Fat graft myringoplasty: a cost-effective but underused procedure

2005 ◽  
Vol 119 (4) ◽  
pp. 277-279 ◽  
Author(s):  
O B Ozgursoy ◽  
I Yorulmaz
Keyword(s):  
Clinical Trial ◽  
Adipose Tissue ◽  
Tympanic Membrane ◽  
Cost Effective ◽  
Fat Graft ◽  
Temporalis Fascia ◽  
Tympanic Membrane Perforations ◽  
Cost Effective Alternative ◽  
One Year

Objectives: The objective of this study was to evaluate the success of fat graft myringoplasty and to discuss the utilities and advantages of a fat graft in primary versus revision myringoplasties.Methods: Eighteen patients who had not had previous otological surgery, and twelve patients whose tympanic membrane perforations have persisted despite myringoplasty with temporalis fascia were included in this prospective clinical trial. All patients were treated by fat graft myringoplasty and followed up for one year.Results: Successful closure of the perforation was obtained in 82.4 per cent of the ears at the final follow up. The success rate in the group of patients who had not had previous otological surgery was higher than those of revision cases.Conclusions: Adipose tissue provides the basic requirements for grafting of the tympanic membrane, with its own favourable characteristics. Fat graft myringoplasty is a cost-effective alternative in small perforations of the tympanic membrane, including revision cases.

scholarly journals Comparative study between fat plug and inlay butterfly cartilage grafts for myringoplasty in adults

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Ahmed Gamal Khafagy ◽  
Mohamed El-Begermy ◽  
Marwa Mohamed El-Begermy ◽  
Pretty O. Afifi
Keyword(s):  
Tympanic Membrane ◽  
Chronic Otitis Media ◽  
Fat Graft ◽  
Cartilage Graft ◽  
Tympanic Membrane Perforations ◽  
Number Of Patients ◽  
Significant Difference ◽  
Hearing Outcomes ◽  
Age Range

Abstract Background This study aims to compare the graft uptake rate and hearing improvement of fat graft versus inlay butterfly tragal cartilage in the repair of perforations in chronic otitis media mucosal in adults. In this retrospective study, twenty-eight patients were included with small dry anteroinferior tympanic membrane perforations (less than 1/3 of the tympanic membrane). The age range was 18 to 44 years old. Myringoplasty was done under general anesthesia for 8 patients with a fat graft (FG) and 20 patients with inlay butterfly cartilage graft (IBCG). Six months postoperatively, a follow-up evaluation was done for successful graft uptake and hearing outcomes. Results The success rate of graft uptake in the first group (fat graft) was 6/8 cases (75%) while in the second group (IBCG) was 19/20 (95%) with no statistically significant difference (P = 0.0148). Also, there was no statistical difference between the two groups as regards postoperative ABG, improvement changes in ABG, and number of patients with improved hearing. Conclusions Inlay butterfly cartilage graft is a useful graft in repairing small tympanic membrane perforations as regard graft take and hearing outcomes.

Results of inlay cartilage myringoplasty in terms of closure of central tympanic membrane perforations

2005 ◽  
Vol 119 (8) ◽  
pp. 611-613 ◽  
Author(s):  
Kamal G Effat
Keyword(s):  
Retrospective Study ◽  
Tympanic Membrane ◽  
Control Group ◽  
Temporalis Fascia ◽  
Current Effort ◽  
Hospital Records ◽  
Tympanic Membrane Perforations ◽  
The Difference ◽  
A Current

There is a current effort to perform myringoplasty for tympanic membrane perforations as a day-stay procedure. In 1998, an inlay myringoplasty using tragal cartilage/perichondrium was described. A retrospective study was performed by the author to analyse the results of inlay carilage myringoplasty, in terms of closure of simple perforations of the tympanic membrane. The results of a control group of previous cases of underlay temporalis fascia myringoplasty were retrieved from the hospital records. All the operations in both groups were performed by the same author at the same institution. The operation of inlay cartilage butterfly myringoplasty has been performed in 28 ears with simple central tympanic membrane perforations. Inconsistent results have been obtained, in that only 43 per cent showed closure of the perforation at the most recent follow-up. A control group of standard underlay temporalis fascia myringoplasty has been performed by the same author in 23 ears. Eighty-three per cent of the perforations were closed at the last follow-up. The difference is statistically highly significant (p < 0.01).

