Closure of small perforation in tympanic membrane by use of fat plug
Keywords:Chronic suppurative otitis media, Myringoplasty, Tympanoplasty
Background: Chronic suppurative otitis media presents mostly with ear discharge and associated decreased hearing. Tympanoplasty is the established surgery for tympanic membrane perforation. Most commonly used graft material for tympanoplasty is temporalis fascia. Others are fascia lata, tragal perichondrium, tragal cartilage, fat. The objective of the study was to compare the graft taken up and hearing improvement following myringoplasty with use of fat.
Methods: Patients of CSOM aged 10 to 65 years old with small central perforation which is dry for at least 3 weeks with normal middle ear mucosa and intact ossicular chain with mild conductive hearing loss. The present study was carried out in Ear, neck and throat (ENT) Department of SCL hospital, Ahmedabad from July 2016 till September 2018 and 25 patients were randomly selected fulfilling the above criteria.
Result: The choice of graft affects not only the outcome of surgery, but also determines the complexity of the procedure and the time taken for the same. Study proves that fat is also a one of the good grafting material which is easily available and keep to prevent from major surgery. The results have been quite encouraging.
Conclusion: Study proves that fat is also a one of the good grafting material which is easily available and keep to prevent from major surgery. An added advantage of this technique was the excellent post-operative quality of life of the operated patients, assessed in terms of the chronic ear survey and evident by the absence of the usual post-operative complaints following a conventional myringoplasty.
Faris C. Scott-Brown’s Otorhinolaryngology, Head and Neck Surgery, 7th edn. Ann R Coll Surg Engl. 2011;93(7):559.
Harold ludman. Chapter 52- Clinical Examination of the EAR. In ABC Of Ear, Nose and Throat 6th edition. Blackwell publishing.2015.
Dragovich JJ. Closure of tympanic membrane perforation. Arch Otol. 1952;55(1):38-42.
Sanna M. Middle ear and mastoid surgery. Thieme publisher. 2015: 106-164.
Glasscock-Shambaugh. Surgery of the ear. 6th edition. People’s medical publishing house. 2010.
Kamakshi SK. Role of fat plug in myringoplasty. Otolaryngol Online J. 2011.
Saliba, I, Froehlich, P. Hyaluronic acid fat graft myringoplasty : an office-based technique adapted to children. Archieves of Otolaryngology-Head and Neck Surgery. 2011,137(12):1203.
Fiorino F. Barbieri F. Fat graft myringoplasty after unsuccessful tympanic membrane repair. Eur Arch Otorinolaryngol. 2007;264(10):1125-8.
Hegazy, Hassan Moustafa. Fat myringoplasty- A prospective clinical study. Egyptian Journal of Ear, Nose, Throat & Allied Sciences. 2013,14(2):91-95.
Mitchell R B, Pereira K D, Lazar RH. Fat graft myringoplasty in children- a safe and successful day stay procedure. J Laryngol Otolog. 1997:111;106-108.
Liew L, Daudia A, Narula AA. Synchronous Fat plug myringoplasty and tympanostomy tube removal in the management of refractory otorrhoea in younger patients. Int J Peadiatr Otorhinolaryngol. 2002;66:291-296.
Hagemann M. Hausler R. Tympanoplasty with adipose tissue. Laryngoscope. 2003;82:393-396.
Ayache S Braccini F. Facon F. thomassin JM. Adipose graft: an original option in myringoplasty. Otolog Neurol. 2003;24:158-164.
Ozjursoy OB. Yorulmaz. Fat graft myringoplasty:a cost effective but underused procedure. J Laryngol Otolog. 2005;119:277-279.