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Comparison of myringoplasty techniques for eardrum perforations.

Chappel Pettit1, Shelby Barrera1, Boris Kuyeb1

  • 1Department of Otolaryngology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, United States of America.

American Journal of Otolaryngology
|May 16, 2025
PubMed
Summary

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Comparing Gelfoam-stuffed, Gelfoam overlay, and fat graft myringoplasty in children, this study found all techniques highly effective. Surgical outcomes were similar across methods, offering flexibility for otolaryngologists.

Area of Science:

  • Otolaryngology
  • Pediatric Surgery
  • Surgical Techniques

Background:

  • Myringoplasty is a surgical procedure to repair a perforated tympanic membrane.
  • Various grafting materials, including Gelfoam and autologous fat, are used in myringoplasty.
  • Choosing the optimal myringoplasty technique in pediatric patients is crucial for successful outcomes.

Purpose of the Study:

  • To compare the surgical outcomes and efficacy of Gelfoam-stuffed graft, Gelfoam overlay graft, and fat graft myringoplasty techniques.
  • To identify factors influencing the success rates of different myringoplasty methods in pediatric patients.
  • To provide insights for otolaryngologists in selecting appropriate myringoplasty techniques for children.

Main Methods:

  • Retrospective analysis of pediatric patients (<18 years) who underwent myringoplasty between 2014 and 2022.
Keywords:
Fat graft myringoplastyGelfoam myringoplastyPediatric otolaryngologyTympanic membrane perforation

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  • Data collection included patient demographics, perforation characteristics, surgical technique, operative time, and postoperative outcomes.
  • Comparison of success rates and complication profiles among Gelfoam-stuffed, Gelfoam overlay, and fat graft techniques.

    • Main Results:

    • A total of 325 pediatric myringoplasties were analyzed, with Gelfoam-stuffed (51%), Gelfoam overlay (39%), and fat graft (10%) being the primary techniques.
    • An overall success rate of 96.3% was achieved, with no significant differences observed among the three techniques.
    • Fat grafts were associated with longer operative times and were more frequently used for persistent perforations.

    Conclusions:

    • Gelfoam-stuffed graft, Gelfoam overlay graft, and fat graft myringoplasty techniques demonstrate comparable efficacy in pediatric patients.
    • Despite variations in operative time, no clinically significant differences in postoperative outcomes were noted.
    • All three techniques are viable options, allowing otolaryngologists to tailor their choice to individual patient needs and clinical scenarios.