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Homograft transplants to the middle ear. A follow‐up report
Author(s) -
Glasscock Michael E.,
House William F.,
Graham Malcolm
Publication year - 1972
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1288/00005537-197205000-00014
Subject(s) - tympanoplasty , medicine , ossicles , surgery , middle ear
Abstract In April, 1967, we performed our first transplant of a homograft tympanic membrane in a case of chronic ear disease. This work was presented in a “Preliminary Report” in January, 1968. The purpose of this paper is to give our experience (almost five years) with this technique of tympanoplasty. Our initial investigation was fraught with many difficulties. At the beginning of the project there were no clear cut legal priorities for obtaining and using cadaver material. No specific or generally accepted preservation solution was available, and the best method of storage was yet to be determined. The aim of the series was to develop a method of grafting the drum in patients with chronic ear disease. In addition, it was our hope that by incorporating the intact ossicles as well we would be able to increase the hearing in those difficult cases in which all ossicular remnants had been destroyed. While our original results were encouraging, the long term evaluation has been somewhat disappointing. The overall take rate for the drums has dropped to 65 percent. Hearing results are approximately the same as for any standard tympanoplasty procedure, no worse, but certainly no better. Since the beginning of our series other investigators have begun to use the technique with considerable more success. Perkins has been able to raise the take rate to 90 percent (acceptable) by using a buffered Formalin solution. The passage of the Uniform Donor Act has made homograft tissues more available and opened the way for the new national ear bank programs. While our experience has been disappointing, we feel we did help to stimulate interest in this procedure and that many of our failures have since been corrected by other investigators. We feel the future is good for homograft transplants to the middle ear and will continue to improve on our own techniques as well as those of others.