One hundred twenty‐five fat myringoplasties: Does marginal perforation matter?

Abstract

Otol Neurotol. 2014;35:1755-1758. Migirov L, Shapira Y, Wolf M. The feasibility of endoscopic transcanal approach for insertion of various cochlear electrodes: a pilot study.

Using endoscopy to locate the round window membrane during cochlear implantation: Our experience with 25 patients

“…However, in a recent study that analysed the orientation of the cochlear basal turn in relation to the ear canal, it was demonstrated that the trajectory provided by the conventional posterior tympanotomy aligned more favourably with the cochlear basal turn than the transcanal approach, thus may result in less damage caused by deflection of the electrode array in the scala tympani. 10 In addition, it has also been reported that transcanal…”

Surgical Outcomes of Pure-Fat Myringoplasty for Small Tympanic Membrane Perforations: A Retrospective Study and Summary of the Literature in the Last 10 Years

“…11,[20][21][22][23] Many researchers have demonstrated appropriate indications or conditions for fat myringoplasty. 1,3,10,21) We summarize 2 sets of representative criteria. First, Fiorino and Barbieri 1) suggested that 1) the interval since a previous surgery should be ≥6 months; 2) perforation of the pars tensa should be no larger than 5 mm; 3) there should be non-marginal localization, i.e., involving the annulus or exposing the malleus handle; 4) there should be no calcific plaques or atrophic areas adjacent to the perforation; 5) the mucous layer in the tympanic cavity should appear normal; 6) there should be no acute inflammation; 7) no middle ear discharge in the last 3 months; 8) no evidence of cholesteatoma; 9) no planned ossicular reconstruction; 10) and no major eustachian tube dysfunction.…”

“…Second, Malafronte and Filosa. 10) proposed the following criteria: 1) absence of granulomatous tissue and cholesteatoma, 2) absence of ossicular chain interruption, and 3) perforation size of up to 35% of the eardrum surface. We believe that although these criteria are not absolute guidelines, they suggest good surgical conditions for fat myringoplasty.…”

“…These findings are in agreement with those of previous studies comparing surgical outcomes between pure-fat myringoplasty and fat myringoplasty with HA 25) as well as those solely reporting outcomes associated with pure-fat myringoplasty. 10,[21][22][23][25][26][27] PRP is an autologous blood product that includes many concentrated autologous growth factors and essential proteins for tissue regeneration; therefore, some researchers have believed that PRP has the potential to not only promote healing of TM perforations and prevent TM dehydration but also stimulate centripetal migration of the outer epithelial layer. 13,20) With these characteristics of PRP, some researchers have documented that fat myringoplasty with PRP allows TM closure success rates exceeding 85%, 13,14) reporting higher success rate than those associated with pure-fat myringoplasty.…”

“…3,8,9) Fat myringoplasty is a simpler, faster, and cost-effective office-based procedure that can be conducted under local anesthesia. 1,10) Moreover, postauricular fat is easily harvestable in surgical field, and myringoplasty using fat is associated with less morbidity.…”