Tympanic Membrane Perforation Clinical Trial
Official title:
Fibrinogen- Based Collagen Fleece Graft Myringoplasty for Chronic Tympanic Membrane Perforations - a Prospective Study
Tympanic membrane perforations are common medical problem that encounters a lot of patients
in all age groups.
The gold standard for treatment of perforations is tympanic membrane closure procedure
(tympanoplasty) which is done under general anesthesia.
This procedure could be problematic for many patients who are not suitable for general
anesthesia due to their medical status.
It's also time consuming for the patient and for the medical system, since it takes a lot of
time to reach the operation room and hospitalization for at least two days.
The purpose in this study is to use Tachosil (Fibrinogen based patch) under local anesthesia
to close tympanic membrane perforations.
Tachosil is in use for hemostasis and for tissue repair after injury. Tachosil is bound to
the tissue and form a waterproof membrane. In the setting of ENT clinic and under local
anesthesia, the investigators will start the procedure with debridement of the tympanic
perforation edges, then they will close the perforation using two pieces of Tachosil under
and above the perforation in the right form (active side to the active side).
If the results will be similar to tympanoplasty results, this method may be used for closure
of tympanic perforation and save time and money for the patient and for the health system.
Tympanoplasty is the gold standard treatment for tympanic membrane perforation.
It is done under general anesthesia in the following form:
Incision in the post auricular area, harvesting of fascia and cartilage from the concha of
the pinna .
In Trans ear canal approach starting with debridement of the edges of the tympanic membrane
perforation and closing the perforation using cartilage and fascia.
After being informed about the study and potential risks, all patients giving informed
consent will participate in the study.
This study will include two groups. The first group will be treated with the conventional way
as described above. The interventional group will be treated using Tachosil in the following
order:
Local anesthesia using Lidocadren (lidocaine and epinephrine) will be injected to the ear
canal using dental needle.
Debridement of the edges of the tympanic membrane perforation Placing the tachosil under and
above the perforation in the correct order. The patient could be discharged home immediately
after the procedure if no adverse effects are seen (dizziness, nausea or vomiting).
After one month, similar to the conventional treatment method, the patient will be invited to
the otology clinic, for hearing test and microscopic examuntaion of the tympanic membrane, to
see if the perforation is closed.
The study will compare the success rate in the two groups and if it will be similar that will
help publish this method and use it in patients who are not suitable to general anesthesia
and in hospitals were waiting time table for operation room is very long.
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