Total tympanic membrane reconstruction: AlloDerm versus temporalis fascia.
OBJECTIVE
Patients who require surgery for chronic otitis media with perforation and cholesteatoma frequently provide no residual tympanic membrane that is usable in grafting procedures. A novel technique of total tympanic membrane reconstruction (TTMR) is described that maximizes perforation closure rate in these situations while minimizing mucosalization, incomplete healing, and anterior blunting. The specific aim of this report is to assess the safety and efficacy of TTMR and to compare the results obtained with AlloDerm compared with temporalis fascia as a grafting material.


METHODS
The records of 50 patients operated within the years 1999 and the 2004 were reviewed. TTMR with intact canal wall was performed in all cases. Both clinical and audiometric data were analyzed.


RESULTS
Overall perforation closure rate was 92%. There was no statistical significance in closure rate when grafting with AlloDerm versus temporalis fascia. A statistically significant shortened healing time was observed with AlloDerm grafting.


CONCLUSIONS
TTMR is a highly effective and safe technique.
Fishman
Andrew J
AJ
Department of Otolaryngology, New York University School of Medicine, New York University Medical Center, NY 10016, USA. andrew.fishman@med.nyu.edu
Marrinan
Michelle S
MS
Huang
Tina C
TC
Kanowitz
Seth J
SJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D003094:Collagen / Q000627:therapeutic use*; D005205:Fascia / Q000637:transplantation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009225:Myringoplasty / Q000379:methods*; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D017768:Skin, Artificial; D015607:Stents; D014184:Transplantation, Homologous; D014432:Tympanic Membrane / Q000601:surgery*; D018058:Tympanic Membrane Perforation / Q000601:surgery*; D014945:Wound Healing
C440568:Alloderm; D003094:Collagen