A Comparative Study of Using Collagen Patch or Fat Plug in Myringoplasty for Small Tympanic Membrane Perforations

Area of Science:

• Otorhinolaryngology
• Biomaterials in Medicine

Background:

• Tympanic membrane perforation is a common otorhinolaryngology issue.
• While small perforations often heal spontaneously, some persist due to factors like infection.
• Various grafting materials have been used with success for persistent perforations.

Purpose of the Study:

• To compare the efficacy of a novel collagen patch versus a conventional fat plug for treating small tympanic membrane perforations.
• To evaluate healing rates, closure success, and hearing improvement as office-based procedures.

Main Methods:

• A prospective study involving 60 patients with small tympanic membrane perforations.
• Patients were divided into two groups: one treated with a collagen patch, the other with a fat plug.
• Success rates, healing, closure, and audiometric (air-bone gap) improvements were assessed at 1 and 2 months post-procedure.

Main Results:

• Both the collagen patch and fat plug groups demonstrated statistically equal success rates for healing and complete closure at 1 and 2 months.
• Significant hearing improvement (air-bone gap reduction) was observed in both treatment groups compared to pre-operative levels.
• Perforation location did not correlate with hearing outcomes, though anterior quadrant perforations showed slightly better healing rates.
• Infective causes were associated with higher failure rates in both groups.

Conclusions:

• Collagen patches and fat plugs are equally effective office procedures for treating small tympanic membrane perforations.
• Both methods lead to significant improvements in hearing following the procedure.
• Perforation etiology (especially infection) and location may influence treatment outcomes.