Endoscopic observation of different repair patterns in human traumatic tympanic membrane perforations

Huang, Peng; Zhang, Shujun; Gong, Xinghong; Wang, Xuesong; Lou, Zihan

doi:10.1016/j.bjorl.2017.06.011

Cited by 8 publications

(8 citation statements)

References 29 publications

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“…Multiple publications evaluated the use of gelatin‐containing material, which included the terms gelatin sponge, gelatin film, and Gelfoam/Gelfilm (Pfizer, New York, NY) 12,38–46 . The sole study on gelatin film was excluded, as the tympanoplasty procedure included ossiculoplasty 47 .…”

Section: Resultsmentioning

confidence: 99%

“…14,37 Gelatin: Gelatin Sponge Multiple publications evaluated the use of gelatincontaining material, which included the terms gelatin sponge, gelatin film, and Gelfoam/Gelfilm (Pfizer, New York, NY). 12,[38][39][40][41][42][43][44][45][46] The sole study on gelatin film was excluded, as the tympanoplasty procedure included ossiculoplasty. 47 This resulted in a total of 511 adult and pediatric cases, in which 21.1% of perforations were grade 1, whereas the remaining 78.9% of perforations were grade 2 or higher.…”

Section: Patching Materials: Paper Patchmentioning

confidence: 99%

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A Systematic Review of Nonautologous Graft Materials Used in Human Tympanoplasty

et al. 2020

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Objectives Nonautologous graft materials may solve several dilemmas in tympanoplasty by obviating the need for graft harvest, facilitating consistent wound healing, and permitting graft placement in the clinical setting. Prior studies of nonautologous grafts in humans have shown variable outcomes. In this systematic review, we aim to 1) summarize clinical outcomes and 2) discuss limitations in the literature regarding nonautologous grafts for tympanoplasty in humans. Methods A literature review was performed using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) recommendations. The study size, etiology and duration of perforation, type of nonautologous graft, and postoperative closure rate were assessed. Results The PRISMA approach yielded 61 articles, including 3,247 ears that met inclusion criteria. Studies evaluated nonautologous grafts including paper patch, gelatin sponge, growth factors, porcine small‐intestinal submucosa, among others. Traumatic perforations (62.3%) were most commonly studied, whereas postinfectious perforations (31.9%) and other etiologies (5.8%) comprised a minority of cases. Acute perforations of <8 weeks duration constituted just over half of all treated ears. Overall closure rate was 82.1%, with significantly higher closure rates in acute (89.9%) versus chronic perforations (64.9%, P < .01), regardless of material. A median postoperative air‐bone gap of 5.6 dB was found in the 23% of studies reporting this metric. Conclusions The majority of publications reviewing nonautologous materials in tympanoplasty evaluate acute or traumatic perforations, and few rigorously report hearing outcomes. Given available data, porcine submucosa and basic fibroblast growth factor may hold promise for chronic perforation closure. Future studies should report closure rates and hearing outcomes in perforations >8 weeks duration. Laryngoscope, 131:392–400, 2021

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Section: Resultsmentioning

confidence: 99%

Section: Patching Materials: Paper Patchmentioning

confidence: 99%

A Systematic Review of Nonautologous Graft Materials Used in Human Tympanoplasty

et al. 2020

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“…10 The small perforations have better closure rates and close earlier as expected. 2 Park et al evaluated 87 patients who had 50% or even larger perforations and compared the steri-strips, paper patches, and spontaneous closure. 3 They found that steri-strips and paper patches had closed earlier however closure rates were not statistically significant among the 3 groups.…”

Section: Discussionmentioning

confidence: 99%

“…7 Huang et al compared the spontaneous closure and the gelfoam patches in 107 patients and found higher closure rate (94.5%) in the gelfoam patch-treated group than the spontaneously healing group (90.4%), however difference was not statistically significant. 2 Vivosorb is a copolymer consisting of poly (lactic acid) and of poly (e-caprolactone) (PCL). Since they have hydrophilic structures, PCL membranes allow the passage of water which is required for the transport of metabolites from the nutritional control and environmental recovery tissues.…”

Section: Discussionmentioning

confidence: 99%

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Histological Study of The Healing of Traumatic Tympanic Membrane Perforation After Vivosorb and Epifilm Application

et al. 2019

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Background: Untreated traumatic tympanic membrane perforations (TMPs) may lead to permanent perforations and hearing loss. There are many materials that have been previously used for repairing the TMPs. Aims and Objectives: The purpose of this study is to evaluate the clinical and histological effects of Vivosorb (Vv) and Epifilm on healing of TMPs in a rat model. Material and Methods: The posterior-inferior quadrant of the tympanic membranes (TMs) in right ears of 14 rats was perforated using a 20-g needle and then the animals were randomly divided into 2 equal groups (n = 7). The perforated right TMs were treated with either Vv (Vv group) or Epifilm (Ep group). The left TMs of 7 rats were perforated in same way and allowed to close spontaneously without any topical material applications (spontaneous closure group as sham control, SC). The left tympanic membranes of the other 7 rats were not perforated and used as normal controls (NC group). On postoperative 15th day, tympanic bullas were extracted from killed rats and examined morphometrically and histopathologically. Results: Perforation closure rate was 85.7% (6/7) in both Vv and SC groups. Perforations of Ep group closed in 7/7 (100%) ears. The thicknesses of the perforated membranes were increased in SC and especially Vv groups. Also, connective tissue fibrosis, blood clots, and epithelial degenerations were detected in SC and Vv groups. The mean fibroblastic reaction scores of Vv, Ep, and SC groups were 2.14(+), 0.57(+), and 1.71(+) respectively, on comparison with NC group. The mean neovascularization score was 1.42(+) in Vv group, 0.14(+) in Ep group, and 0.57(+) in SC group. Conclusion and Significance: Vivosorb and especially Epifilm can improve the healing process in traumatic TMPs and additionally, Epifilm might be more preferred for the treatment of TMPs because of causing lesser fibrosis.

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To patch or not to patch acute isolated traumatic tympanic membrane perforations: a case series and systematic literature review

Duek

Oron

Handzel

et al. 2021

Eur Arch Otorhinolaryngol

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Endoscopic observation of different repair patterns in human traumatic tympanic membrane perforations

Abstract: In the regeneration of traumatic tympanic membrane perforations, Gelfoam patching not only plays a scaffolding role for epithelial migration, it also promotes edema and hyperplasia of granulation tissue at the edges of the perforation and accelerates eardrum healing.

Cited by 8 publications

References 29 publications

A Systematic Review of Nonautologous Graft Materials Used in Human Tympanoplasty

A Systematic Review of Nonautologous Graft Materials Used in Human Tympanoplasty

Histological Study of The Healing of Traumatic Tympanic Membrane Perforation After Vivosorb and Epifilm Application

To patch or not to patch acute isolated traumatic tympanic membrane perforations: a case series and systematic literature review

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