title: Intravital staining with methylene blue in tympanoplasty.
abstract: Objective of the study is to investigate usefulness of the methylene blue staining for the operation of tympanoplasty in surgical training process with randomized, controlled trial. Two hospitals were involved: Department of Otolaryngology, Assaf Harofeh Medical Center, and Department of Otolaryngology Head and Neck Surgery, Soroka University Medical Center. Tympanoplasty with graft placement was performed by young surgeons on 30 patients (30 ears) with anterior perforations using intraoperative staining of tympanoplasty grafts with methylene blue (Group 1). The same number of patients/ears was operated by the young surgeons without intraoperative staining (Group 2). 76 patients operated without staining by experienced surgeons served as a control group. Results showed tympanic membrane healing (graft take) in 30 (100%) cases in Group 1 and in 26 (86.66%) cases in Group 2. The pure-tone audiogram testing revealed significant improvement of hearing in all successful cases (p < 0.05). No side immediate or postponed effects were detected. We conclude that intravital staining with methylene blue in tympanoplasty simplifies the operation and could assist in better visualization and proper placement of the graft. This technique could be most useful in a training process for resident surgeons.
authors.affiliation: Department of Otolaryngology, Assaf Harofeh Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. vaimed@yahoo.com
authors.forename: Michael
authors.initials: M
authors.lastname: Vaiman
authors.forename: Shlomo
authors.initials: S
authors.lastname: Sarfaty
authors.forename: Haim
authors.initials: H
authors.lastname: Gavriel
authors.forename: Moshe
authors.initials: M
authors.lastname: Kraus
authors.forename: Daniel
authors.initials: D
authors.lastname: Kaplan
authors.forename: Max
authors.initials: M
authors.lastname: Puterman
mesh_terms: D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D015331:Cohort Studies; D006085:Graft Survival / Q000502:physiology; D006314:Hearing Loss, Conductive / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D006801:Humans; D008751:Methylene Blue; D009225:Myringoplasty / Q000379:methods*; D011183:Postoperative Complications / Q000175:diagnosis; D016378:Tissue Transplantation; D014432:Tympanic Membrane / Q000473:pathology; D018058:Tympanic Membrane Perforation / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*
chemical_list: D008751:Methylene Blue