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Anales de Otorrinolaringología Mexicana

2005, Number 1

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Otorrinolaringología 2005; 50 (1)

Seal of fibrin on repairing tympanic perforations

Saynes-Marín FJ

Language: Spanish
References: 24
Page: 9-18
PDF size: 153.23 Kb.


ABSTRACT

Background. In last years, diverse investigations have taken place on the use of tissue adhesives in otorhinolaryngology. The use of cianoacrylate in the repair of tympanic perforations is controversial due to the poisonous effects that can cause in middle and internal ear. Also, the increasing use of fibrinogen derivatives allows to implement new options for the otologic surgery. In this study, an investigation and a revision on the elaboration of a fibrin and papain seal are presented, made with the infrastructure available in a public hospital for its use in the repair of tympanic perforations in doctor’s office. Material and methods. It was examined 35 patients with tympanic perforation by different causes and free ear from otorrhea. The material used for the closing was homologous fascia of temporary muscle, plus the adhesive before mentioned. The results based on the index of perforation closing, and the graft stay time were evaluated on this one. Results. In 31 (88.5%) patient, perforation closing was observed, and in 20 (57.1%) it was necessary a second procedure to relocating fascia due migration of the graft. In some cases, although there was migration of the graft, the perforation was not discovered, or the permanence of the graft induced reepithelization of the perforation, reason why there was already no necessity to relocating fascia (in three patients). In 24 patients (70%) auditory improvement of the closing of the perforation was observed soon, and in 30% there were no changes. Most of patients displayed migration of fascia between the second and third weeks (› 60%). Conclusions. The duration and the firmness of the adhesion were sufficient to allow, in suitable conditions, the closing of nonmarginal tympanic perforations; in average, it was obtained after the third week.


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