[Tympanoplasty with adipose tissue]. / Tympanoplastik mit autologem Fettgewebe.

ABSTRACT

BACKGROUND: Among other materials it is also possible to use autologous fat tissue for closing tympanic membrane perforations. In this study we have evaluated 44 consecutive myringoplasties with adipose tissue performed between 1999 and 2001. MATERIAL AND METHOD: The indications were residual microperforations following tympanoplasty with temporalis fascia or tympanic membrane perforations due to trauma or chronic otitis media simplex. Myringoplasty with fat tissue was performed as an outpatient procedure and took about 15 minutes. The adipose tissue was harvested from the posterior side of the ear lobe in local anaesthesia. After refreshing the borders of the tympanic membrane perforation with a micro hook, the adipose tissue was positioned into the perforation by using a handheld or fixed ear speculum. The graft was covered with a silk strip soaked with Garamycine ointment. In bigger perforations a bed of gelfoam was put into the tympanic cavity in order to avoid adhesions between the graft and the promontorium. RESULTS: A permanent healing of the tympanic membrane was achieved in 40 (91 %) out of the 44 patients. In 21 patients hearing improved between 5 -10 dB. Surgical complications did not occur. CONCLUSIONS: Our results indicate that transcanal myringoplasty with adipose tissue is a simple and minimally invasive method for closing small to medium sized tympanic membrane perforations.