The behavior of alloplastic tympanic membranes in Staphylococcus aureus-induced middle ear infection. I. Quantitative biocompatibility evaluation.

The biocompatibility of dense Silastic implants and porous implants made of Estane 5714 F1 polyether urethane, polypropylene oxide, and an HPOE/PBT segmented polyether polyester copolymer was evaluated during an induced Staphylococcus aureus middle ear infection. The middle ear response to infection seemed not to be affected by the presence of implants made of either of the polymers. Light microscopical morphometry and transmission electron microscopy showed degradation of the porous implants under study, but not of Silastic implants, which were invariably surrounded by a fibrous capsule. This finding, combined with the degree of porous implant degradation, the composition of the tissues surrounding the implants, and the tissue/biomaterial interface reactions are consistent with the results obtained in the noninfected middle ear. Round-cell infiltrates however, were predominantly associated with implants made of polypropylene oxide and HPOE/PBT copolymer; while the presence of (phagocytosed) microbial debris was associated with copolymer. The present findings indicate that with respect to implant behavior in infected surroundings Estane is the best porous material, whereas the behavior of Silastic implants did not deviate from that in non-infected ears.