The Efficiency of Endoscopic Fat Myringoplasty under Local Anesthesia

Abstract

Background: Myringoplasty is one of the most common surgical operations in the field of otology, and is known to have good outcomes. Endoscopic fat myringoplasty (EFM) is simple, safe, and cost-effective for the closure of eardrum perforations.
Objectives: To evaluate the success rate of EFM to close small and moderate-sized tympanic perforations under local anesthesia.
Materials and Methods: This retrospective study was conducted at 2 hospitals: Al Hussein Teaching Hospital, Karbala, and Al-Ramadi Teaching Hospital, Anbar, Iraq. This project covered the period from January 2015 until October 2019. Patients were selected for the presence of central dry small- and moderate-sized eardrum perforations for over 6 months either due to traumatic or infective causes. The success rate, including healthy grafts and hearing improvement was carefully analyzed.
Results: There were 63 ears in 59 patients subjected to EFM. After 6 months of dealing with a perforation, the success rate of graft-taking by EFM was 92.1% (58 out of 63). There was no statistical difference in success rate in terms of age, gender, cause, site, and size of the perforation: P Value > 0.05.
The mean air-bone gap was significantly improved from 12.71 Db ± 2.275 preoperatively to 9.40dB±1.819 at 6 months after surgery: P-Value < 0.05.
Conclusion: EFM can be considered the treatment of choice to repair uncomplicated small- and medium-sized tympanic membrane perforations under local anesthesia. Further study is recommended for a more comprehensive evaluation.