Outcomes of Tympanic Membrane Regenerative Surgery Using Gelatin Sponge, Recombinant Basic Fibroblast Growth Factor, and Fibrin Glue

使用明胶海绵、重组碱性成纤维细胞生长因子和纤维蛋白胶进行鼓膜再生手术的结果

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Abstract

Objective We evaluated the outcomes of tympanic membrane regenerative treatment using gelatin sponge, recombinant basic fibroblast growth factor (bFGF), and fibrin glue at Yokosuka Kyosai Hospital. Methodology We enrolled a total of 42 patients with tympanic membrane perforations (TMPs) (44 ears; right:left = 21:23) that were treated using gelatin sponge, recombinant bFGF, and fibrin glue between July 2020 and December 2023 at Yokosuka Kyosai Hospital. TMP closure rates, improvement of hearing level, and complications were retrospectively included in the evaluation items. TMP was evaluated at least one month after surgery. The treatment was repeated up to four times until the TMP was completely closed. Results The perforation size distribution was as follows: grade I, 30 ears (68.1%); grade II, 11 ears (25.0%); and grade III, three ears (6.8%). The overall closure rate for TMP was 84.1% (37/44). Closure was achieved in 72.7% (32/44) after the first treatment and 11.4% (5/44) after the second treatment. No closures were achieved after the third and fourth treatments. Factors contributing to the incomplete closure of TMPs included patient refusal of surgery more than once, and the disappearance of the gelatin sponge one week after each surgery. Mean air-conduction thresholds and mean air-bone gaps improved after TMP closure in successful patients; however, no change in mean bone-conduction thresholds was observed at any frequency. No serious complications were observed. Conclusions We found high success rates for TMP closure, good hearing recovery, and no severe complications. Our findings suggest that our novel technique has favorable outcomes.

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