Gérard J M, Gersdorff M
Department of Oto-Rhino-Laryngology, University Hospital Saint-Luc, Brussels, Belgium.
B-ENT. 2006;2(4):177-9.
This article describes the technique and the preliminary results of transcanal myringoplasty for small or midsized tympanic membrane perforations with the Tutopatch (Tutogen Medical, Inc., Alachua, FL, USA), a xenograft derived from bovine pericardium.
All procedures started with a Rosen incision. The meatal skin was loosened from the bone up to the fibrous annulus, which was dislocated out of the sulcus, and the tympanic membrane was elevated from the malleus handle. The Tutopatch was placed over the malleus handle, the annulus, and the denuded bone.
Eleven patients were included, and follow-up ranged from 3 to 14 months. Ten of the eleven eardrums were successfully closed. One patient developed myringitis 2 months after the procedure. The average air-bone gap at 0.5, 1, 2, and 4 kHz, of all but one patient was less than 10 dB.
When anatomically feasible, a transcanal myringoplasty with a Tutopatch graft yields similar audiological results compared to fascia temporalis, perichondrium or tragal perichondrium-cartilage, but reduces the surgical trauma, the complications of the autograft harvesting, and the negative cosmetic and psychological impact of this procedure.
本文描述了使用Tutopatch（美国佛罗里达州阿拉楚阿市Tutogen Medical公司）进行经耳道鼓膜成形术治疗中小型鼓膜穿孔的技术及初步结果，Tutopatch是一种源自牛心包的异种移植物。
所有手术均从Rosen切口开始。将耳道皮肤从骨膜松解至纤维环，使纤维环从沟中脱位，然后将鼓膜从锤骨柄上掀起。将Tutopatch置于锤骨柄、纤维环和裸露的骨面上。
纳入11例患者，随访时间为3至14个月。11只鼓膜中有10只成功愈合。1例患者术后2个月发生鼓膜炎。除1例患者外，其余所有患者在0.5、1、2和4kHz频率下的平均气骨导差均小于10dB。
在解剖学可行的情况下，与颞肌筋膜、软骨膜或耳屏软骨膜-软骨相比，使用Tutopatch移植物进行经耳道鼓膜成形术可获得相似的听力学结果，但可减少手术创伤、自体移植物采集的并发症以及该手术对外观和心理的负面影响。
