scholarly journals The efficacy of fat myringoplasty in small central perforation of pars tensa

2017 ◽  
Vol 3 (2) ◽  
pp. 359
Author(s):  
Rachana W Gangwani ◽  
Kirti P. Ambani ◽  
Sanket D Vakharia ◽  
Bhavya B. M. ◽  
Ashish U. Katarkar
Keyword(s):  
Tympanic Membrane ◽  
Fat Graft ◽  
Graft Material ◽  
Microscopic Approach ◽  
Suppurative Otitis Media ◽  
Pars Tensa ◽  
Central Perforation ◽  
Tertiary Centre ◽  
Small Perforation ◽  
Air Conduction

<p class="abstract"><strong>Background:</strong> In the present study, an attempt was made to study the effectiveness of fat graft material and the improvement in hearing following fat myringoplasty in small central perforations of pars tensa.</p><p class="abstract"><strong>Methods:</strong> This prospective study was carried out in our tertiary centre between October 2014 to October 2015 in 38 patients selected randomly who attended our ENT OPD. Patients with tubotympanic type of chronic suppurative otitis media CSOM (TT), with dry small central perforation involving less than 25% of tympanic membrane (TM) were included. Patients with ossicular fixation or disruption with air bone gap (ABG) &gt;40dB were excluded. All procedures were performed under local anesthesia (LA). Fat graft was harvested from ear lobule and was placed through endomeatal microscopic approach after freshening perforation margin. All patients were followed up to 5months postoperative period and graft status and audiological assessment was made.  </p><p class="abstract"><strong>Results:</strong> In 86.8% cases (33 patients) graft was taken up while in 13.2% cases (5 patients) graft was not taken up. Mean pre-operative air conduction in right/left ear was 28.5±7.6/27.1±8.5 and post-operative was 24.9±5.3/23.4±6.9 dB respectively. Similarly, it was seen that mean pre-operative air bone gap in right/left ear was 17.6±7.2/17.0±7.4 and post-operative was 14.0±5.3/13.2±6 dB respectively.</p><strong>Conclusions:</strong> It is a very safe, simpler procedure and in this we don’t disturb the annulus so the chance of lateralization or medialization of graft is nil. During fat myringoplasty the angle of tympanic membrane and anterior recess is maintained in natural position and we don’t disturb acoustics, so fat myringoplasty is an excellent option especially for small perforation.

scholarly journals Closure of small perforation in tympanic membrane by use of fat plug

2020 ◽  
Vol 6 (9) ◽  
pp. 1647
Author(s):  
Nehal R. Patel ◽  
Vaibhav V. Patel ◽  
Dimpal Padavi ◽  
Mayur Prajapati ◽  
Rachana M. Khokhani ◽  
...  
Keyword(s):  
Tympanic Membrane ◽  
Ossicular Chain ◽  
Tympanic Membrane Perforation ◽  
Major Surgery ◽  
Graft Material ◽  
Middle Ear Mucosa ◽  
Suppurative Otitis Media ◽  
Membrane Perforation ◽  
Conventional Myringoplasty ◽  
Small Perforation

<p class="abstract"><strong>Background: </strong>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.</p><p class="abstract"><strong>Methods:</strong> 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.</p><p class="abstract"><strong>Result: </strong>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.</p><p class="abstract"><strong>Conclusion: </strong>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.</p>

Fat graft myringoplasty in children – a safe and successful day-stay procedure

1997 ◽  
Vol 111 (2) ◽  
pp. 106-108 ◽  
Author(s):  
R. B. Mitchell ◽  
Kevin D. Pereira ◽  
Rande H. Lazar
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media With Effusion ◽  
Tympanic Membrane Perforation ◽  
Successful Outcome ◽  
Fat Graft ◽  
Graft Material ◽  
Surgical Closure ◽  
Tympanic Membrane Perforations ◽  
Membrane Perforation ◽  
Ventilation Tubes

