How is a fat-plug tympanoplasty used to treat tympanic membrane perforation (TMP)?

Updated: Dec 14, 2020
  • Author: Robert A Saadi, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Another in-office treatment, a fat-plug tympanoplasty, is performed by obtaining a small plug of fat from the ear lobe, with the patient under local anesthesia (although this procedure may also be performed under general anesthesia). The TMP is prepared by anesthetizing its margins with carefully applied phenol solution. Next, the edges are mechanically debrided with microcup forceps. The fat is then tucked into the perforation, extending both into the canal and into the middle ear space. It is important to retract the fat slightly to prevent the edges of the perforation from growing inward to the middle ear and to avoid the formation of a cholesteatoma. The success rate is similar to paper patch but inferior to more formal tympanoplasty; moreover, it is dependent on the location of the perforation. [5]

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