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

ORL ◽  
2020 ◽  
pp. 1-8
Author(s):  
Jae Sang Han ◽  
Jung Ju Han ◽  
Jung Mee Park ◽  
Jae-Hyun Seo ◽  
Kyoung Ho Park
Keyword(s):  
Tympanic Membrane ◽  
Fat Graft ◽  
Closure Rate ◽  
Tertiary Referral Center ◽  
Term Stability ◽  
Long Term Stability ◽  
Tympanic Membrane Perforations ◽  
The Mean

<b><i>Background/Aims:</i></b> 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. <b><i>Methods:</i></b> 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. <b><i>Results:</i></b> 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. <b><i>Conclusion:</i></b> 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.

scholarly journals A comparative study between fat myringoplasty and temporalis fascia tympanoplasty in moderate to large central perforation of pars tensa of tympanic membrane

2017 ◽  
Vol 3 (4) ◽  
pp. 997
Author(s):  
Kirti P. Ambani ◽  
Rachana W. Gangwani ◽  
Bhavya B. M. ◽  
Sanket D. Vakharia ◽  
Ashish U. Katarkar
Keyword(s):  
Tympanic Membrane ◽  
Postoperative Infection ◽  
Bone Conduction ◽  
Fat Graft ◽  
Graft Material ◽  
Temporalis Fascia ◽  
Membrane Repair ◽  
Tympanic Membrane Perforations ◽  
Fascia Graft ◽  
Group 2

<p class="abstract"><strong>Background:</strong> To compare the efficacy between fat graft (FG) and temporalis fascia (TF) graft in tympanic membrane perforations larger than 4mm size or involvement of &gt;25% of tympanic membrane.</p><p class="abstract"><strong>Methods:</strong> This prospective study was carried out during December 2015 to January 2016, for a period of 13months at our Otolaryngology Department. All study patients, who fit into inclusion and exclusion criteria, were divided into two groups according to the type of graft material taken. In group- 1temporalis fascia (TF) graft was taken while in group- 2 fat graft (FG) was taken. An evaluation of hearing was done with full Audiometric and Eustaschian tube function testing. All laboratory preoperative testing was done. Postoperative follow up was done at 2<sup>nd</sup>, 3<sup>rd</sup> and 5<sup>th</sup> month’s period and sos, graft status and hearing evaluation with PTA for all four frequencies 500, 1000, 2000 and 4000 Hz with air conduction and bone conduction thresholds were recorded and compared with preoperative PTA records in both groups.  </p><p class="abstract"><strong>Results:</strong> In TF group total 24 (80%) patients had graft uptake, 4 (13.3%) patients had residual perforation and 2 (6.6%) patients had graft failure due to postoperative infection. In FG group total 16 (53.3%) patients had graft uptake, 6 (20%) patients had graft medialised and necrosed, 6 (20%) patients had residual perforation and 2 (6.6%) patient had graft rejection due to postoperative infection. Graft uptake rate in group 1 was 80% while in group 2 was 53.3%. Mean preoperative ABG in TF group was 25±17 dB and mean postoperative ABG was 10±02 dB, in fat graft technique mean preoperative ABG was 25±13 dB and mean postoperative ABG was 16±15 dB. Fat graft technique is simple, quick and minimally invasive. It doesn’t require middle ear manipulation.</p><p><strong>Conclusions:</strong> There is no ideal material for tympanic membrane repair but for moderate to large perforation temporalis fascia graft is better than fat graft in terms of healing and hearing outcomes but considering morbidity fat gives less morbidity. </p>

Adipose Plug Myringoplasty: An Alternative to Formal Myringoplasty Techniques in Children

1989 ◽  
Vol 101 (6) ◽  
pp. 617-620 ◽  
Author(s):  
Charles W. Gross ◽  
Mahan Bassila ◽  
Rande H. Lazar ◽  
Thomas E. Long ◽  
Shirley Stagner
Keyword(s):  
Tympanic Membrane ◽  
Operative Technique ◽  
Cost Effective ◽  
Temporalis Fascia ◽  
Effective Technique ◽  
Tympanic Membrane Perforations ◽  
Cost Effective Technique ◽  
Criteria For Selection

Adipose myringoplasty is presented as a simple and cost-effective technique in managing small tympanic membrane perforations in children. A review of 76 fat plug myringoplasties performed on 62 children with drum perforations over a 15-year period was done. Fifty-nine myringoplasties were postinflammatory and/or after extrusion of pressure-equalizing (PE) tubes. Sixteen were residual perforations following temporalis fascia tympanoplasty, and one was posttraumatic perforation. Criteria for selection, operative technique, and results are discussed.

