DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20190505

Non-surgical approach for repairing perforations of pars tensa in tympanic membrane using TCA cauterization

Sushil Gaur, Monika Patel, Prince Hirdesh, Vandana Singh

Abstract


Background: Tympanic membrane perforations occurring due to mucosal COM usually require surgical interventions for repair (myringoplasty or tympanoplasty) depending on the size and site of the perforation and the ossicular chain continuity. Various studies have shown TCA cautery as an efficacious non surgical method for repairing small and medium sized TM perforations. This technique was successfully used and popularized for repairing small and medium sized perforations by Derlacki in 1953.

Methods: In this study we included dry pars tensa perforations in 100 patients occurring due to trauma or unresolved cases after inflammation/infection of middle ear. 50% w/v trichloro acetic acid was used for a maximum number of 5 applications at the margins of the perforations which were followed up for the next one year.  

Results: In this study, involving a total of 125 perforations (75 unilateral and 50 bilateral), success rate was high among the patients with traumatic perforations and small sized perforations while a few number of perforations only reduced in size, which were later corrected with surgical approaches (myringoplasty/tympanoplasty). The overall success rate achieved in this study was 72.16%.

Conclusions: Though there are various materials and methods available for this procedure, the principle remains the same. This technique should be attempted for patients that fit the criteria for undergoing this procedure before being undertaken for surgical approaches to minimize the risks and cost burden associated with surgery and anesthesia.


Keywords


Non-surgical, Perforation, Pars tensa, Tympanic membrane, TCA, Cauterization

Full Text:

PDF

References


Uppal KS, Singh R, Singh J, Popli SP. Closure of tympanic membrane perforation by chemical cautery. Indian J Otolaryngol Head Neck Surg. 1997;49:151-3.

World Health Organization. Deafness and Hearing Impairment – Fact Sheet; April, 2010.

Rahman A. Healing of tympanic membrane perforation: an experimental study, from Karolinska Institute and University Hospital, Stockholm, Sweden; 2007.

Govaerts P, Jacob W, Marquet J. Histological study of the thin replacement membrane of human tympanic membrane perforations. Acta Otolaryngol (Stockh). 1988;105:297-302.

Banzer M. Disputatio de auditione laesa. 1640.

Griffin WL Jr. A retrospective study of traumatic tympanic membrane perforations in a clinical practice. Laryngoscope. 1979;89:261-82.

Yearsley J. Deafness practically illustrated. London: Churchill & Sons; 1853.

Roosa DB, Diseases of the ear. New York: William wood &Co.; 1876.

Taylor M, McMinn RM. Healing of experimental perforations of the tympanic membrane. J Laryngol Otol. 1965;79:148.

Gladstone HB, Jackler RK, Varav K. Tympanic membrane wound healing. An overview. Otolaryngol Clin North Am. 1995;28:913-32

Somers T, Gooverts G, Schelfhout L, Peeters S, Govaerts PJ, Offeciers E. Growth factors in tympanic membrane perforations. Am J Otol. 1998;19:428-34.