Hyaluronic acid fat graft myringoplasty: A minimally invasive technique

Saliba, Issam; Woods, Owen

doi:10.1002/lary.21365

Cited by 56 publications

(46 citation statements)

References 32 publications

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“…The fat graft has potent revascularization activity. Several studies have shown that the angiogenesis of fat tissue precedes the adipogenesis [12][13][14][15][16] . These characteristics are connected to the strong secretory action of fat cells, which produces a lot of proteins and metabolites.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of Hyaluronic Acid Fat Graft Myringoplasty, Fat Graft Myringoplasty and Temporal Fascia Techniques for the Closure of Different Sizes and Sites of Tympanic Membrane Perforations

Gün¹,

Boztepe²,

Atan³

et al. 2016

Int Adv Otol

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OBJECTIVE:To compare the efficacy of three different myringoplasty techniques, namely hyaluronic acid fat graft myringoplasty (HAFGM), fat graft myringoplasty (FGM), and temporal fascia for the closure of different sizes and sites of tympanic membrane perforations. MATERIALS and METHODS:We retrospectively analyzed the medical records of patients who had undergone a type 1 tympanoplasty operation at our clinic between May 2007 and February 2013. The patients were divided into three groups depending on the patient's choice of technique as follows: Fat Graft Myringoplasty (FGM) (Group I), Hyaluronic Acid Fat Graft Myringoplasty (HAFGM) (Group II), and Temporalis Fascia (TF) (Group III). A total of 136 patients were included in the study, split in to the FGM (57 patients; 56.1% female; median age: 30 years), HAFGM (31 patients; 54.8 female; median age: 25 years), and TF (48 patients; 58.3% females; median age: 33 years) surgery technique groups. RESULTS:The patients were further divided into two groups, depending on the size of the perforation (small and large), and into three groups, depending on its location (anterior, inferior, and central). None of techniques provided a significantly better success rate in terms of perforation location (p>0.05). Also, none of the techniques provided a significantly better success rate in terms of perforation size (p>0.05). CONCLUSION:We propose using HAFGM for large perforations and FGM alone for small perforations. The TF technique is a successful and well-defined technique for tympanic membrane perforations; however, in our opinion, its technical difficulties make it a secondary choice, particularly for small-sized perforations.

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Section: Discussionmentioning

confidence: 99%

“…These characteristics are connected to the strong secretory action of fat cells, which produces a lot of proteins and metabolites. By adding HA EpiDisc® to the FGM procedure, Saliba [12] obtained a flat TM, which could not be accomplished by the FGM procedure alone for large TM perforations [16,17] .…”

Section: Discussionmentioning

confidence: 99%

Comparison of Hyaluronic Acid Fat Graft Myringoplasty, Fat Graft Myringoplasty and Temporal Fascia Techniques for the Closure of Different Sizes and Sites of Tympanic Membrane Perforations

Gün¹,

Boztepe²,

Atan³

et al. 2016

Int Adv Otol

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“…In a recent trial investigating the treatment of chronic and dry TMP, hyaluronic acid fat graft myringoplasty (HAFGM) was an effective technique for TMP treatment. The success rate of HAFGM in this trial was comparable to that of both the underlay and the overlay techniques [18]. However, it was necessary to locally anesthetize via injection and to make an incision in order to harvest fat.…”

Section: Discussionmentioning

confidence: 71%

“…Those patients with no therapy showed a preoperative ABG was 26.1 dB HL, whereas the mean postoperative ABG was 5 dB HL [3]. Some studies of patch materials to treat the TMP are listed in Table 2 [3151617181920]. …”

Section: Discussionmentioning

confidence: 99%

Fibrinogen-Based Collagen Fleece Graft Myringoplasty for Traumatic Tympanic Membrane Perforation

Choi

Song

2016

J Audiol Otol

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Background and ObjectivesThe aim of this study was to investigate how fibrinogen-based collagen fleece (Tachocomb®) graft myringoplasty (FCGM), performed under microscopic guidance, improves both hearing and tympanic membrane tissue repair in patients with traumatic tympanic membrane perforation (TMP).Subjects and MethodsBetween August 2009 and March 2015, a total of 52 patients with traumatic TMP visited the department of otorhinolaryngology at a secondary medical center. Twenty-nine of these underwent FCGM under microscopic guidance in our outpatient clinic. For each patient, we recorded the location and size of the perforation, the time elapsed from the onset of TMP until the myringoplasty, and the hearing level both before and after myringoplasty.ResultsThe TMP closed completely in all cases (29 of 29 patients). After myringoplasty, the postoperative air-bone gap (ABG) differed significantly from the preoperative ABG. Three of the 29 patients (10.3%) experienced complications. Specifically, 2 presented with otorrhea after FCGM, but conservative management led to improvement without recurrence of perforation. One patient showed delayed facial palsy 1 week after the procedure. The condition of this patient also improved and the palsy was not permanent.ConclusionsFCGM may be an effective treatment option in case of traumatic TMP. The procedure requires no hospitalization, and can be used to avoid traditional tympanoplasty.

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“…In tympanic perforations, the combination therapy has demonstrated better outcomes than either isolated substance [5][6][7] comparable to gold standard surgical closure [8].…”

Section: Discussionmentioning

confidence: 98%

Enhanced Hyaluronic Acid Fat Grafts, Histological Findings and Specific Markers

Torres¹,

Nuciforo²,

Bonanno³

2017

JDC

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Fat grafts have become particularly popular in recent years due to their autologous origin, permanent volumetric and regenerative properties. Different attempts in improving the re-absorption rate through manipulation or enhancement are possible.Hyaluronic acid is one of the agents that could improve the outcome of the treatment given its natural anticoagulant and volume stabilizer actions. A new HA dermal filler Varioderm (Adoderm GmbH, Germany, concentration 12 mg/ml) was used to enhanced the fat grafts prior to inoculation.Samples of the enhanced grafts were extracted for laboratory analysis, cytometry, staining and markers analysis. Control fat grafts were taken, to compare the results.Histologic findings show better cytoarchitecture, less cellular rupture and inflammation in the HA enhanced fat graft.The former findings show that fat graft enhancement through HA can be a promising way to potentiate the action of the graft prior to inoculation.

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Hyaluronic acid fat graft myringoplasty: A minimally invasive technique

Abstract: HAFGM success rate is comparable to that of the underlay and overlay techniques. Furthermore, it requires no hospitalization and avoids the difficulty of overlay and underlay tympanoplasty.

Cited by 56 publications

References 32 publications

Comparison of Hyaluronic Acid Fat Graft Myringoplasty, Fat Graft Myringoplasty and Temporal Fascia Techniques for the Closure of Different Sizes and Sites of Tympanic Membrane Perforations

Comparison of Hyaluronic Acid Fat Graft Myringoplasty, Fat Graft Myringoplasty and Temporal Fascia Techniques for the Closure of Different Sizes and Sites of Tympanic Membrane Perforations

Fibrinogen-Based Collagen Fleece Graft Myringoplasty for Traumatic Tympanic Membrane Perforation

Enhanced Hyaluronic Acid Fat Grafts, Histological Findings and Specific Markers

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