Dataset Information

Bilayer Graft for Incisionless In-Office Endoscopic Repair of Tympanic Membrane Perforations: A Pilot Study.

ABSTRACT: Tympanic membrane (TM) perforations may result in significant patient morbidity. While intraoperative myringoplasty or tympanoplasty allow for effective repair, not all patients are candidates for general anesthesia. Herein, we describe a novel graft design and technique for in-office repair of TM perforations in the clinic setting. Two pieces of porcine submucosa material were interdigitated to create a bilayer design with lateral and medial flanges. Topical and injected lidocaine were used for local anesthesia. The perforation was rimmed. Grafts were grasped, and medial flanges were placed through the perforation, with lateral flanges resting on the TM surface. TM repair occurred in 5 awake patients with a mean age of 72 years. There were no complications. All perforations healed, with 1 case requiring a minor in-office revision. Audiometry was performed at 4 weeks. The preoperative air-bone gap (mean 0.25, 0.5, 1, 2, and 4 kHz) was 12.2 ± 4.1 dB, and postoperatively, it was 4.2 ± 2.4 dB (P = .001). Novel design of available graft material may allow for effective in-office TM repair.

SUBMITTER: Kozin ED

PROVIDER: S-EPMC6712757 | biostudies-literature | 2019 Jul-Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Bilayer Graft for Incisionless In-Office Endoscopic Repair of Tympanic Membrane Perforations: A Pilot Study.

Kozin Elliott D ED Lee Daniel J DJ Remenschneider Aaron K AK

OTO open 20190701 3

Tympanic membrane (TM) perforations may result in significant patient morbidity. While intraoperative myringoplasty or tympanoplasty allow for effective repair, not all patients are candidates for general anesthesia. Herein, we describe a novel graft design and technique for in-office repair of TM perforations in the clinic setting. Two pieces of porcine submucosa material were interdigitated to create a bilayer design with lateral and medial flanges. Topical and injected lidocaine were used for ...[more]

PMID: 31489397

Similar Datasets

Project description:PurposeInjury or inflammation of the middle ear often results in the persistent tympanic membrane (TM) perforations, leading to conductive hearing loss (HL). However, in some cases the magnitude of HL exceeds that attributable by the TM perforation alone. The aim of the study is to better understand the effects of location and size of TM perforations on the sound transmission properties of the middle ear.MethodsThe middle ear transfer functions (METF) of six human temporal bones (TB) were compared before and after perforating the TM at different locations (anterior or posterior lower quadrant) and to different degrees (1 mm, ¼ of the TM, ½ of the TM, and full ablation). The sound-induced velocity of the stapes footplate was measured using single-point laser-Doppler-vibrometry (LDV). The METF were correlated with a Finite Element (FE) model of the middle ear, in which similar alterations were simulated.ResultsThe measured and calculated METF showed frequency and perforation size dependent losses at all perforation locations. Starting at low frequencies, the loss expanded to higher frequencies with increased perforation size. In direct comparison, posterior TM perforations affected the transmission properties to a larger degree than anterior perforations. The asymmetry of the TM causes the malleus-incus complex to rotate and results in larger deflections in the posterior TM quadrants than in the anterior TM quadrants. Simulations in the FE model with a sealed cavity show that small perforations lead to a decrease in TM rigidity and thus to an increase in oscillation amplitude of the TM mainly above 1 kHz.ConclusionSize and location of TM perforations have a characteristic influence on the METF. The correlation of the experimental LDV measurements with an FE model contributes to a better understanding of the pathologic mechanisms of middle-ear diseases. If small perforations with significant HL are observed in daily clinical practice, additional middle ear pathologies should be considered. Further investigations on the loss of TM pretension due to perforations may be informative.

Dataset Information

Bilayer Graft for Incisionless In-Office Endoscopic Repair of Tympanic Membrane Perforations: A Pilot Study.

Publications

Bilayer Graft for Incisionless In-Office Endoscopic Repair of Tympanic Membrane Perforations: A Pilot Study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets