Human amniotic membrane as a homograft material in myringoplasty
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Date
2001-11
Authors
Dalip Singh, Harvinder Singh
Journal Title
Journal ISSN
Volume Title
Publisher
Universiti Sains Malaysia
Abstract
To evaluate the efficacy of preserved human amniotic membrane as an
alternative graft material in terms of its anatomical and functional outcomes in
closing tympanic membrane defects during myringoplasties. We also
compared it with the standard temporal fascia graft. A prospective review of 50 cases operated for tympanic membrane defects in
Hospital University Sains Malaysia from June 1999 to June 2001. Twenty
cases used preserved human amniotic membrane and 30 cases used
temporal fascia graft. Clinical and audiometric assessment were done 3
months postoperatively. During a period 2 years, a total of 50 ears with tympanic membrane
perforations were operated, out of this 28 were males and the remaining 22
were females. The age range was between 10 to 70 years with a mean age of
32.08 years. The operations were carried out by senior surgeons in the
department. The surgical approach was either permeatal, endaural or
postaural but the technique was limited to underlay or pop in through
perforation. Postoperative results were evaluated with respect to the
anatomical and functional outcomes. To assess anatomic results, we took into
account successful closures, presence of residual perforations, infections, graft dislodgment and lateralization. In the temporal fascia group, successful
closure were achieved in 17 (56.7o/o) of 30 cases. Among the 13 failures
(43.3%), 6 were due to residual perforation, 4 infections, 2 graft dislodgment
and one lateralization. In the human amniotic membrane group, successful
closure were achieved in 13 (65%) of 20 cases. Among the 7 failures (35o/o), 4
were residual perforations, 2 due to infection and one graft lateralization. In
the evaluation of the functional outcomes, both groups showed significant
difference between pre and postoperative mean air conduction thresholds
component of hearing. However, a significant closure of air-bone gap was
only observed in the human amniotic membrane group. Human amniotic membrane is a simple, safe and cost effective technique for
repairing perforated tympanic membranes. It gives good anatomic and
functional results and is comparable to the standard temporal fascia graft
material so widely used today.
Description
Keywords
Human amniotic membrane