COMPARATIVE STUDY BETWEEN FAT AND PERICHONDRIUM GRAFT MYRINGOPLASTY

Abstract

Introduction: Longstanding tympanic membrane perforation may cause hearing loss and middle ear infection even if they are small in size. The purpose of myringoplasty is to repair such perforations and thus to improve hearing and eliminate the susceptibility to middle ear infection.
Methodology: This study was included 40 patients with dry central tympanic membrane perforation, not associated with ossicular pathology, retraction pocket or cholesteatoma showing conductive hearing loss with an air bone gab not exceeding 30 dBHL in the studied ear. Patients were divided into 2 groups (group I and group II) 20 patients who have undergone fat myringoplasty and 20 patients who have undergone perichondrium tympanoplasty. Each group was subdivided into 2 subgroups (A and B) according to size of perforation. Audiological evaluation was done pre and postoperative.
Results: In fat myringoplasty, the success rate was 50% with success rate of 80% in group I A (<4 mm) and a success rate of 20% in group IB (>4 mm). In perichondrium tympanoplasty, the overall success rate was about 80% with only 4 failed cases from 20 cases.
It was found that there was improvement of hearing in group IA ranging from 7.5-10dB with a mean of 9±1 while in group IIA; there was improvement of hearing ranging from 5-20 dB with a mean of 10±6.5. There was no significant difference as regards improvement of hearing (P=0.67). While in group IB, the 2 successful cases showed improvement of hearing ranging of about 10 dB while in group IIB; there was improvement of hearing ranging from 7.5-20 dB with a mean of 12± 5dB. So, in large perforation, there was no significant difference between the studies groups (P=0.6).
Conclusion: Fat graft myringoplasty is a reliable technique with shorter duration less operative care. Success rate is higher for perichondrium graft. Hearing improvement is not significantly different between both groups.
Key words: fat graft- Perichondrium tympanoplast.