A study on fat plug myringoplasty for small tympanic membrane perforation

Introduction: Fat plug myringoplasty is an under-used technique to repair a small central tympanic membrane perforation. It is easy, quick and cost effective way with minimal morbidity. It can be done as an OPD procedure. The fat is readily available from ear lobe, abdomen and buttocks. Fat graft myringoplasty (FGM) is a noninvasive, but underused surgery for perforations of the tympanic membrane. It is also preferable for use in children. Fat tissue has been used as an autogenous material for different surgeries and is known to have a high capacity for resistance. Our study is conducted to evaluate the effectiveness of using fat plug in small central tympanic membrane perforation.Aim: To evaluate the effectiveness of using fat plug in small central tympanic membrane perforation.Materials and Methods: This study was conducted in the ENT department of Sree Mookambika Institute of Medical Sciences, Kulasekharam, Kanyakumari district in a time period from JUNE 2020 to November 2020.The sample size was taken as 30 patients who had presented with complaints of ear discharge, and hearing loss, surgical procedure was done where a fat graft was inserted through the perforation for those patients who fulfilled the inclusion criteria. The study was conducted after obtaining the clearance from Institutional Human Ethical Committee.Study Design: Prospective descriptive study.Results and analysis: 30 patients were included in the study. Age range, 20 to 80 years with a tympanic perforation (size, up to one-quarter of the pars tensa). Out of which 24 % had graft failure due to variety of causes. Success rate was 76% in our study, where as the study conducted by Ringenberg et al. The success rate was 86.5%. Posterior perforations had an overall closure rate of 63%, and in anterior perforations, the overall closure rate was 36%.Conclusion: In conclusion it is simple, safe, quick, economical procedure done under local anesthesia with as success rate as temporalis fascia and minimal or no morbidity and complications. The failure rate in our study was 24% due to infection, detached fat graft and dehiscence due to undersized grafts. Posterior perforations had an overall closure rate of 63%, and in anterior perforations, the overall closure rate was 36%. Pure tone audiometry was used to assess average AB gap pre and post operatively. Postoperatively there was an improvement in hearing compared to preoperative hearing.