Tympanic Membrane Perforation Repair with Acellular Porcine Submucosa

Spiegel, Jeffrey H.; Kessler, Joshua L

doi:10.1097/01.mao.0000169636.63440.4e

Cited by 56 publications

(37 citation statements)

References 11 publications

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“…Although thermal injury to the TM does create a chronic perforation, the histology of the perforated edge differs from that seen clinically 17. Given that we did not utilize the thermal technique, but a modification used successfully by others,20 we were only able to create two or three flaps instead of four because the TMs quickly lost tensile strength after the first incision and consequently became difficult to further manipulate. These variations may have contributed to our decreased incidence of chronic perforation but reflect the clinical situation since the majority of chronic perforations occur in the inferior/anterior quadrant of the pars tensa.…”

Section: Discussionmentioning

confidence: 99%

“…These characteristics make ECMs distinct from other sources used for TM repair. To our knowledge, only one other study has utilized an ECM, small intestinal submucosa (SIS), for TM perforation repair 20. Although SIS and UBM share many characteristics in the process of tissue remodeling, UBM is thought to provide an advantage in terms of epithelial cell repopulation due to the presence of an intact basement membrane 21…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Repair of the tympanic membrane with urinary bladder matrix

et al. 2009

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“…Recent reports demonstrate its successful use in laparoscopic inguinal hernia repair, para-oesophageal defect, diaphragmatic hernia and gastroschisis repair [8][9][10][11]. SIS has also been used for both tympanic membrane defects and nasal septum defect repairs [12,13]. Our own experience demonstrates that its usefulness in incisional hernia repair and both primary and revision diaphragmatic hernia repair in the paediatric population [14].…”

Section: Discussionmentioning

confidence: 94%

The novel use of small intestinal submucosal matrix for chest wall reconstruction following Ewing’s tumour resection

Murphy

Corbally

2007

Pediatr Surg Int

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Chest wall reconstruction following major tumour resection remains a challenging problem in the paediatric population due to the need for growth and development following the repair. Synthetic non-biodegradable grafts and materials have led to asymmetrical growth and significant functional and cosmetic compromise. The ideal graft material should be biological non-immunogenic which enables natural healing and facilitates further growth. Ewing's sarcoma is an uncommon primitive neuroectodermal tumour which rarely occurs in the ribs. However, recent improvements in management have produced a significantly improved survival; increasing the importance of chest wall reconstruction. We prospectively assessed the utilisation of Surgisis (an acellular collagen matrix) as a replacement graft in two children undergoing primary chest wall reconstruction following tumour resection. Surgisis is derived from porcine small intestinal submucosa (SIS) that serves as a template for tissue reconstruction and remodeling. The graft was well tolerated; there was no herniation and it allowed normal symmetrical chest movement and growth to occur. The properties of SIS allows natural collagen growth and compares favourably with marlex mesh and other forms of chest wall reconstruction. We believe its unique properties allow it to act as a suitable framework for chest wall reconstruction allowing chest wall growth and development.

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“…However, inflammation and residual scaffold remnants remain a problem. 47 Nevertheless, Surgisis has successfully achieved fascia regeneration between the graft and muscle, raising the possibility of repeat harvest of neofascia in revision cases. 46 The UBM scaffold consists of a mucosa and lamina propria after a decellularization process, providing an intact basement membrane scaffold for epithelial migration.…”

mentioning

confidence: 99%

Tissue Engineering of the Tympanic Membrane

Teh

Marano

Shen

et al. 2013

Tissue Engineering Part B: Reviews

120

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Tympanic membrane (TM) perforations are common, with current treatments for chronic perforations involving surgery, using various graft materials, from autologous cartilage or fascia through to paper patch. Recent research developments in this field have begun applying the principles of tissue engineering, with appropriate scaffolds, cells, and bioactive molecules (BMs). This has revolutionized the therapeutic approach due to the availability of a wide range of materials with appropriate compatibility and mechanical properties to regenerate the membrane acoustics and may also represent a paradigm shift in the management of TM perforations in an outpatient setting without surgery. However, many factors need to be considered in the fabrication of a bioengineered TM. This review discusses the issues associated with current treatment and examines TM wound healing relevant to the construction of a bioengineered TM. It also describes the tissue-engineering approach to TM regeneration by summarizing currently used scaffolds, BMs, and cells in TM wound healing. Finally, it considers the design of scaffolds, delivery of BMs, and cell engraftment toward potential clinical application.

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Tympanic Membrane Perforation Repair with Acellular Porcine Submucosa

Abstract: These results suggest that small intestine submucosa is a viable alternative to autologous and cadaveric grafts in tympanoplasty. A larger randomized study in humans is indicated to evaluate this material in clinical practice.

Cited by 56 publications

References 11 publications

Repair of the tympanic membrane with urinary bladder matrix

Repair of the tympanic membrane with urinary bladder matrix

The novel use of small intestinal submucosal matrix for chest wall reconstruction following Ewing’s tumour resection

Tissue Engineering of the Tympanic Membrane

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