AbstractThe surgical closure of dry tympanic membrane perforations in children remains a controversial issue due to conflicting opinions on the appropriate technique, graft material and success rate. We present a review of 342 children who underwent fat graft myringoplasty as a day-stay procedure over a six-year period. Successful closure of the tympanic membrane perforation was achieved in 92 per cent of ears. Subsequent recurrent otitis media with effusion required insertion of ventilation tubes in 12 per cent. No relationship was observed between the age of the child and a successful outcome. We conclude that day-stay fat graft myringoplasty is a safe and successful procedure which results in a dry and safe ear in the majority of children.

scholarly journals Study of clinical profile, pathological and functional changes in contralateral ear in patients of chronic suppurative otitis media

2019 ◽  
Vol 5 (5) ◽  
pp. 1368
Author(s):  
Ritu Nigam ◽  
Rajesh Kumar Bairwa ◽  
Ayesha Goel
Keyword(s):  
Tympanic Membrane ◽  
Hearing Impairment ◽  
Otitis Media ◽  
Neck Surgery ◽  
Clinical Profile ◽  
Chronic Suppurative Otitis Media ◽  
Suppurative Otitis Media ◽  
Functional Changes ◽  
Pars Tensa ◽  
Contralateral Ear

<p><strong>Background:</strong> Since unilateral chronic suppurative otitis media (CSOM) does not look to be an isolated entity, but rather a series of constitutional events that affect both ears. The aim of the present study is to study the clinical profile, pathological and functional changes in contralateral ear in patients of CSOM.</p><p><strong>Methods:</strong> Three thundred CSOM patients were studied in the Department of Otorhinolaryngology and Head and Neck Surgery. Patients were examined with otoscope after complete history and sociodemographic taking.  </p><p class="abstract"><strong>Results:</strong> CSOM was more prevalent among females (54%) of young age group (41.6%) and with lower socioeconomic status (46%). Right ear was mostly affected (52.66%). Majority had discharge with hearing impairment (49.3%), 32.3% had ear discharge and 13.6% had hearing impairment and majority had pars tensa perforation (82.66%). In mucosal type CSOM, in CLE majority had abnormal tympanic membrane TM, of them majority had thinning (17.33%) and out of 65 patients with pars tensa retraction, majority had Grade I (22.17%). In squamosal type of CSOM, in CLE, 75% had abnormal TM, out of that 34.61% had pars tensa retraction and of that 23.07% had Grade I.</p><p><strong>Conclusions:</strong> Abnormal contralateral ear was more prevalent. Mucous type of CSOM has a chance forming various grades of tympanic membrane retraction, tympano sclerosis, thin healed membrane in the contralateral ear whereas squamous type of CSOM has a greater chance of contralateral ear involvement like, retraction granulation.</p>

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>

Myringoplasty: impact of perforation size on closure and audiological improvement

2009 ◽  
Vol 123 (9) ◽  
pp. 973-977 ◽  
Author(s):  
J D Wasson ◽  
C E Papadimitriou ◽  
H Pau
Keyword(s):  
Tympanic Membrane ◽  
Tympanic Membrane Perforation ◽  
Smoking History ◽  
Graft Material ◽  
Tympanic Membrane Perforations ◽  
Membrane Perforation ◽  
Size Grade ◽  
The Mean ◽  
The Impact ◽  
Air Conduction

