Our Summary

This study is a review of research on non-human graft materials used in tympanoplasty, a surgical procedure to repair a damaged eardrum. The use of non-human grafts could solve several problems in this type of surgery by avoiding the need to harvest graft material from the patient, making the healing process more consistent, and allowing the graft to be placed during a regular clinic visit.

In the review, the authors looked at 61 articles and found that these non-human graft materials, which included things like paper patches, gelatin sponges, growth factors, and pig intestine lining, had been used on 3,247 ears. The most common reason for the surgery was traumatic damage to the eardrum (62.3% of cases), although infection was also a significant cause (31.9% of cases).

They found that the overall rate of successful closure of the eardrum was 82.1%. However, the success rate was higher for acute (recent) damage (89.9%) compared to chronic (long-standing) damage (64.9%).

The review also noted that only 23% of the studies reported on the improvement in hearing after the surgery, which is a significant limitation. According to the studies that did report this, the median improvement in hearing was 5.6 dB.

The authors concluded that pig intestine lining and basic fibroblast growth factor might be particularly promising materials for these surgeries, especially for chronic eardrum damage. They recommended that future studies should report on both the success rate of eardrum closure and improvement in hearing for damage lasting longer than 8 weeks.

FAQs

  1. What is tympanoplasty and what kind of graft materials are typically used in this surgery?
  2. What was the overall success rate of eardrum closure in the studies reviewed, and how did it differ between acute and chronic damage?
  3. What recommendations did the authors of the study make for future research on tympanoplasty?

Doctor’s Tip

A helpful tip a doctor might give a patient undergoing tympanoplasty is to follow all post-operative instructions carefully to ensure proper healing and successful outcomes. This may include avoiding activities that could put pressure on the ear, keeping the ear dry, and attending all follow-up appointments. It is also important to report any unusual symptoms or concerns to the doctor promptly.

Suitable For

Patients who are typically recommended for tympanoplasty are those who have a damaged eardrum due to trauma or infection. The review found that traumatic damage was the most common reason for the surgery, followed by infection. Both acute and chronic damage can be treated with tympanoplasty, although the success rate is higher for acute damage compared to chronic damage. Patients with chronic eardrum damage may benefit from non-human graft materials such as pig intestine lining and basic fibroblast growth factor.

It is important for future studies to report on both the success rate of eardrum closure and improvement in hearing after tympanoplasty, especially for cases of damage lasting longer than 8 weeks. This information can help guide treatment decisions and improve outcomes for patients undergoing this type of surgery.

Timeline

Before tympanoplasty:

  1. Patient experiences symptoms such as hearing loss, ear pain, ear drainage, or recurrent ear infections.
  2. Patient undergoes a thorough medical history and physical examination by an otolaryngologist (ENT specialist).
  3. Patient may undergo hearing tests and imaging studies to determine the extent of the damage to the eardrum.
  4. Surgery is scheduled and the patient receives pre-operative instructions.

After tympanoplasty:

  1. Patient undergoes tympanoplasty surgery to repair the damaged eardrum using non-human graft materials.
  2. Patient is monitored in the recovery room and may be discharged the same day or stay overnight in the hospital.
  3. Patient may experience some pain, swelling, and drainage from the ear post-surgery.
  4. Patient follows post-operative instructions, including keeping the ear dry, avoiding blowing the nose forcefully, and taking prescribed medications.
  5. Patient returns for follow-up appointments to monitor healing and assess hearing improvement.
  6. Over time, the eardrum heals, and the patient’s symptoms improve, leading to a successful closure of the eardrum and potentially improved hearing.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with tympanoplasty using non-human graft materials?
  2. How long is the recovery process expected to be after tympanoplasty with non-human graft materials?
  3. What is the success rate of tympanoplasty using non-human graft materials in repairing a damaged eardrum?
  4. Are there any specific post-operative care instructions or restrictions that I need to follow after the surgery?
  5. How soon after the surgery can I expect to see an improvement in my hearing?
  6. Are there any alternative treatment options to tympanoplasty using non-human graft materials that I should consider?
  7. What is the long-term outlook for my eardrum repair following tympanoplasty with non-human graft materials?
  8. Will I need follow-up appointments or further procedures after the initial surgery?
  9. Is there anything specific I should watch out for or be aware of during the healing process?
  10. How experienced are you in performing tympanoplasty using non-human graft materials, and what is your success rate with this procedure?

Reference

Authors: Ghanad I, Polanik MD, Trakimas DR, Knoll RM, Castillo-Bustamante M, Black NL, Kozin ED, Remenschneider AK. Journal: Laryngoscope. 2021 Feb;131(2):392-400. doi: 10.1002/lary.28914. Epub 2020 Jul 27. PMID: 33176008