Tympanoplasty using fascia-form molds to shape autogenous temporalis fascia for closing large perforations

Abstract

To study the efficiency of using autogenous temporalis fascia which was formed and shaped by formaldehyde cross-linking with special fasciaform molds in the repair of large tympanic membrane perforations. Base on machine technique and published data, the molds was designed according to the shape of tympanic membrane (TM), autologous fascia graft shaped by 4% formaldehyde (pH 5.6) was cross-linked on the mold to resemble the natural TM more closely repairing the large perforations of tympanic membrane with the formed fascia. Sixty-one operations were performed to close large perforations in patients with intact ossicular chain in fifty-seven patients from November 2006 to April 2009. The follow up was done from one month to thirty months; the average follow up period was eleven months. Statistical analysis was performed using a SPSS 13.0 software. The repairing of the perforations were successfully with rate of 95.1% (58/61). Three ears were remained small remnant perforations after the surgery, but all hearing had been improved except one patient with biauricular total sensorineural hearing loss within the group. The air bone gap (ABG) of preoperative average (x ± s) hearing level of fifty-nine ears was (31.5 ± 6.1) dB, and the ABG of postoperative average hearing level of same group was (14.2 ± 4.4) dB, the difference was significant (t = 21.3, P < 0.01). During the early stage of using this technique, six ears were found to have graft lateralization recovery, but one case was slightly blunting recovery. No pearl tumor and epicyst had been found during the follow-up period. The formaldehyde fasciaform technique produces consistent, reliable as well as reproducible results for repairing large tympanic membrane perforations with minimal complications.