Hyaluronic acid ester in myringoplasty

Abstract

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

Comparison of Hyaluronic Acid Fat Graft Myringoplasty, Fat Graft Myringoplasty and Temporal Fascia Techniques for the Closure of Different Sizes and Sites of Tympanic Membrane Perforations

“…The liquid form of HA has been used in otologic practice for many years [13][14][15] . The solid polyester form is reabsorbed in eight weeks [13] .…”

“…TM has a distinct auto-reparative capacity that makes it different from other tissues' healing processes [13][14][15] . These processes include a continuous migration of the outer squamous epithelial layer toward the external ear canal and the absence of a supportive matrix under the regenerating epithelial layer of a perforation, which prevents the movement of reparative cells and nutrients into the perforation margins [13][14][15] .…”

“…Hyaluronic Acid EpiDisc® plays a key role by stimulating the migration of the epithelial cells over the fat tissue in the HAFGM technique, and it also prevents dehydration of the perforation margins [15] . The fat graft has potent revascularization activity.…”

“…Guneri et al [14] and Stenfors applied topical HA in their studies to show the positive effect of the material on the healing of acute traumatic TM perforations and showed some good results. Prior et al [15] used another material made of a solid polyester form of HA (Epifilm; Xomed Surgical Products, Sherbourne House Croxley Business Centre Watford, UK) for myringoplasty. However, they concluded that the repair of TM perforations with HA ester films alone is not recommended because the application failed in their first five patients [15] .…”

“…Prior et al [15] used another material made of a solid polyester form of HA (Epifilm; Xomed Surgical Products, Sherbourne House Croxley Business Centre Watford, UK) for myringoplasty. However, they concluded that the repair of TM perforations with HA ester films alone is not recommended because the application failed in their first five patients [15] . Saliba and Woods reported a new technique in 2008 combining fat graft myringoplasty (FGM) with the use of HA solid polyester form and reported better results compared with those of the temporalis fascia technique.…”