Endoscopic fat myringoplasty: graft uptake and audiological outcome in inactive mucosal chronic otitis media: a prospective study

The objective of this study was to compare the graft uptake and audiological outcome of endoscopic myringoplasty in Inactive Mucosal Chronic Otitis Media with various tympanic membrane perforation sizes using fat graft from ear lobule or abdominal donor sites.This prospective study was conducted at Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India. 46 patients fulfilling the inclusion criteria who were suffering from inactive mucosal chronic otitis media and attended Otorhinolaryngology outpatient department of this tertiary care centre were considered for this study. Endoscopic myringoplasty using fat graft was performed in all cases. Fat graft was harvested from ear lobule or abdominal donor sites according to tympanic membrane perforation size. They were evaluated for graft uptake and postoperative audiometric status and were followed upto 12 weeks.We found the overall success rate of Endoscopic fat myringoplasty to be 83%. No statistical difference was noted in tympanic membrane closure rates amongst various perforation sizes. The evaluation of fat graft material harvested from either ear lobule or abdominal donor site on closure rates was found to be statistically insignificant. Audiometric gain was statistically significant in successful patients with better gain demonstrated in larger perforations.Thus we conclude that ear lobule or abdominal fat graft can be effectively used in inactive mucosal chronic otitis media for successful closure of small, medium and even large tympanic membrane perforations with comparable graft uptake rates and good audiological outcome with better audiometric gains in larger perforations.