Hostname: page-component-6766d58669-bp2c4 Total loading time: 0 Render date: 2026-05-17T05:51:59.675Z Has data issue: false hasContentIssue false
  • English
  • Français

Comparison of the repair of permanent tympanic membrane perforations by hydrocolloidal dressing and paper patch

Published online by Cambridge University Press:  29 June 2007

Odd Spandow ,
Sten Hellström ,
Michael Dahiström  and
Lennart Bohlin
Odd Spandow*
Affiliation:
Department of Otorhinolaryngology. Umeá University Hospital, S-901 85 Umeå, Sweden
Sten Hellström
Affiliation:
Department of Otorhinolaryngology. Umeá University Hospital, S-901 85 Umeå, Sweden
Michael Dahiström
Affiliation:
Department of Otorhinolaryngology. Umeá University Hospital, S-901 85 Umeå, Sweden
Lennart Bohlin
Affiliation:
Department of Otorhinolaryngology. Umeá University Hospital, S-901 85 Umeå, Sweden
*
Dr O. Spandow, M.D., Ph.D., Department of Otolaryngology, Ume University Hospital, S-901 85 Ume, Sweden.
Get access Rights & Permissions [Opens in a new window]

Abstract

Thirty consecutive patients with permanent perforations of their tympanic membranes (TM) present from 2.5 to 50 years (mean 18.7 years) were admitted to a prospective study using two alternative methods of dressings for closure of the perforations. An adhesive-coated hydrocolloid material was compared with a conventional dressing of vaseline impregnated rice paper patch after de-epithelialization of the perforation border. Nine of the permanent TM perforations (30 per cent), five with the hydrocolloidal dressing and four with the rice paper patch had healed when followed-up after one year. The size of eight of the central perforations that had healed was equal to or less than 25 per cent of the TM. Also one perforation with a size of 65 per cent had healed. Seven perforations were located in the posterior part of the TM:Jour in the posterior-superior quadrant, one in the inferior quadrant, one had engulfed the posterior half of the TM and one included the anterior-inferior quadrant. Only two perforations out of 14, with a size of 25 per cent or less, located in the anterior-inferior quadrant, healed. No significant difference was demonstrated between the two types of dressings. Both groups noted an immediate improvement in hearing of 10.8 and 9.3 dB, respectively, after application of the dressing.

The study demonstrates that application of an occlusive dressing or paper patch in 30 per cent of patients can promote the healing of long-standing perforations. The chances for healing are better if the perforation is located in the posterior part of the TM. This simple technique immediately improved hearing and should be tried before a patient is referred for myringoplasty surgery.

