Tympanoplasty without use of gelfoam in the middle ear

Introduction:  In usual technique of tympanoplasty almost all of otologic surgeons use gelfoam in the middle ear for support of graft against margin of tympanic membrane perforation. In this study we use technique that we did not use gelfoam in the middle ear. We compared results of graft taking rate in two techniques. Materials and Methods: In a clinical trial study during ۲ years ۱۸۱ patients with COM underwent tympanoplasty with underlay grafting. In ۸۳ patients used gelfoam in the middle ear for tympanoplasty or tympanomastoidectomy (CCTM, OCTM). In ۹۸ patients we did not use gelfoam in the middle ear. Results: In ۸۳ patients with use of gelfoam, graft taking rate in ۵۹ (۷۱.۱%) cases with tympanoplasty and CCTM was ۵۴ (۹۱%) and in ۲۴ (۲۸.۹%) cases with OCTM was ۲۰ (۸۳%). In ۹۸ patients without use of gelfoam, graft taking rate in ۶۱ (۶۲.۲%) cases with tympanoplasty and CCTM was ۵۴ (۸۹%) and in ۳۷ (۳۷.۸%) cases with OCTM were ۳۱ (۸۴%). Conclusion: In this study, results of graft taking rate were similar in ۲ groups. On the other hand, gelfoam entirely reabsorbed during ۴۵ to ۵۴ days in the middle ear and immune system react by a round cell response. This sponge encourages the formation of the fibrous tissue at a higher rate than naturally occurs in the ear. In our technique we had not these problems. Another advantage of this technique is rapid improvement of patient hearing after removing of the external ear canal rosebud. We think this technique could be used in tympanoplasty and tympanomastoidectoy routinely. ‍‍‍

کلیدواژه ها:

Tympanoplasty ، Gelfoam ، Underlay graft