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Can Fat-plug Myringoplasty Be a Good Alternative to Formal Myringoplasty? A Systematic Review and Meta-analysis

Lee, Doh, Young; Kim, Young, Ho

doi: 10.1097/MAO.0000000000001732
REVIEW ARTICLE

Objective: This study reviewed available literature to evaluate the success rate of fat myringoplasty compared with methods using other graft materials and suggests proper indications for this procedure.

Data Sources: Studies reporting the success rate of fat myringoplasty were systematically reviewed by searching the MEDLINE, PubMed, and Embase databases for studies published from database inception to 2017.

Study Selection: The following terms were used for the literature search: (“Fat” OR “Adipose”) and (“Myringoplasty” OR “Tympanoplasty”).

Data Extraction: Eight case series reported the data of perforation size and audiologic results. The success rate varied according to the perforation size with a cutoff value of 3 to 5 mm in length or 30% of the total tympanic membrane area. The success rate in anterior perforation was lower than that in other sites, ranging from 76.7 and 85.2% to 84.5 and 91.7%, respectively. The meta-analysis was performed on 10 articles. The overall success rate in fat myringoplasty and paper patch technique was not significantly different, while the success rate of fat myringoplasty was lower than that for the conventional myringoplasty technique using fascia or perichondrium (OR 0.63, 95% CI 0.49–0.80). Hyaluronic acid showed a significantly higher success rate than fat myringoplasty (90.1% versus 69.9%) (OR 0.20, 95% CI 0.09–0.46).

Conclusions: The success rate of fat myringoplasty may be associated with the perforation site and size. The success rate of fat myringoplasty was equivalent to that of the paper patch but inferior to a conventional method using perichondrium or fascia.

Department of Otorhinolaryngology–Head and Neck Surgery, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea

Address correspondence and reprint requests to Young Ho Kim, M.D., Ph.D., Department of Otolaryngology–Head and Neck Surgery, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, 5 Gil 20, Boramae-Road, Dongjak-Gu, Seoul 156-707, South Korea; E-mail: yhkiment@gmail.com

Source of Funding: This study was supported by a clinical research grant provided from Seoul National University Boramae Medical Center.

The authors disclose no conflicts of interest.

Copyright © 2018 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company