AbstractObjectives:To investigate the impact of perforation size and other variables on the success of myringoplasty, and also to determine audiological gain following successful closure of tympanic membrane perforations of various sizes.Study design:Retrospective analysis of 130 case notes.Main outcome measures:(1) Successful closure of tympanic membrane following myringoplasty, in relation to recorded variables (i.e. perforation size, grade of surgeon, surgical technique, graft material, previous myringoplasty and smoking history). (2) Mean, four-frequency, air conduction audiometric gain following successful myringoplasty for various, pre-operatively categorised tympanic membrane perforation sizes.Results and Conclusion:The collective myringoplasty success rate was 80.8 per cent (105/130); for successful patients, the mean air conduction audiometric gain was −6.8 dB (t = 5.29, p < 0.0001). Neither perforation size nor any other assessed variable was a statistically significant determinant factor for successful myringoplasty. Air conduction audiometric gains following successful myringoplasty were directly correlated with pre-operative perforation size (−4.0 dB for 0–20 per cent perforations, −5.0 dB for 21–40 per cent, −9.1 dB for 41–60 per cent, −10.8 dB for 61–80 per cent and −13.3 dB for 81–100 per cent).

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.

Tympanic membrane atelectasis in childhood otitis media with effusion

1995 ◽  
Vol 109 (6) ◽  
pp. 495-498 ◽  
Author(s):  
H. L. Tay ◽  
R. P. Mills
Keyword(s):  
Multivariate Analysis ◽  
Tympanic Membrane ◽  
Otitis Media With Effusion ◽  
Pars Tensa ◽  
Hearing Thresholds ◽  
Inferior Segment ◽  
Glue Ear ◽  
The Difference ◽  
A Prospective Study ◽  
Relevant Factors

AbstractA prospective study on the dynamics of tympanic membrane atelectasis during the treatment for glue ear was performed in a sample of 115 ears of 83 children aged between one and 11 years. The progression in the degree of pars tensa atelectasis was analysed in relation to six potentially relevant factors. Multivariate analysis showed that the factor with the most predictive value on the progression of the pars tensa retraction was the grade of atelectasis at initial detection (p<0.0001). The use of grommets did not have any significant influence on the outcome grade of atelectasis. There was an association between previous grommet insertion and localized retractions in the inferior segment of the pars tensa (P<0.0001). However, localized retractions in the postero-superior quadrant were not associated with previous grommet insertion (P<0.02). Although the hearing thresholds of atelectatic ears were significantly worse than normal ears especially at 4 kHz (p<0.006), the difference was less than 5 dB.

Surgical results and factors affecting outcome in patients with fat-graft myringoplasty

2021 ◽  
pp. 014556132110632
Author(s):  
Hong Chan Kim ◽  
Kyeong Suk Park ◽  
Hyung Chae Yang ◽  
Chul Ho Jang
Keyword(s):  
Success Rate ◽  
Tympanic Membrane ◽  
Surgical Outcomes ◽  
Underlying Disease ◽  
Tertiary Hospital ◽  
Tympanic Membrane Perforation ◽  
Fat Graft ◽  
Ear Surgery ◽  
Closure Rate ◽  
Diabetes Status

Objectives: We evaluated the closure rate after fat-graft myringoplasty (FGM) of perforations differing in size and location. We explored whether patient’s factors and the FGM surgical technique influenced surgical outcomes. Methods: We retrospectively studied patients with tympanic membrane perforations who underwent FGM from March 2015 to March 2019. All procedures were performed by a single senior surgeon at our tertiary hospital. The patients who followed-up for at least 6 months after surgery were enrolled. We recorded hypertension and diabetes status, age, any prior ear surgery, any calcific plaques adjacent to the perforation, and perforation size and location. Results: A total of 150 patients were enrolled. Our success rate of FGM was 90%. Hypertension, diabetes, prior ear surgery history, and eardrum calcific plaques did not affect the surgical outcomes. There was no statistical difference in the surgical success rate according to the size (< 50%) or location of perforation. The closure rate was 97.2% in patients aged 1660 and 87.5% in patients aged > 60, respectively. However, FGM was successful in only two of six children (33.3%) aged ≤ 15 years, thus significantly less than in the other groups. Conclusion: FGM is a fast, safe, and efficient method for repairing tympanic membrane perforation. The surgical outcome is not significantly affected by underlying disease, perforation size or location, or by the condition of the tympanic membrane or older age. However, it may be poor in children with dysfunctional Eustachian tube.

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