Jongmin Kim1, Hyung-Joo Park2,3, Dae-Neung Lee1, Chul Ho Jang4. 1. Department of Otolaryngology, Chonnam National University Medical School, Gwangju, Republic of Korea. 2. Department of Otolaryngology, Cheomdan General Hospital, Gwangju, Republic of Korea. 3. Postgraduate School, Chonnam National University Medical School, Gwangju, Republic of Korea. 4. Department of Otolaryngology, Chonnam National University Medical School, Gwangju, Republic of Korea; chulsavio@hanmail.net.
Abstract
BACKGROUND/AIM: Recently, hyaluronic acid disc has been known to enhance the success rate of fat myringoplasty. However, hyaluronic acid disc (Epidisc) is not covered by south Korean medical insurance. To date, fat myringoplasty using middle ear packing has rarely been reported. In this study, we studied whether middle ear packing with dexamethasone soaked gelfoam and fibrin glue over the fat graft could promote the success rate of tympanic membrane perforation (TMP) closure without hyaluronic acid disc, regardless of perforation size. PATIENTS AND METHODS: Between January 2005 and July 2020, a total of 209 patients who underwent fat myringoplasty due to chronic TMP at a tertiary referral center were enrolled, and the success rate and audiologic outcomes were analyzed. RESULTS: The mean successful tympanic membrane (TM) closure rate was 88.0%. The success rate by different age groups showed no significant difference. Further, the size of perforation showed no significant difference, and the perforation site (anterior or posterior) was not significant. The preoperative mean thresholds of air conduction (AC), bone conduction (BC), and air-bone gap (ABG) were 55.71, 12.98, and 42.73 dB respectively. The postoperative mean thresholds of AC, BC, and ABG were 23.67, 12.98, and 10.69 dB, respectively. Change in preoperative and postoperative hearing showed was statistically significant. CONCLUSION: Middle ear packing by gelfoam combined with external ear canal packing using fibrin glue enabled stable adhesion between the remnant TM and the fat graft. Regardless of the size of the TMP, the success rate of the fat myringoplasty by our technique can be enhanced without use of hyaluronic acid disc.
BACKGROUND/AIM: Recently, hyaluronic acid disc has been known to enhance the success rate of fat myringoplasty. However, hyaluronic acid disc (Epidisc) is not covered by south Korean medical insurance. To date, fat myringoplasty using middle ear packing has rarely been reported. In this study, we studied whether middle ear packing with dexamethasone soaked gelfoam and fibrin glue over the fat graft could promote the success rate of tympanic membrane perforation (TMP) closure without hyaluronic acid disc, regardless of perforation size. PATIENTS AND METHODS: Between January 2005 and July 2020, a total of 209 patients who underwent fat myringoplasty due to chronic TMP at a tertiary referral center were enrolled, and the success rate and audiologic outcomes were analyzed. RESULTS: The mean successful tympanic membrane (TM) closure rate was 88.0%. The success rate by different age groups showed no significant difference. Further, the size of perforation showed no significant difference, and the perforation site (anterior or posterior) was not significant. The preoperative mean thresholds of air conduction (AC), bone conduction (BC), and air-bone gap (ABG) were 55.71, 12.98, and 42.73 dB respectively. The postoperative mean thresholds of AC, BC, and ABG were 23.67, 12.98, and 10.69 dB, respectively. Change in preoperative and postoperative hearing showed was statistically significant. CONCLUSION: Middle ear packing by gelfoam combined with external ear canal packing using fibrin glue enabled stable adhesion between the remnant TM and the fat graft. Regardless of the size of the TMP, the success rate of the fat myringoplasty by our technique can be enhanced without use of hyaluronic acid disc.
Authors: Chul Ho Jang; Yong Beom Cho; Cheol Hee Choi; Jun Sik Lee; Sung In Kang Journal: Int J Pediatr Otorhinolaryngol Date: 2012-10-06 Impact factor: 1.675