O. Spandow et al., COMPARISON OF THE REPAIR OF PERMANENT TYMPANIC MEMBRANE PERFORATIONS BY HYDROCOLLOIDAL DRESSING AND PAPER PATCH, Journal of Laryngology and Otology, 109(11), 1995, pp. 1041-1047
Thirty consecutive patients with permanent perforations of their tympa
nic membranes (TM) present from 2.5 to 50 years (mean 18.7 years) were
admitted to a prospective study using two alternative methods of dres
sings for closure of the perforations. An adhesive-coated hydrocolloid
material was compared with a conventional dressing of vaseline impreg
nated rice paper patch after de-epithelialization of the perforation b
order. Nine of the permanent TM perforations (30 per cent), five with
the hydrocolloidal dressing and four with the rice paper patch had hea
led when followed-up after one year. The size of eight of the central
perforations that had healed was equal to or less than 25 per cent of
the TM. Also one perforation with a size of 65 per cent had healed. Se
ven perforations were located in the posterior part of the TM: four in
the posterior-superior quadrant, one in the inferior quadrant, one ha
d engulfed the posterior half of the TM and one included the anterior-
inferior quadrant. Only two perforations out of 14, with a size of 25
per cent or less, located in the anterior-inferior quadrant, healed. N
o significant difference was demonstrated between the two types of dre
ssings. Both groups noted an immediate improvement in hearing of 10.8
and 9.3 dB, respectively, after application of the dressing. The study
demonstrates that application of an occlusive dressing or paper patch
in 30 per cent of patients can promote the healing of long-standing p
erforations. The chances for healing are better if the perforation is
located in the posterior part of the TM. This simple technique immedia
tely improved hearing and should be tried before a patient is referred
for myringoplasty surgery.