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Fat graft myringoplasty: results of a long-term follow-up
Roee Landsberg1, Gadi Fishman, Ari DeRowe
1Department of Otolaryngology-Head and Neck Surgery, Meir Medical Center, Kfar Saba, affiliated with Sackler Faculty of Medicine, Tel Aviv, Isreal. jeroy@bezeqint.net
Objective:
To evaluate the long-term results of fat graft myringoplasty in adult and pediatric populations.
Design:
Prospective case series study.
Main Outcome Measures:
Patients with chronic tympanic membrane perforations were considered candidates for fat graft myringoplasty. Excluded were patients with purulent discharge, suspected ossicular disease, suspected cholesteatoma, or a perforation diameter greater than 6.5 mm. Fat was harvested from the ear lobule or subcutaneous tissue just posterior-inferior to the lobule.
Results:
The study population comprised 27 adults and 11 children. Twenty-eight perforations were small (73.7%) and 10 were large (26.3%). Altogether, 31 of 38 perforations were successfully repaired (81.6%), including 22 of 28 small perforations (78.6%) and 9 of 10 large perforations (90%). Assessment by age showed that 23 of 27 perforations of the adults (85.2%) and 8 of 11 perforations of the children (72.7%) successfully closed (p = .648). Follow-up ranged from 25 to 53 months (mean 40.6 +/- 8.3 months). No recurrence of the perforation during the follow-up period was recorded if the initial results were successful. The speech reception threshold improved significantly (18.5 +/- 7.7 dB vs 23.5 +/- 8 dB; p = .043). No significant sensorineural hearing loss occurred.
Conclusions:
Fat graft myringoplasty is a reliable technique for the closure of small- and medium-sized perforations. The grafting results showed excellent long-term durability. Given the simplicity of the technique, its short duration, and the favourable hearing results, fat graft myringoplasty should be considered the procedure of choice in patients with suitable perforations and when not otherwise contraindicated.
Insights
Fat graft myringoplasty effectively repairs chronic tympanic membrane perforations in adults and children, showing durable results and improved hearing. This simple procedure offers a reliable surgical option for suitable cases.
Area of Science:
- Otolaryngology
- Surgical Innovation
- Regenerative Medicine
Background:
- Chronic tympanic membrane perforations can lead to hearing loss and recurrent infections.
- Traditional myringoplasty techniques have varying success rates.
- Fat graft myringoplasty presents a minimally invasive alternative for tympanic membrane repair.
Purpose of the Study:
- To assess the long-term efficacy and durability of fat graft myringoplasty.
- To evaluate outcomes in both adult and pediatric patient populations.
- To determine the impact on hearing thresholds post-procedure.
Main Methods:
- Prospective case series evaluating fat graft myringoplasty for chronic tympanic membrane perforations.
- Exclusion criteria included purulent discharge, ossicular disease, cholesteatoma, and large perforations (>6.5 mm).
- Fat was harvested from the ear lobule or adjacent subcutaneous tissue.
Main Results:
- Successful closure was achieved in 31 of 38 perforations (81.6%) over a mean follow-up of 40.6 months.
- Higher success rates were observed in large perforations (90%) compared to small ones (78.6%).
- Significant improvement in speech reception threshold was noted (p = .043) with no sensorineural hearing loss.
Conclusions:
- Fat graft myringoplasty is a reliable and durable technique for closing small to medium tympanic membrane perforations.
- The procedure demonstrates favorable hearing outcomes and simplicity.
- It is recommended as a primary surgical option for suitable perforations.
