title: Comparison of Hyaluronic Acid Fat Graft Myringoplasty, Fat Graft Myringoplasty and Temporal Fascia Techniques for the Closure of Different Sizes and Sites of Tympanic Membrane Perforations.
abstract: OBJECTIVE
  To compare the efficacy of three different myringoplasty techniques, namely hyaluronic acid fat graft myringoplasty (HAFGM), fat graft myringoplasty (FGM), and temporal fascia for the closure of different sizes and sites of tympanic membrane perforations.
  
  
  METHODS
  We retrospectively analyzed the medical records of patients who had undergone a type 1 tympanoplasty operation at our clinic between May 2007 and February 2013. The patients were divided into three groups depending on the patient's choice of technique as follows: Fat Graft Myringoplasty (FGM) (Group I), Hyaluronic Acid Fat Graft Myringoplasty (HAFGM) (Group II), and Temporalis Fascia (TF) (Group III). A total of 136 patients were included in the study, split in to the FGM (57 patients; 56.1% female; median age: 30 years), HAFGM (31 patients; 54.8 female; median age: 25 years), and TF (48 patients; 58.3% females; median age: 33 years) surgery technique groups.
  
  
  RESULTS
  The patients were further divided into two groups, depending on the size of the perforation (small and large), and into three groups, depending on its location (anterior, inferior, and central). None of techniques provided a significantly better success rate in terms of perforation location (p>0.05). Also, none of the techniques provided a significantly better success rate in terms of perforation size (p>0.05).
  
  
  CONCLUSIONS
  We propose using HAFGM for large perforations and FGM alone for small perforations. The TF technique is a successful and well-defined technique for tympanic membrane perforations; however, in our opinion, its technical difficulties make it a secondary choice, particularly for small-sized perforations.
authors.affiliation: Department of Ear Nose Throat, Bahçeşehir University School of Medicine, İstanbul, Turkey. taylangun@gmail.com.
authors.forename: Taylan
authors.initials: T
authors.lastname: Gün
authors.forename: Osman Fatih
authors.initials: OF
authors.lastname: Boztepe
authors.forename: Doğan
authors.initials: D
authors.lastname: Atan
authors.forename: Aykut
authors.initials: A
authors.lastname: İkincioğulları
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Dere
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005205:Fascia / Q000637:transplantation; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid; D008297:Male; D008875:Middle Aged; D009225:Myringoplasty / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D018058:Tympanic Membrane Perforation / Q000473:pathology / Q000601:surgery*; D055815:Young Adult
chemical_list: D006820:Hyaluronic Acid