Chemical closure of chronic tympanic membrane perforations.
BACKGROUND
The purposes of closing chronic dry perforations of the tympanic membrane are to improve hearing and prevent middle ear infections. Before the use of the operating microscope and improved instrumentation, tympanic membrane perforations were closed by application of chemicals or with a temporary patch. Today, although surgery is the treatment of choice, small dry perforations may be successfully closed by chemical means in an office setting.


METHODS
Twenty-eight of the 69 patients with chronic dry tympanic membrane perforations on the surgical waiting list at Hawke's Bay Regional Hospital, Hastings, New Zealand, underwent attempts at chemical myringoplasty. Two techniques were used: (i) cautery of the rim of the perforation with a silver nitrate bead on a metal probe and (ii) application of a urea ointment patch covering and overlapping the perforation.


RESULTS
Eighteen of the 28 patients (64%) treated by chemical means experienced closure of their tympanic membrane perforations. Successful closure was achieved in 26% of the patients on the waiting list during the 6-month period.


CONCLUSIONS
Chemical myringoplasty is not only of historical interest. It is an effective means of tympanic membrane closure in selected patients, thereby reducing the surgical waiting list and saving time and money for the patient, surgeon and hospital.
Goldman
Nelson C
NC
Department of Otolaryngology, University of Florida Health Science Center Jacksonville, Jacksonville, Florida 32209, USA. nelson.goldman@jax.ufl.edu
D000328:Adult; D002648:Child; D002908:Chronic Disease; D005500:Follow-Up Studies; D006309:Hearing; D006801:Humans; D009824:Ointments; D012835:Silver Nitrate / Q000627:therapeutic use; D016896:Treatment Outcome; D018058:Tympanic Membrane Perforation / Q000188:drug therapy* / Q000601:surgery*; D014508:Urea / Q000008:administration & dosage / Q000627:therapeutic use