The Gelfoam® plug: An alternative treatment for small eardrum perforations

Abstract

Aim: To examine if a Gelfoam V R plug in combination with surgical removal of the perforation edges could be an alternative to the widely accepted fat plug treatment for smaller ear drum perforations.Materials and Methods: A prospective study of 17 consecutive patients with persistent small ear drum perforations considered for myringoplasty. The perforations were central perforations 2 to 4 mm in diameter. Patient ages ranged from 6 to 83 years, and the operation was performed under general anesthesia with mask ventilation in children and under topical local anesthesia in adults. A Gelfoam V R plug was inserted into the perforation after surgical removal of the perforation edges. The follow-up time was more than 3 months.Results: The closure rate of the ear drum was 83% (15/18). Pure tone average (PTA) was 19 dB preoperatively and 16 dB postoperatively.Conclusions: We show for the first time in humans that a Gelfoam V R plug in combination with surgical removal of the perforation edges seems to result in about the same closure rate as the fat plug technique in persistent small ear drum perforations. Moreover, the method using Gelfoam V R is simpler and faster than the fat plug technique. We suggest that randomized studies comparing the Gelfoam V R plug technique with the fat plug technique should be performed.

Healing of laser-induced tympanic membrane perforations in rats: No contribution of granulocyte colony-stimulating factor or Gelfoam®

“…It has been indicated that a Gelfoam 1 plug in minor myringoplasty surgery might have better results than using fascia or fat plugs [21] and that it is associated with shortened healing time in acute perforations [22]. After application of Gelfoam 1 an infiltration of neutrophils, fibroblasts and an angiogenesis have been described in the surrounding tissue and matrix [19].…”

The perforation margin phenotypes and clinical outcome of traumatic tympanic membrane perforation with a Gelfoam patch: Our experience from a retrospective study of seventy‐four patients

“…Gelfoam patching was usually used to treat traumatic tympanic membrane perforations and chronic dry small perforations . However, in clinical outpatient setting, we observed that some perforations could heal rapidly while others failed to close.…”

“…It is well known that the patch serves as a scaffold to guide migrating epithelium to close the eardrum perforation. Gelfoam is frequently utilised in otology because of its convenience in outpatient setting, but it is associated with varying clinical outcomes as some perforations heal rapidly while others fail to close and stay patent …”

Closure of Small Central Perforations of Tympanic Membrane With Gelfilm Patch and Application of Platelet Rich Plasma Versus Chemical Cauterization: A Comparative Study

“…[9] The functioning of several potential synthetic biodegradable eardrum grafts and non-degradable, microporous eardrum grafts was examined by Feenstra et al, both visually and histologically in experimental studies with animals. [10] In 2011, Nicklasson et al conducted a study of Gelfoam plug after freshening of TM, providing a success rate of 83%. [11] In 1992, Baldwin and Loftin conducted 115 cases of Gelfilm myringoplasty with an interlocking Gelfilm stent and obtained 94% closure.…”