Myringoplasty: Comparing Fresh Porcine Submucosa with Rice Paper Patch

Philadelphia

Objective: To evaluate and compare the efficacy of freshly prepared porcine small intestine submucosa (SIS) with rice paper patch in the repair of large chronic tympanic membrane perforations. Materials and methods: Chronic tympanic membrane perforations were bilaterally produced in five adult chinchillas using a 3mm aural speculum and a myringoplasty knife for a total of 10 perforations. Each chinchilla was post-operatively monitored for five weeks to assess whether perforations spontaneously closed or became infected prior to surgical repair with myringoplasty. The left and right ear of each chinchilla was repaired with a rice paper patch onlay and freshly prepared porcine SIS graft, respectively. Results: One chinchilla was excluded from the study due to an ear infection, leaving four chinchillas for a total of 8 perforations. Four out of four (100%) myringoplasties performed with the fresh SIS xenograft remained healed after 5 weeks. Harvest of rice paper patch grafts demonstrated little healing and only one out of four (25%) ears showed TM epithelium under microscopic examination. Conclusion: The results and histological analysis indicate fresh SIS xenografts a practical alternative to rice paper patch for the repair of chronic tympanic membrane perforations.