ORIGINAL ARTICLES   

Otorinolaringologia 1998 December;48(4):145-50

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: Italian

Tympanic membrane repair with hyaluronic-acid. Personal technique

Guastella C., Borsi C., Gibelli S., Klinger F., Mantovani M.

Università degli Studi - Milano I Clinica ORL (Direttore: Prof. A. Ottaviani) Ospedale Maggiore IRCCS - Milano

Background. Tympanic membrane laceration is anything but rare in every-day ENT practice. Hyaluronic-acid has been recently shown to be an effective tool for tympanic membrane reconstruction.
Methods. Forty consecutive patients with tympanic membrane perforations (31 traumatic and 9 due to chronic otitis) have been treated with hyaluronic-acid through a four steps procedure:
l) trimming of the edges of tympanic membrane perforation under local anesthesia;
2) insertion of Spongostan® pieces into middle ear;
3) covering of both sides of tympanic membrane perforation with preshaped hyaluronic-acid sheets in order to seal the hole;
4) medication of external auditory canal.
Postoperative treatment required removal of the external canal medication after seven days from surgery, followed by hyaluronic-acid instillation, twice a day, for further seven days (performed by the patient).
Results and conclusions. Restitutio ad integrum was detected in 80% of patients treated with hyaluronic-acid, who also showed a full recovery of the auditory function. 15% of patients had a residual small tympanic membrane perforation with the evidence of on going reparative process.
The remaining 5% of patients did not show any improvement.