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. 2021;83(2):85-92.
doi: 10.1159/000512084. Epub 2020 Dec 18.

The Long-Term Stability of Fat-Graft Myringoplasty in the Closure of Tympanic Membrane Perforations and Hearing Restoration

Jae Sang Han  1 , Jung Ju Han  1 , Jung Mee Park  2 , Jae-Hyun Seo  1 , Kyoung Ho Park  3
Affiliations

The Long-Term Stability of Fat-Graft Myringoplasty in the Closure of Tympanic Membrane Perforations and Hearing Restoration

Jae Sang Han et al. ORL J Otorhinolaryngol Relat Spec. 2021.

Abstract

Background/aims: This study was conducted to evaluate the long-term stability of fat-graft myringoplasty (FGM) for chronic tympanic membrane perforations, analyzing the perforation closure rate and re-gained hearing outcome with respect to the size and location of the perforations.

Methods: Between August 2007 and June 2018, a total of 193 patients who underwent FGM due to chronic tympanic membrane perforation at a tertiary referral center were enrolled and analyzed.

Results: The mean follow-up was 14.6 months (range 6-39). The complete perforation closure rate after FGM was 89.6%, with no statistical difference among the perforation size groups. The mean postoperative air-bone gap (ABG) was 11.0 dB and mean ABG improvement was 4.9 dB.

Conclusion: Our FGM technique had a favorable tympanic closure rate for small to large perforations, and yielded relatively good hearing improvement in the mid-size perforation cases over long-term follow-up periods. According to the topographic evaluation of FGM, this procedure resulted in a reliable perforation closure rate and audiological results regardless of the perforation site.

Keywords: Autologous fat; Ear surgery; Myringoplasty.

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Conflict of interest statement

All authors approved this manuscript, and there are no conflicts of interest to report.

Figures

Fig. 1
Fig. 1
The areas of total TM (thick outer line) and perforation site (thin inner line) were measured using the image analysis program after manual drawing of the margins.
Fig. 2
Fig. 2
Representative endoscopic findings of the TMs preoperatively and at 2 months after FGM. a–d Any type of chronic TM perforations, including various sizes and locations, could be a good indication for FGM. e–h Complete healing of the perforation and the revascularization of the newly formed TM after surgery is evident. Pre-op, preoperative; Post-op, postoperative.
Fig. 3
Fig. 3
Mean postoperative ABG and ABG improvement according to perforation size group (a) and location group (b). No statistically significant differences were observed except for the PAI <10% group, which showed less ABG improvement. Kruskal-Wallis test, * p = 0.003.
See this image and copyright information in PMC

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