Ventilation Tube Removal: Indications for Paper Patch Myringoplasty

Pribitkin, Edmund A.; Handler, Steven D.; Tom, Lawrence W. C.; Potsic, William P.; Wetmore, Ralph F.

doi:10.1001/archotol.1992.01880050041010

Cited by 30 publications

(20 citation statements)

References 3 publications

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“…The success rate of procedure in our study is 91.2% which is similar to or better than that reported by various authors. 11,[14][15][16][17][18][19] However, our general success rate is lower than that reported by Lou et al 17 In their study, almost 98% of 504 cases with traumatic TM perforations were acute onset (within 1 month after a trauma), and a spontaneous healing rate of 89% cases was reported. In our study, all perforations with traumatic etiology healed well, whereas the ones in which the procedure failed had inflammatory etiology.…”

Section: Discussioncontrasting

confidence: 58%

Office myringoplasty by chemical cauterization and paper patching: a prospective study

Upreti

2018

Int J Otorhinolaryngol Head Neck Surg

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Background: Surgery for tympanic membrane perforation entails its own morbidity, risk of anesthesia, psychological trauma, along with long waiting periods for patients, especially in a tertiary care centre like ours. The purpose of this study was to evaluate outcomes of chemical cauterization and patching of perforation, performed as an office procedure in select cases.Methods: The study was conducted in a tertiary hospital from January 2016 to December 2017. The patients were selected based on the inclusion criteria, after thorough clinical assessment, examination under microscope and pure tone audiogram. All cases underwent cauterization of margins of perforation using 10% trichloroacetic acid (TCA), followed by patching with appropriately sized pre-sterilized cigarette paper patch. The patients were followed up weekly till the perforation was completely healed or till 12 weeks. If required, the procedure was repeated. Results: 68 cases were included in the study. Most common site of perforation was antero-inferior quadrant of pars tensa. Most common etiology was inflammatory. Number of applications ranged from 1 to 3. The procedure was successful in 62 cases (91.2%). All cases with traumatic perforation, residual perforation post-surgery and persistent perforation after grommet extrusion healed well. All 6 cases with treatment failure had inflammatory etiology, 4 involving postero-superior quadrant.Conclusions: In patients with small, central, dry perforation of tympanic membrane, chemical cauterization using TCA and paper patching can yield results comparable to that of surgery, while abating the morbidity and psychological trauma of surgery and saving time for both patient and doctor.

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Section: Discussioncontrasting

confidence: 58%

Office myringoplasty by chemical cauterization and paper patching: a prospective study

Upreti

2018

Int J Otorhinolaryngol Head Neck Surg

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“…Perforations can lead to pain, increased susceptibility to infection, cholesteatoma formation, nonphysiologic gas exchange, and tympanosclerosis, and contribute to conductive hearing loss. Small central TM perforations that do not heal may be reconstructed with a paper patch myringoplasty; however, the efficacy of this technique is questionable 9. After myringoplasty failure, autologous graft material is often utilized to surgically reconstruct the TM.…”

Section: Introductionmentioning

confidence: 99%

Repair of the tympanic membrane with urinary bladder matrix

et al. 2009

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Objectives/Hypothesis-To test urinary bladder matrix (UBM) as a potential treatment for tympanic membrane (TM) healing and regeneration.Study Design-This prospective pilot study was designed to provide both qualitative and semiquantitative assessment of temporal and spatial healing events in the chinchilla model of chronic TM perforations with and without UBM patching.Methods-Bilateral myringotomies were performed and repeated as necessary to create subtotal perforations over an 8-week period. Myringoplasty was then performed, with left TMs serving as controls and right TMs receiving UBM patches. TMs were excised at 4 weeks, 8 weeks, and 12 weeks. Fixed tissue samples were characterized for gross morphology, then processed for microscopic evaluation.Results-Chronic perforations were maintained with one or more repeated myringotomies. Although both control and patched TMs were thicker than native tissue, patched TMs were transparent and uniform in thickness without any inclusions. UBM patches were readily degraded and replaced by newly deposited and organized host tissue that recapitulated the native TM layers.Conclusions-UBM scaffolds were an effective biological scaffold for TM closure and tissue remodeling, leading to thicker than normal anatomy but otherwise normal morphology. Future studies are required to determine functional and temporal outcomes as well as alternative patch orientations. The results show particular promise as a superior alternative means of reconstructing not only chronic TM perforations but also dimeric TMs associated with retraction pockets and atelectasis.

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“…This is to act as a scaffold for the migration of epithelium and consequent closure of the defect. The materials used in previous studies have included silastic sheeting [12], gelfoam patching [13,20], gelfilm patching [6,13,20,23], gelfoam plug [14], steri-strip TM (3 M) or paper patching [5,6,[15][16][17][18][19], fat plug [6,21] and trichloroacetic acid [22]. The majority of these studies (see Table 1) were retrospective reviews and only one [12] was a randomised non-blinded controlled trial in which the incidence of persistent perforation was observed following freshening of the edges of the perforation and freshening of the edges with application of silastic sheeting to the defect.…”

Section: Resultsmentioning

confidence: 99%