title: New perspectives in myringoplasty.
abstract: Until 1950 the treatment of a perforated eardrum consisted of covering the drum permanently with artificial material. Since then a surgical technique to establish a functional reconstruction of the eardrum was developed (myringoplasty). A survey of the biological grafting materials used in this technique is given. Biodegradable and non-degradable synthetic materials may prove to be a valuable supplement of the existing biological grafting materials. Artificial eardrums made from several biodegradable poly(alpha-hydroxy acids) and poly(alpha-amino acids) and made from a number of microporous poly(tetrafluorethylene) membranes and from a microporous bisphenol-A poly(carbonate) membrane were implanted into the ears of rats and dogs and as a reference subcutaneously. The implants were histologically examined for periods up to one year. From the biodegradable polymers studied poly(beta-benzyl-L-aspartate-co-L-leucine) 50/50 evoked the least tissue reaction and the newly formed eardrums were the best in terms of thickness and overall integrity. The formation of a reinforced eardrum may be accomplished by the support of an inert, very thin, highly porous poly(tetrafluoroethylene membrane) preferably implanted as a composite graft with a biodegradable polymer.
mesh_terms: D000818:Animals; D001559:Benzhydryl Compounds; D001672:Biocompatible Materials; D001673:Biodegradation, Environmental; D003094:Collagen; D003487:Cyanoacrylates; D004427:Ear Diseases / Q000601:surgery; D005205:Fascia / Q000637:transplantation; D049670:History, 17th Century; D049671:History, 18th Century; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D007773:Lactates; D019344:Lactic Acid; D008567:Membranes, Artificial; D008855:Microscopy, Electron, Scanning; D009225:Myringoplasty / Q000266:history / Q000379:methods; D010455:Peptides; D011091:Polyesters; D011100:Polyglycolic Acid; D011108:Polymers; D011138:Polytetrafluoroethylene; D011142:Polyvinyl Alcohol; D019736:Prostheses and Implants; D013997:Time Factors; D014180:Transplantation; D014432:Tympanic Membrane / Q000033:anatomy & histology / Q000293:injuries / Q000502:physiology; D000098826:Bisphenol A Compounds; D000098827:Polycarbonates
chemical_list: D001559:Benzhydryl Compounds; D001672:Biocompatible Materials; D003094:Collagen; D003487:Cyanoacrylates; D007773:Lactates; D019344:Lactic Acid; D008567:Membranes, Artificial; D010455:Peptides; D011091:Polyesters; D011100:Polyglycolic Acid; D011108:Polymers; D011138:Polytetrafluoroethylene; D011142:Polyvinyl Alcohol; C028237:bisphenol-A-polycarbonate; D000098826:Bisphenol A Compounds; D000098827:Polycarbonates; C029932:poly(methyl cyanoacrylate); C027819:polyleucine; C033141:poly-beta-benzyl-aspartate; C033616:poly(lactide)