Fat Myringoplasty: Better Patient Selection for Better Results

Abstract

Objectives: (1) Evaluate the outcome of fat myringoplasty in relation to the perforation size. (2) Compare the outcome in relation to 2 fat sources (ear lobule and abdominal wall). Methods: This study was conducted between May 2012 and April 2013 in the ENT department, University of Alexandria, Egypt. It was carried out on 30 patients with tympanic membrane perforations <30% of its surface (20 patients with perforations equal or less than 2 mm and 10 patients with perforations exceeding 2 mm in diameter), and with a maximum air bone gap of 20 dB. There were 2 randomized groups. Group A: 15 patients who had myringoplasty with ear lobule fat. Group B: 15 patients operated on using abdominal wall fat. Patients were followed for 6 months postoperatively. Results: Among the 20 patients with a perforation size ≤2 mm, 18 patients (90%) succeeded and 2 (10%) failed. Among the 10 patients with a perforation exceeding 2 mm, 5 patients (50%) succeeded and 5 (50%) failed. There was a significant statistical difference between perforation size and success rate. In group A, 12 patients (80%) had successful operations and 3 patients (20%) failed. In group B, 11 patients (73.3%) were successful and 4 patients (26.7%) failed. There were no significant differences between the 2 groups with regard to the success rate and hence its relation to the fat source ( P > .05). Conclusions: Fat myringoplasty can be performed safely in cases with small perforations, especially up to 2 mm in diameter and small air bone gap. Ear lobule constitutes a convenient source of fat.