Safety and Efficacy of the Ophira Mini-Sling System: One Year Follow-Up From a Multicenter International Clinical Trial

2011 ◽  
Vol 04 (03) ◽  
Author(s):  
Paulo Palma ◽  
Cassio Riccetto ◽  
Rodrigo Castro ◽  
Sebastian Altuna ◽  
Viviane Herrmann ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Safety And Efficacy ◽  
International Clinical Trial ◽  
One Year ◽  
Mini Sling

Early Intervention Options for Acute Low Back Pain Patients: A Randomized Clinical Trial with One-Year Follow-Up Outcomes

2010 ◽  
Vol 20 (2) ◽  
pp. 256-263 ◽  
Author(s):  
Travis Whitfill ◽  
Robbie Haggard ◽  
Samuel M. Bierner ◽  
Glenn Pransky ◽  
Robert G. Hassett ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Low Back Pain ◽  
Back Pain ◽  
Early Intervention ◽  
Randomized Clinical Trial ◽  
Low Back ◽  
Acute Low Back Pain ◽  
One Year ◽  
Pain Patients

Effective Pharmacist led interventional strategies to improve outcomes in hypertensive patients: a narrative review

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Samra Bashir ◽  
Akash Syed
Keyword(s):  
Pharmaceutical Care ◽  
Cost Effective ◽  
Pharmacist Intervention ◽  
Care Plan ◽  
Hypertensive Patients ◽  
Disease Outcomes ◽  
Cost Effective Alternative ◽  
The Impact

The role of pharmacist intervention as a cost-effective alternative to physician in disease management is increasingly been recognized. Studies have demonstrated that pharmaceutical care can improve drug therapy as well as patient satisfaction in chronic health conditions including cardiovascular diseases. This study is aimed to review and outline a comprehensive pharmaceutical care plan from the randomized controlled trials previously conducted to assess the impact of pharmacist-managed care on disease outcomes in hypertensive patients. Compared with usual care, the pharmaceutical intervention involved patient evaluation, patient education and counselling, medication review and management, patient monitoring and follow-up, and feedback to the primary physician as major strategies.

Preoperative muscle strength as a predictor of complications after esophagectomy.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 454-454
Author(s):  
Madison Colcord ◽  
Michael D Watson ◽  
Nicole Lee Gower ◽  
Jennifer H Benbow ◽  
Sally Jeanne Trufan ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Adipose Tissue ◽  
Muscle Mass ◽  
Clinical Care ◽  
Cost Effective ◽  
Skeletal Muscle Index ◽  
Intramuscular Adipose Tissue ◽  
Operative Outcomes ◽  
Increased Risk ◽  
One Year

454 Background: Sarcopenia has been associated with post-operative complications and length of stay (LOS) in patients undergoing esophagectomy. A variety of methods exist to measure muscle mass and strength, with few comparisons between methods. We compared hand-grip strength (HGS), muscle mass and intramuscular adipose tissue as predictors of post-operative outcomes. Methods: Patients with esophageal cancer undergoing esophagectomy were identified between January 2015 – June 2019 at Levine Cancer Institute. Skeletal muscle index (SMI) and skeletal muscle density (SMD), a measure of intramuscular adipose tissue, were derived from CT. HGS was measured using a dynamometer. Uni- and multivariable GLM analyses were performed. Results: 115 patients (100 male, 15 female) underwent esophagectomy with an average age of 64.3 +/- 9.8. The analysis was stratified by sex due to significant differences in HGS, SMI, and SMD. Among men, univariable analysis revealed a significant association between pre-operative HGS <25 kg and increased risk of post-operative pneumonia ( p=0.02), ventilation >48hrs ( p=0.02), LOS ( p=0.002), discharge to home ( p=0.001), and one-year mortality ( p=0.005). All associations except discharge home remained significant in multivariable analyses (Table). Among women, no factors analyzed were significantly associated with postoperative outcomes. Conclusions: HGS is a more powerful predictor of postoperative complications and LOS than either muscle mass or intramuscular adipose tissue among men undergoing esophagectomy. HGS is cost-effective and easily incorporated into routine clinical care, allowing for preoperative intervention to optimize patients for esophagectomy. To better understand the implications in women, additional research with a larger cohort is needed. [Table: see text]

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