Open AccessBilayer Graft for Incisionless In‐Office Endoscopic Repair of Tympanic Membrane Perforations: A Pilot Study
Author(s) -
Kozin Elliott D.,
Lee Daniel J.,
Remenschneider Aaron K.
Publication year - 2019
Publication title -
oto open
Language(s) - English
Resource type - Journals
ISSN - 2473-974X
DOI - 10.1177/2473974x19869911
Subject(s) - medicine , surgery , tympanoplasty , tympanic membrane perforation , myringoplasty , perforation , lidocaine , cholesteatoma , materials science , punching , metallurgy
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.