Diaz Alfonso Rodriguez, Reina Carlos O'Connor, Plaza Guillermo, Posadas Elena Rodriguez, Arevalo Francisco Valdeon, Iriarte Maria Teresa Garcia
Hospital Naval de San Carlos, Otorhinolaryngology Department Hospital Naval de San Carlos, San Fernando Cadiz, Spain.
Othorhinolaryngology Department, 170643Hospital Quironsalud Marbella, Marbella, Spain.
Ear Nose Throat J. 2021 Jun;100(3_suppl):229S-234S. doi: 10.1177/0145561320973555. Epub 2020 Dec 14.
To assess clinical and functional outcomes of a fat graft myringoplasty under local in an office setting.
Prospective case series.
Tertiary care facility.
Patients with a tympanic membrane (TM) perforation presenting between December 2005 and June 2019. Inclusion criteria included perforation size >25% of the surface of the pars tensa of the TM, entire perforation margins visualized through a transcanal view, and lack of spontaneous closure at the 6-month follow-up. The exclusion criteria were the presence of cholesteatoma, wet appearance of the mucosa in the tympanic cavity, ear discharge in the 3 months before surgery, or signs of ossicular inconsistency.
In-office fat graft myringoplasty technique under local anesthesia.
Complete perforation closure rate and audiometric outcomes.
A total of 121 patients underwent the procedure, of whom 21 had bilateral sequential procedures (total 142 ears). Average age was 51.1 ± 18.4 years (range, 3-78 years). The size of perforation was <25% of TM in 39 (27.5%) ears, 25% to 50% of TM in 49 (34.55%) ears, 50% to 75% of TM in 34 (23.91%) ears, and 75% to 100% of TM in 20 (14.10%) ears. Complete perforation closure was evident in 130 (91.55%) of the 142 ears. Preoperative mean air conduction threshold was 59.3 dB (17-95 dB) and significantly improved into 35.6 dB (10-85 dB; < .0004) after surgery. Preoperative air-bone gap was 30.2 dB (5-70 dB) and also significantly improved into 10.2 dB (5-65 dB; < .0001) after surgery.
In office fat graft myringoplasty, in adult and pediatric patients with variable perforation sizes, is a well-tolerated procedure with very satisfactory clinical results.
评估在门诊局部麻醉下进行脂肪移植鼓膜成形术的临床和功能结果。
前瞻性病例系列。
三级医疗设施。
2005年12月至2019年6月期间出现鼓膜穿孔的患者。纳入标准包括穿孔大小>鼓膜紧张部表面的25%，通过经耳道视图可看到整个穿孔边缘，且在6个月随访时无自发闭合。排除标准为存在胆脂瘤、鼓室黏膜呈湿润外观、术前3个月有耳漏或听骨链不一致的体征。
在门诊局部麻醉下进行脂肪移植鼓膜成形术。
完全穿孔闭合率和听力测量结果。
共有121例患者接受了该手术，其中21例进行了双侧序贯手术（共142耳）。平均年龄为51.1±18.4岁（范围3 - 78岁）。穿孔大小<鼓膜25%的有39耳（27.5%），25%至50%的有49耳（34.55%），50%至75%的有34耳（23.91%），75%至100%的有20耳（14.10%）。142耳中有130耳（91.55%）实现了完全穿孔闭合。术前平均气导阈值为59.3 dB（17 - 95 dB），术后显著改善至35.6 dB（10 - 85 dB；P <.000４）。术前气骨导差为30.2 dB（5 - 70 dB），术后也显著改善至10.2 dB（5 - 65 dB；P <.0001）。
对于穿孔大小各异的成年和儿童患者，门诊脂肪移植鼓膜成形术是一种耐受性良好且临床效果非常令人满意的手术。
