Analysis of Effect of Eggshell Membrane Patching for Moderate-to-Large Traumatic Tympanic Membrane Perforation

Abstract

Background and ObjectivesTo evaluate the effect of eggshell membrane (ESM) patching for tympanic membrane (TM) perforation, and to investigate correlations between healing time and age, gender, patching time, perforation size, and perforation location.Subjects and MethodsOne hundred and seventy-five patients diagnosed with traumatic TM perforation at the Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Ansan Hospital, between January 2008 and October 2013. Patients were divided into two groups, according to perforation edge approximation or ESM patching treatment. Healing time was compared between the group that received perforation edge approximation and the group that received ESM patching. Perforation grade, age, onset, and location were also compared between the two groups.ResultsESM patching significantly improved healing time compared to spontaneous healing, especially in patients with moderate or large traumatic TM perforations (≥grade II). However, patient age, gender, perforation location, and especially timing of procedure, did not significantly affect healing time.ConclusionsESM patching can be a good treatment choice to promote tympanic membrane healing in large traumatic TM perforations.

The effects of everted or inverted edges on healing of traumatic-induced tympanic membrane perforations

“…5–7 Early edge approximation has been reported to restore the original anatomy and reduce the perforation size, thereby facilitating the healing process and shortening the closure time of traumatic tympanic membrane perforations. 6–9 However, in the present study, the closure rate was not significantly different between edge approximation subgroup A (reversed edge of more than 50 per cent of the total perforation), edge approximation subgroup B (reversed edge of less than 50 per cent of the total perforation) and the spontaneous healing group. In addition, the closure time was not significantly different between edge approximation subgroups A and B, and there was no significant correlation between the healing outcome and the reversed edge area.…”

“…Some research groups have suggested that early edge approximation facilitates eardrum healing and shortens closure time. 5–9 However, there have been no previous detailed studies on the correlation between healing outcome and the size of the everted or inverted edge. Typically, barotraumas in peacetime are caused by a slap or the impact of a fist on the ear.…”

3D printing‐assistedcombinatorial approach for designing mechanically‐tunable and vascular supportive nanofibrous membranes to repair perforated eardrum

“…Because previous study reported that eggshell membrane presented an excellent healing effect for tympanic membrane defect and healing time was significantly shorter in the eggshell membrane patch. 5…”

“…However, there are many disadvantages associated with the conventional treatment modality, which involves cost, risk, defective donor sites, and the inconvenience of an operation. 5 Therefore, a type of noninvasive treatment, such as TM patch application, is usually selected as initial treatment. A variety of autografts, allografts and xenografts, such as paper patch, eggshell membrane, fascia temporalis, tragus perichondrium, acellular dermal allograft, are a few established options for treating TM perforations [5][6][7][8][9] (Figure 1).…”

“…5 Therefore, a type of noninvasive treatment, such as TM patch application, is usually selected as initial treatment. A variety of autografts, allografts and xenografts, such as paper patch, eggshell membrane, fascia temporalis, tragus perichondrium, acellular dermal allograft, are a few established options for treating TM perforations [5][6][7][8][9] (Figure 1). However, additional incisions are required during the operation to harvest these materials, such as fascia temporalis, that is considered as the "best available choice", which increases patient suffering and the risk of postoperative infection.…”