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Hyaluronic acid ester in myringoplasty

Published online by Cambridge University Press:  21 December 2007

M Prior ,
N Gibbins ,
G John ,
S Rhys-Williams  and
P Scott
M Prior
Affiliation:
ENT Department, Derriford Hospital, Plymouth, UK
N Gibbins*
Affiliation:
ENT Department, Addenbrooke's Hospital, Cambridge, UK
G John
Affiliation:
ENT Department, Poole Hospital NHS Trust, UK
S Rhys-Williams
Affiliation:
ENT Department, Poole Hospital NHS Trust, UK
P Scott
Affiliation:
ENT Department, Poole Hospital NHS Trust, UK
*
Address for correspondence: Mr Matthew Prior, Consultant Otolaryngologist, ENT Department, Derriford Hospital, Plymouth PL6 8DH, UK. Fax: 01752 763299 E-mail: [email protected]
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Abstract

Objectives:

To investigate the use of a new technique to close persistent tympanic membrane perforations under general anaesthesia, in patients in whom this has previously been considered impractical.

Design:

Twenty patients aged 50 years and over were recruited. All had a persistent, symptomatic tympanic membrane perforation in at least one ear. Pre-operatively, an audiogram was performed and the tympanic membrane was assessed in order to establish the site and size of the perforation. Under general anaesthesia, the edges of the perforation were freshened and a sheet of Epifilm, trimmed to a size roughly 2 mm larger in diameter than the perforation, was tucked through the perforation. The ear was dressed appropriately. Patients were seen two weeks post-operatively in the out-patients department and reassessed.

Setting:

The study was based at Poole General Hospital, a District General Hospital.

Participants:

Twenty patients were recruited from the out-patients clinics of Poole Hospital ENT department.

Main outcome measures:

(1) closure of the perforation, as a percentage of the original size; (2) improvement of hearing, as an average across all frequencies, expressed in dB hearing level; and (3) presence or absence of discharge.

Results:

Five patients were operated upon and assessed six weeks post-operatively. The Epifilm had dissolved but the perforations remained the same size in all five patients. There were no other adverse effects. Pure tone audiometry at this stage was redundant. The study was subsequently aborted.

Conclusions:

The authors conclude that repair of tympanic membrane perforations with hyaluronic acid ester films is not to be recommended.

Keywords

Tympanic MembraneChronic Otitis MediaOtologic Surgical ProceduresMyringoplastyHyaluronic Acid
Type
Online Only Main Article
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 2 , February 2008 , e3
Copyright
Copyright © JLO (1984) Limited 2007

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References

1 Booth, J, ed. Scott-Brown's Otolaryngology, 6th edn. Oxford: Butterworth-Heinemann, 1997:4Google Scholar
2 Austin, DF, Shea, JJ. A new system of tympanoplasty using vein graft. Laryngoscope 1961;71:596–611CrossRefGoogle ScholarPubMed
3 Williamson, PA, Thomas, DM, Beasley, P. Posterior tragal perichondrium harvesting for myringoplasty. Clin Otolaryngol 1999;24:252–4CrossRefGoogle ScholarPubMed
4 Cross, CW, Bassila, M, Lazar, RH, Long, TE, Stagner, S. Adipose tissue plug myringoplasty techniques in children. Otolaryngol Head Neck Surg 1999;101:617–20Google Scholar
5 Inamoglu, M, Isik, AU, Acuner, O, Harova, G, Bahadir, O. Fat-plug and paper-patch myringoplasty in rats. J Otolaryngol 1999;27:318–21Google Scholar
6 Maeta, M, Saito, R, Nakagawa, F, Miyahara, T, Uno, K, Sonobe, N. A clinical comparison of orthodox myringoplasty and a simple method with fibrin glue. Journal of the Oto-Rhino-Laryngological Society of Japan 1998;101:1062–8Google Scholar
7 Sakai, N, Kokobun, T, Asai, T, Kurihara, H, Nishizawa, N, Matsushima, J et al. Simple in-office closure of small intractable tympanic membrane perforations after myringoplasty. Aurus Nasus Larynx 1997;24:43–6CrossRefGoogle ScholarPubMed
8 Puls, T. Myringoplasty: is molded collagen xenograft a valid alternative for fresh temporalis fascia? Acta Otorhinolaryngol Belg 1996;50:111–14Google Scholar
9 Sheehy, JL, Anderson, RG. Myringoplasty: a review of 472 cases. Ann Otol Rhinol Laryngol 1980;89:331–4Google Scholar
10 Somers, TH, Houben, V, Goovaerts, G, Govaerts, PJ, Offeciers, FE. Histology of the perforated tympanic membrane and its muco-epithelial junction. Clin Otolaryngol 1997;22:162–6Google Scholar
11 Rizer, FM. Overlay versus underlay tympanoplasty. Part II: the study. Laryngoscope 1997;107:26–36CrossRefGoogle ScholarPubMed
12 Doyle, JP, Schleuning, AJ, Echevarria, J. Tympanoplasty: should grafts be placed medial or lateral to the tympanic membrane? Laryngoscope 1992;82:1425–30CrossRefGoogle Scholar
13 Kotecha, B, Fowler, S, Topham, J. Myringoplasty: a prospective audit study. Clin Otolaryngol 1999;24:126–9Google Scholar
14 Xomed Surgical Products Inc. Epifilm Product Information. Watford, UK: Xomed Surgical Productions, 2001Google Scholar
15 Chauvin, K, Bratton, C, Parkins, C. Healing large tympanic membrane perforations using hyaluronic acid, basic fibroblast growth factor, and epidermal growth factor. Otolaryngol Head Neck Surg 1999;121:43–7CrossRefGoogle ScholarPubMed