Abstract
Objectives: To evaluate the indications, efficacy, and technique of transcanal transtympanic fat myringoplasty in pediatric patients.
Methods: Design: Retrospective setting in a private practice. Main outcome measures: Microscopic otoscopy and audiometric evaluations.
Results: Sixty-five outpatient fat myringoplasties were performed from 1994 to 2001 on 46 patients, aged 3 to 18 years. The average patient age was 9 years. The most common reasons for surgery were retained ventilation tubes longer than 3 years, persistent perforations after several sets of ventilation tubes, and recurrent ear infections from water contamination while swimming with tubes or perforations. Perforations were less than 25% of the tympanic membrane in size and were most frequently located in the anterior or inferior quadrants. Fat myringoplasty was combined with tympanoplasty in the contralateral ear in 6 patients and bilateral fat myringoplasties were performed in 9 patients. Hearing remained unchanged in nearly all patients. Two patients had persistent perforations postoperatively and one reperforated the eardrum 6 months after surgery. Seven ears developed middle ear effusions and seven patients developed tympanic membrane retractions. One patient required ventilation tube placement 1 year after surgery.
Conclusions: Transcanal transtympanic fat myringoplasty is a highly effective outpatient surgical modality with low morbidity for closing perforations of less that 25% of the tympanic membrane in pediatric patients.