Comparison in Outcome with Endoscopic and Microscopic Fat Myringoplasty

By June 7, 2019

Lin, Sheng-Chiao1; Liu, Yu-Hsi1,2; Lin, Ming-Yee1
1 Department of Otorhinolaryngology – Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan;
2 School of Medicine, National Defense Medical Center, Taipei, Taiwan.

Fat myringoplasty was a simple office procedure with minimal morbidity to the patient. This study aimed to compare the success of endoscopic and microscopic fat myringoplasty under local anesthesia.

– Study Design: retrospective case review.
– Setting: tertiary referral center.
– Patients: chronic otitis media patients treated at our referral center from November 2014 to December 2017.
– Intervention: therapeutic.

– Main Outcome Measures: take rate, air conduction threshold
– Results: There were 11 patients with a male-to-female ratio of 1:1.75. Four (36.4%) patients underwent endoscopic fat myringoplasty, and seven (63.6%) patients took microscopic surgery. The average perforation size was significantly bigger (p = 0.006) in patients treated with endoscopic surgery (26.3%) than in those received microscopic surgery (14.3%). Endoscopic surgery was associated with significantly higher (p <0.001) graft take rate (100%) than microscopic surgery (57.1%). The air conduction thresholds were improved (p = 0.148) after fat myringoplasty with endoscopy (8.13 dB) than with microscopy (0.54 dB).

Endoscopic fat myringoplasty was associated with significantly higher take rate and comparable air conduction gain benefit. Due to better visualization with endoscopy and fair feasibility of fat graft myringoplasty, the endoscopic fat myringoplasty under local anesthesia may be utilized to repair eardrums in patients with small perforation.