外来手術として行なう鼓膜形成術

Abstract

We attempted to close 26 eardrum perforations with fibrin glue in Shiroyama Hospital from November, 1990 to October, 1992 with a success rate of approximately 96%. The average hearing improvement was 17.7dB. This procedure can be carried out in one day but the patients must be carefully selected. Dry central perforation is the best indication for this procedure, but if careful inspection of the middle ear through the perforation is carried out, patients with slight ear discharge can be helped by this procedure.We used autograft temporal fascia in almost all cases. After denuding of the perforation margin, several small pieces of gelatin sponge were placed in the middle ear just beneath the perforation to support the fascia in place beneath the perforation. The fascia was then pulled into the middle ear through the perforation and made to fit on the drum beneath the perforation. A small amount of fibrin glue was dripped onto the lateral margin of the perforation.This technique can be used not only for small perforations, but also for large perforations which lack a posterior margin or total perforations of the membrane. This technique is very useful in the preservation of the tympano-meatal angle of the membrane and prevents lateralization of the membrane in the future. In addition, this technique with some modifications can be extended to tympanoplasty.