Comparison of myringoplasty techniques for eardrum perforations.

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.
• 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.