred. The successful procedures were (88.2%) from the entire patient group. Post-operatively, the mean improvement in the air/bone gap was about 15 dB for the successful cases. The success rate for each group was: (89%) for post-tympanostomy tube extraction persistent perforations, (90%) for post traumatic persistent perforations and (86.6%) for each of chronic tubotympanic inactive suppurative otitis media with perforation and post myringoplasty residual perforation. ConclusionFat graft myringoplasty is an easy, simple, fast and minimally invasive procedure for the repair of small tympanic membrane perforations with favorable hearing results.