{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T23:55:49Z","timestamp":1791330949925,"version":"4.3.1"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,11,10]],"date-time":"2024-11-10T00:00:00Z","timestamp":1731196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We aimed to assess the outcomes of fat graft myringoplasty augmented with hyaluronic acid in closing large\u2010sized eardrum perforations compared to the traditional underlay cartilage\u2010perichondrium composite myringoplasty (CPCM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>It was a prospective randomised comparative study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Settings<\/jats:title>\n                    <jats:p>It was held in tertiary referral institutions between May 2020 and April 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>We included 100 patients with a large\u2010sized eardrum perforation (50%\u201375% 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>We evaluated the closure rates 1, 6\u2009months and 1\u2009year after surgery. Also, we assessed the audiological performance of the patients with a successful closure before and 1\u2009year after the operation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fat graft myringoplasty operation was statistically shorter than the CPCM. The closure rate 1\u2009year after surgery was 92% in the first group and 86% in the second group, without a statistically significant difference between both groups. Successful air\u2010bone gap closure to less than 10\u2009dB occurred in 93.5% of group A and 81.4% of group B without a statistically significant difference. The mean postoperative air\u2010bone gap was 5.3\u2009\u00b1\u20093.95\u2009dB in the first group and 7.95\u2009\u00b1\u20095.17\u2009dB in the second group, with a statistically significant difference.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Fat graft myringoplasty augmented with hyaluronic acid was a reliable, safe, simple, and effective manoeuvre to close large\u2010sized eardrum perforations compared to the conventional CPCM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/coa.14252","type":"journal-article","created":{"date-parts":[[2024,11,10]],"date-time":"2024-11-10T19:58:28Z","timestamp":1731268708000},"page":"288-294","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Endoscopic Fat Graft Myringoplasty Augmented With Hyaluronic Acid for Managing Large\u2010Sized Eardrum Perforations; A Prospective Comparative Randomised Study"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2643-6502","authenticated-orcid":false,"given":"Mahmoud F.","family":"Mandour","sequence":"first","affiliation":[{"name":"Otorhinolaryngology Department, Faculty of Medicine Tanta University  Tanta Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0701-9444","authenticated-orcid":false,"given":"Mohamed","family":"Tomoum","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Department, Faculty of Medicine Tanta University  Tanta Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed N.","family":"Elsheikh","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Department, Faculty of Medicine Tanta University  Tanta Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amani","family":"El\u2010Gharib","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Department, Faculty of Medicine Tanta University  Tanta Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9477-2460","authenticated-orcid":false,"given":"Saad","family":"Elzayat","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Department, Faculty of Medicine Kafrelsheikh University  Kafrelsheikh Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Barbara","sequence":"additional","affiliation":[{"name":"Department of Neuroscience Mental Health and Sensory Organs, Sant Andrea University Hospital, Faculty of Medicine and Psychology, Sapienza University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerio","family":"Margani","sequence":"additional","affiliation":[{"name":"Department of Neuroscience Mental Health and Sensory Organs, Sant Andrea University Hospital, Faculty of Medicine and Psychology, Sapienza University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5303-2012","authenticated-orcid":false,"given":"Haitham H.","family":"Elfarargy","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Department, Faculty of Medicine Kafrelsheikh University  Kafrelsheikh Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Amer","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Department, Faculty of Medicine Tanta University  Tanta 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