Outcomes of Minimally Invasive Tympanoplasty: Fat Graft Myringoplasty

Document Type : Original


Department of Otorhinolaryngology, AIIMS Gorakhpur, India.



Fat tympanoplasty is repair of small dry tympanic membrane perforations using fat as graft material. It is a simple office procedure with minimal morbidity and manipulation of the middle ear.
Materials and Methods:
The present study was a prospective review of 60 patients who underwent fat tympanoplasty over the period of 15 months. In all the patients fat was harvested from ear lobule.
Patients were kept on follow up for 3 months and evaluated for graft uptake and hearing gain. 86.66% closure rate of tympanic membrane defect was achieved. Postoperative air conduction was 29.6 ± 5.3 while air bone gap was 13.2 ± 6.1.
The study concludes that fat plug myringoplasty is a simple, quick, less invasive method to repair small tympanic membrane defects.


Main Subjects

  1. cholesteatoma, Diseases of ear, nose, throat, head and neck surgery. 1st edition.2013: 20.
  2. Shambaugh and Glasscock. Surgery of the Ear. 1980. p. 411-412.
  3. Ringenberg JC. Fat graft tympanoplasty. Laryngoscope 1962;72:188-192.44–51.
  4. Kim DK, Park SN, Yeo SW, Kim EH, Kim JE, Kim BY, et al.Clinical efficacy of fat-graft myringoplasty for perforations of different sizes and locations. Acta Otolaryngol. 2011; 131:22-6. 
  5. Saliba I. Hyaluronic acid fat myringoplasty: how we do it. Clin Otolaryngol.2009;33(6):610-4.
  6. Fiorino F, Barbieri F. Fat graft  myringoplasty  after unsuccessful tympanic  membrane repair. Eur Arch Otorhinolaryngol. 2007; 264:1125-8.
  7. Hagemann M, Hausler R. Tympanoplasty with adipose tissue. Laryngorhinootologie. 2003; 82(6): 393-6.
  8. Liew L,Daudia A, Narula AA.Synchronous fat plug myringoplasty and tympanostomy tube removal in the management of refractory otorrhoea in younger    International journal of paediatric Otorhinolaryngology. 2002; 66:291-6.
  9. Ozgursoy OB, YorulmazI. Fat graft myringoplasty: a cost-effective but underused procedure. J Laryngol Otol. 2005; 119:277-9.
  10. Gross CW, Bassila M, Lazar RH, Long TE, Stagner S. Adipose plug myringoplasty: an alternative to formal myringoplasty techniques in children. Otolaryngol Head Neck Surg 1989;101:617–20.
  11. De S, Karkanevatos A, Srinivasan VR, Roland NJ, Lesser TH. Myringoplasty using a subcutaneous soft tissue graft. Clin Otolaryngol Allied Sci 2004; 29: 314-317.
  12. Kaddour HS. Myringoplasty under local anaesthesia: day case surgery. Clin Otolaryngol Allied Sci 1992; 17:567-568.
  13. Ringenberg JC. Closure of tympanic membrane perforations by the use of fat. Laryngoscope. 1978; 88: 982-93.
  14. Deddens AE, Muntz HR, Lusk RP. Adipose myringoplasty in children. Laryngoscope 1993; 103:216-9.
  15. Terry RM, Bellini MJ, Clayton MI, Gandhi AG. Fat graft myringoplasty- a prospective trial. Clin Otolaryngol Allied SCI 1998; 13:227-229.
  16. Al-qahtani B, Al Tuwajiri M, Al Mokhatrish M. Fat myringoplasty and its impact on the Hearing Mechanism of Middle Ear. Int J Otorhinolaryngol Clin 2015;7(3):138-140.
  1. Ambani KP, Gangwani RW, Bhavya BM, Vakhariya SD, Kataria AU. A comparative study between fat myringoplasty and temporalis fascia tympanoplasty in moderate to large central perforation of pars tension tympanic membrane. Int J Otorhinolaryngol Head Neck Surg. 2017 Oct; 3(4): 997-1001.
  2. Mahajan R, Mahajan N, Kour B. Fat graft myringoplasty: A clinical study and review of literature. Indian K Med Sci 2021; 73:340-2.
  3. Gangwani RW, Ambani KP, Vakharia SD, Bhavya BM, Kaatarkar AU. The efficacy of fat myringoplasty in small central perforation of pars tensa. Int J Otorhinolaryngol Head Neck Surg 2017; 3: 359-63.
  4. Kim DK, Park SN, Yeo SW, Kim EH, Kim JE, Kim BY, et al. Clinical efficacy of fat-graft myringoplasty for perforations of different sizes and locations. Acta Otolaryngol. 2011; 131:22-6.
  5. Gun T,Sozen T,Baztepe OF, Gur OE, Muluk NB, Cingi C. Influence of size and site of perforation on fat myringoplasty. Auris Nasus Larynx. 2014;41: 507-12.