Mahmoud F Mandour, Mohamed Tomoum, Mohamed N Elsheikh, Amani El-Gharib, Saad Elzayat, Maurizio Barbara, Valerio Margani, Haitham H Elfarargy, Mohamed Amer
{"title":"内窥镜脂肪移植耳廓成形术辅以透明质酸治疗大型鼓膜穿孔;一项前瞻性随机对比研究。","authors":"Mahmoud F Mandour, Mohamed Tomoum, Mohamed N Elsheikh, Amani El-Gharib, Saad Elzayat, Maurizio Barbara, Valerio Margani, Haitham H Elfarargy, Mohamed Amer","doi":"10.1111/coa.14252","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to assess the outcomes of fat graft myringoplasty augmented with hyaluronic acid in closing large-sized eardrum perforations compared to the traditional underlay cartilage-perichondrium composite myringoplasty (CPCM).</p><p><strong>Study design: </strong>It was a prospective randomised comparative study.</p><p><strong>Settings: </strong>It was held in tertiary referral institutions between May 2020 and April 2022.</p><p><strong>Participants: </strong>We included 100 patients with a large-sized eardrum perforation (50%-75% of the eardrum surface area). Using the endoscopic transcanal approach, 50 patients were managed by fat graft myringoplasty augmented with hyaluronic acid, while CPCM managed the other 50 patients.</p><p><strong>Main outcome measures: </strong>We evaluated the closure rates 1, 6 months and 1 year after surgery. Also, we assessed the audiological performance of the patients with a successful closure before and 1 year after the operation.</p><p><strong>Results: </strong>Fat graft myringoplasty operation was statistically shorter than the CPCM. The closure rate 1 year after surgery was 92% in the first group and 86% in the second group, without a statistically significant difference between both groups. Successful air-bone gap closure to less than 10 dB occurred in 93.5% of group A and 81.4% of group B without a statistically significant difference. The mean postoperative air-bone gap was 5.3 ± 3.95 dB in the first group and 7.95 ± 5.17 dB in the second group, with a statistically significant difference.</p><p><strong>Conclusions: </strong>Fat graft myringoplasty augmented with hyaluronic acid was a reliable, safe, simple, and effective manoeuvre to close large-sized eardrum perforations compared to the conventional CPCM.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7000,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Endoscopic Fat Graft Myringoplasty Augmented With Hyaluronic Acid for Managing Large-Sized Eardrum Perforations; A Prospective Comparative Randomised Study.\",\"authors\":\"Mahmoud F Mandour, Mohamed Tomoum, Mohamed N Elsheikh, Amani El-Gharib, Saad Elzayat, Maurizio Barbara, Valerio Margani, Haitham H Elfarargy, Mohamed Amer\",\"doi\":\"10.1111/coa.14252\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>We aimed to assess the outcomes of fat graft myringoplasty augmented with hyaluronic acid in closing large-sized eardrum perforations compared to the traditional underlay cartilage-perichondrium composite myringoplasty (CPCM).</p><p><strong>Study design: </strong>It was a prospective randomised comparative study.</p><p><strong>Settings: </strong>It was held in tertiary referral institutions between May 2020 and April 2022.</p><p><strong>Participants: </strong>We included 100 patients with a large-sized eardrum perforation (50%-75% of the eardrum surface area). Using the endoscopic transcanal approach, 50 patients were managed by fat graft myringoplasty augmented with hyaluronic acid, while CPCM managed the other 50 patients.</p><p><strong>Main outcome measures: </strong>We evaluated the closure rates 1, 6 months and 1 year after surgery. Also, we assessed the audiological performance of the patients with a successful closure before and 1 year after the operation.</p><p><strong>Results: </strong>Fat graft myringoplasty operation was statistically shorter than the CPCM. The closure rate 1 year after surgery was 92% in the first group and 86% in the second group, without a statistically significant difference between both groups. Successful air-bone gap closure to less than 10 dB occurred in 93.5% of group A and 81.4% of group B without a statistically significant difference. The mean postoperative air-bone gap was 5.3 ± 3.95 dB in the first group and 7.95 ± 5.17 dB in the second group, with a statistically significant difference.</p><p><strong>Conclusions: </strong>Fat graft myringoplasty augmented with hyaluronic acid was a reliable, safe, simple, and effective manoeuvre to close large-sized eardrum perforations compared to the conventional CPCM.</p>\",\"PeriodicalId\":10431,\"journal\":{\"name\":\"Clinical Otolaryngology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2024-11-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Otolaryngology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/coa.14252\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"OTORHINOLARYNGOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Otolaryngology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/coa.14252","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}
Endoscopic Fat Graft Myringoplasty Augmented With Hyaluronic Acid for Managing Large-Sized Eardrum Perforations; A Prospective Comparative Randomised Study.
Objectives: We aimed to assess the outcomes of fat graft myringoplasty augmented with hyaluronic acid in closing large-sized eardrum perforations compared to the traditional underlay cartilage-perichondrium composite myringoplasty (CPCM).
Study design: It was a prospective randomised comparative study.
Settings: It was held in tertiary referral institutions between May 2020 and April 2022.
Participants: We included 100 patients with a large-sized eardrum perforation (50%-75% of the eardrum surface area). Using the endoscopic transcanal approach, 50 patients were managed by fat graft myringoplasty augmented with hyaluronic acid, while CPCM managed the other 50 patients.
Main outcome measures: We evaluated the closure rates 1, 6 months and 1 year after surgery. Also, we assessed the audiological performance of the patients with a successful closure before and 1 year after the operation.
Results: Fat graft myringoplasty operation was statistically shorter than the CPCM. The closure rate 1 year after surgery was 92% in the first group and 86% in the second group, without a statistically significant difference between both groups. Successful air-bone gap closure to less than 10 dB occurred in 93.5% of group A and 81.4% of group B without a statistically significant difference. The mean postoperative air-bone gap was 5.3 ± 3.95 dB in the first group and 7.95 ± 5.17 dB in the second group, with a statistically significant difference.
Conclusions: Fat graft myringoplasty augmented with hyaluronic acid was a reliable, safe, simple, and effective manoeuvre to close large-sized eardrum perforations compared to the conventional CPCM.
期刊介绍:
Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with:
current otorhinolaryngological practice
audiology, otology, balance, rhinology, larynx, voice and paediatric ORL
head and neck oncology
head and neck plastic and reconstructive surgery
continuing medical education and ORL training
The emphasis is on high quality new work in the clinical field and on fresh, original research.
Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject.
• Negative/null results
In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.