Keywords

Tympanic membraneMyringoplasty

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 109 , Issue 11 , November 1995 , pp. 1041 - 1047
Copyright
Copyright © JLO (1984) Limited 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Alvarez, O., Mertz, P., Eaglstein, W. J. (1983) The effect of occlusive dressings on collagen synthesis and re-epithelialization in superficial wounds. Journal of Surgical Research 35: 142–148.CrossRefGoogle ScholarPubMed
Amoils, C. P., Jackler, R. K., Lustig, L. R. (1992) Repair of chronic tympanic membrane perforations using epidermal growth factor. Otolaryngology-Head and Neck Surgery 107: 669–683.CrossRefGoogle ScholarPubMed
Brockbank, M. J., Jonathan, D. A., Grant, H. R., Wright, A.(1988) Goode T-tubes: do the benefits of their use outweigh their complication? Clinical Otolaryngology 13: 351–356.CrossRefGoogle Scholar
Brown, G. L., Curtsinger, L., Jurkiewicz, M. J., Nahai, F., Schultz, G. (1991) Stimulation of healing of chronic wounds by epidermal growth factor. Plastic and Reconstructive Surgery 88: 189–194.CrossRefGoogle ScholarPubMed
Cherry, G. W., Ryan, T. J., McGibbon, D. (1984) Trial of a new dressing in venous leg ulcers. Practitioner 228: 1175–1178.Google ScholarPubMed
Deddens, A. E., Muntz, H. R., Lusk, R. p. (1993) Adipose myringoplasty in children. Laryngoscope 103: 216–219.CrossRefGoogle ScholarPubMed
Derlacki, E. L. (1973) Office closure of central tympanic membrane perforations: a quarter century of experience. Transactions of the American Academy of Ophthalmology and Otology 77: 53–66.Google ScholarPubMed
Dunlap, A. M., Schuknecht, H. F. (1947) Closure of perforations of tympanic membrane. Laryngoscope 57: 479–490.CrossRefGoogle ScholarPubMed
Fiebach, A., Matschke, R. G. (1987) Verweildauer und Komplikationen nach PaukenrOhrcheneinlage im Kindesalter. HNO 35: 61–66.Google Scholar
HellstrOm, S., Laurent, C., Schmidt, S-H., Spandow, O., Fellenius, E. (1989) Experimental tympanic membrane perforations: a model for studying wound healing? Effects of hyaluronic acid and hydrocortisone. In Cutaneous Development, Aging and Repair. (Abatangelo, G., Davidson, J. M., eds.), Vol. 18. Fidia Res Series, Liviana Press, Padua, pp 179–188.Google Scholar
Hellstrom, S., Spandow, O. (1994) Exogenous heparin. topically administered, aids the remodelling of connective tissue in the healing of experimental tympanic membrane perforations. Journal for Oto-Rhino-Laryngology and its Related Specialities 56: 45–50.CrossRefGoogle ScholarPubMed
Hermans, M. H. E., Hermans, R. P. (1986) DuoDERM®: an alternative dressing for smaller burns. Burns 12: 214–219.CrossRefGoogle ScholarPubMed
Karma, P., Sipila, M., Kokko, E. (1982) Long-term results of tympanostomy treatment in chronic secretory otitis media. Acta Oto-Laryngologica (Sweden) Suppl. 386: 163–165.CrossRefGoogle Scholar
Katz, D.. McGinley, K., Leyden, J. (1986) Semipermeable occlusive dressings. Effects on growth of pathogenic bacteria and re-epithelialization of superficial wounds. Archives of Dermatology 122: 58–62.CrossRefGoogle Scholar
Laurent, C., HellstrOm, S., Fellenius, E. (1988) Hyaluronan improves the healing of experimental tympanic membrane perforations: a comparison of preparations with different rheologic properties. Archives of Otolaryngology, Head and Neck Surgery 114: 1435–1441.CrossRefGoogle ScholarPubMed
Laurent, C., Siiderberg, O., Anniko, M., Hartwig, S. (1991) Repair of chronic tympanic membane perforations using application of hyaluronan or rice paper prostheses. Journal for Oto-Rhino-Laryngology and Its Related Specialities 53: 37–40.CrossRefGoogle ScholarPubMed
Lim, D. J.. Bluestone, C. D., Saunders, W. H., Senturia, B. H. (1980) Report of research conference: recent advances in otitis media with effusion. Definition and classification. Annals of Otology, Rhinology and Laryngology 89 (suppl. 69): 4–8.CrossRefGoogle Scholar
Lindeman, P., Edstrom, S., Granstrom, G., Jacobsson, S., von Sydow, C., Westin, T., Aberg, B. (1987) Acute traumatic tympanic membrane perforations. Cover or observe? Archives of Otolaryngology 113: 1285–1287.CrossRefGoogle ScholarPubMed
Rivas Lacarte, M. P., Casasin, T., Pumarola, F., Alonso, A. (1990) An alternative treatment for the reduction of tympanic membrane perforations: sodium hyaluronate. Acta Oto-Laryngologica (Sweden) 110: 110–114.CrossRefGoogle ScholarPubMed
Saarni, H., Hopsu-Havu, V. K. (1978) The decrease of hyaluronate synthesis by anti-inflammatory steroids in vivo. British Journal of Dermatology 98: 445–449.CrossRefGoogle Scholar
Spandow, O., Hellstrom, S., Schmidt, S-H. (1990) Hydrocortisone delay of tissue repair of experimental tympanic membrane perforations. Annals of Otology, Rhinology and Laryngology 99: 647–653.CrossRefGoogle ScholarPubMed
Spandow, O., Hellstrom, S. (1991) DuoDERM-platta - ett hydroaktivt fOrband vid behandling av trumhinneperforation. Societas Oto-Laryngologica Svecica 1: 64–65.Google Scholar
Stenfors, L. E. (1987) Treatment of tympanic membrane perforations with hyaluronan in an open pilot study of unselected patients. Acta Oto-Laryngologica (Sweden) 442: 81–87.CrossRefGoogle Scholar
Stenfors, L.-E. (1989) Repair of tympanic membrane perforations using hyaluronic acid: an alternative to myringoplasty. Journal of Laryngology and Otology 103: 39–40.CrossRefGoogle ScholarPubMed
Taylor, M., McMinn, R. M. H. (1967) Cytology of repair in experimental perforations of the tympanic membrane and its relationship to chronic perforations in man. Transactions of the American Academy of Ophthalmology and Otology 71: 802–812.Google ScholarPubMed
Turner, T. D. (1985) Semiocclusive and occlusive dressings. In An Environment for Healing: the Role of Occlusion. (Ryan, T. J., ed.), Royal Society of Medicine International Congress and Symposium Series, No. 88, London, pp 5–14.Google Scholar
Vartiainen, E., Nuutinen, J. (1993) Success and pitfalls in myringoplasty: follow-up study of 404 cases. American Journal of Otology 14: 301–305.Google ScholarPubMed
Weir, N. (1990) Otolaryngology: An Illustrated History. Butterworths, London, p 90.Google Scholar