Clinical and audiological short-term and long-term outcomes of fat graft myringoplasty

Abstract

Introduction: Results of fat graft myringoplasty are often reported with only short-term follow-up. Audiological results are less commonly reported, as well as long-term follow-up results.

Materials and methods: One hundred consecutive patients scheduled for fat graft myringoplasty were included in a prospective cohort study. Clinical and audiological outcomes were assessed at six weeks and one year postoperatively.

Results: Perforation sizes ranged from 0.5 to 4 mm. The six-week follow-up showed a total perforation closure rate of 72.9% with a statistically significant (p = .03) higher rate for the pediatric age group (83.0%). 64.4% of all patients were healed at one-year follow-up. Statistical analyses for background factors did not reveal any significant difference in healing rates with regard to patient sex or location or cause of the perforation. The mean preoperative air-conduction (AC) threshold was 25 dB with an air-bone gap of 12 dB. At the one-year follow-up the mean air conduction threshold for healed ears was improved to 16.6 dB, still 54.2% of them had a type B tympanogram.

Conclusions: Children had a higher perforation closure rate at six-week follow-up than adult patients. Recurrent tympanic membrane perforations were common after initially successful fat graft myringoplasties. Long-term hearing was improved after successful fat graft myringoplasty, resulting in a mean AC threshold of 16.6 dB.

Chinese abstract

引言：脂肪移植物置管置入术的结果通常只通过短期随访而得以报道。听力学结果通常不太予以报道, 对于长期随访的结果同样如此。

材料与方法：一百个连续性病例接受脂肪移植鼓膜修补术的患者被纳入具有前瞻性的群体研究。术后6周和1年后对临床和听力结果进行评估。

结果：穿孔尺寸范围为0.5至4毫米。六个星期的随访显示, 总的穿孔闭合率为72.9%, 其中儿科年龄组地比率较高（83.0%）, 具有统计学意义（p = 0.03）。在所有患者中, 64.4%在一年随访时已经全愈。背景因素的统计分析没有显示相对于患者性别或位置或穿孔原因来说, 愈合率有任何显著差异。平均术前气导（AC）阈值为25 dB, 空气-骨骼间隙为12 dB。在一年随访时, 愈合耳朵的平均气导阈值改善到16.6 dB, 其中54.2%的患者仍然有B型鼓室图。

结论：儿童在6周随访时穿孔闭合率高于成人患者。在最初成功进行的脂肪移植鼓膜修补术后, 鼓膜穿孔复发是常见的。成功进行脂肪移植鼓膜修补术后, 长期听力得到改善, 平均AC阈值达16.6dB。

Keywords:

• Tympanic membrane perforation
• fat graft myringoplasty
• pediatric patients
• audiometry
• tympanometry
• healing result

Acknowledgements

The study was supported by the Centre for Clinical Research Västmanland County – Uppsala University.

Disclosure statement

The authors have no conflicts of interest to disclose.

Additional information

Funding

The study was supported by the Centre for Clinical Research Västmanland County – Uppsala University.