Fat graft myringoplasty using umbilical fat

Background: Myringoplasty is a common procedure performed by otolaryngologists, particularly in the pediatric population. Tympanic membrane (TM) perforations can be caused by a variety of factors including retained tympanostomy tubes, infection and trauma. First described in 1878, myringoplasty has evolved to include many different materials for repair. Current materials used for myringoplasties include fascia, perichondrium, gelfoam, fat and paper. Multiple studies have looked at the success rates for these different materials. Fat graft myringoplasties in particular offer the advantage of a high success rate commonly reported in the range between 80% and 90%. Fat graft is classically harvested from ear lobe or post-auricular subcutaneous tissue. Purpose: In this study, we described the techniques and results of harvesting umbilical fat for the use in pediatric myringoplasty. Method: Twenty-eight cases of umbilical fat-graft myringoplasty performed between June 2008 and January 2011 was retrospectively reviewed and studied for rate of successful TM closure. Results: Average length of follow up was 8 months ranging from 3 months to 26 months. Overall rate for successful TM closure of 100% was achieved. Literature review was performed to compare our results with those of studies using auricular fat graft. Furthermore, a review of existing literature on various properties of fat graft was done to explain the potential advantages of using umbilical fat for myringoplasty. Conclusion: Fat patch myringoplasty using umbilical fat is a safe and successful procedure for TM repair. (C) 2012 Elsevier Ireland Ltd. All rights reserved.