The purpose of closure of small dry tympanic membrane
perforations is to restore the continuity of the tympanic membrane in order to
improve hearing and decrease the incidence of middle ear infections. Small and
cost effective procedures like Chemical Cauterization and Fat Plug
Myringoplasty have been found to be effective in healing small central
perforations with significant hearing improvement. A study was carried out in 69
patients with central perforations in the Department of ENT, Gauhati Medical
College & Hospital for the duration of 1 year from August 11 to
July 12. Out of 69 patients, 36 underwent Chemical Cauterization and 33 Fat
Plug Myringoplasty. Pre-and post-operative hearing assessments of each
patient were done and statistically analyzed. The success rate was found to be
83.33% and 90.9% respectively. In both groups, there was
statistically significant hearing improvement with a P value 0.01. From our study, it was found
that the two procedures are simple, reliable and also lessened the morbidity of
the patient. Thus we recommend the use of these two official procedures for the
treatment of central perforations of tympanic membrane less than 5 mm.
References
[1]
U. Chalishazar, “Fat Plug Myringoplasty,” Indian Journal of Otolaryngology and Head Neck Surgery, Vol. 57, No. 1, 2005, pp. 43-44.
[2]
J. C. Ringerberg, “Closure of Tympanic Membrane Perforations by the Use of Fat,” Laryngoscope, Vol. 88, No. 6, 1978, pp. 982-993. http://dx.doi.org/10.1288/00005537-197806000-00010
[3]
W. R. Wilde and A. Hewson, “Practical Observations on Aural Surgery and the Nature and Treatment of Diseases of the Ear,” Blanchard & Lea, Philadelphia, 1853, pp. 292-293.
[4]
S. Jadia, et al., “Office Procedure for the Management of Central Perforation: A Comparative Study,” Indian Journal of Otology, Vol. 16, 2010, pp. 5-9.
[5]
E. L. Derlacki, “Office Closure of Central Tympanic Membrane Perforation: A Quarter Century Experience,” Transactions of the American Academy of Ophthalmology, Vol. 77, 1973, pp. 53-56.
[6]
E. Dursun, et al., “Comparison of Paper Patch, Fat and Perichondrium Myringoplasty in Repair of Small Tympanic Perforations,” Otolaryngology Head Neck Surgery, Vol. 138, No. 3, 2008, pp. 353-356. http://dx.doi.org/10.1016/j.otohns.2008.01.003
[7]
R. Landsberg, G. Fishman, A. DeRowe, E. Berco and G. Berger, “Fat Graft Myringoplasty: Results of a LongTerm Follow-Up,” Journal of Otolaryngology, Vol. 35, No. 1, 2006, pp. 44-47. http://dx.doi.org/10.2310/7070.2005.4124
[8]
N. C. Goldman, “Chemical Closure of Chronic Tympanic Membrane Perforations,” ANZ Journal of Surgery, Vol. 77, No. 10, 2007, pp. 850-851. http://dx.doi.org/10.1111/j.1445-2197.2007.04256.x
[9]
L. F. Scaramella, et al., “Effectiveness in Non-Surgical Office Closure of Tympanic Membrane Pars Tensa Perforations,” Ear, Nose and Throat Journal, Vol. 81, No. 8, 2002, pp. 556-560.
[10]
I. H. Udaipurwala, et al., “Efficacy of Fat-Plug Myringoplasty in Small and Dry Perforation of Pars Tensa,” Medical Channel, Vol. 16, No. 1, 2010, pp. 62-64.
[11]
K. S. Uppal, et al., “Closure of Tympanic Membrane Perforations by Chemical Cautery,” IJO & HNS, Vol. 49, No. 2, 1997, pp. 151-153.
