Title:
Uncomplicated type I tympanoplasty with bovine xenografts versus human allografts: functional results and prognostic factors for graft success
Authors:
F. Declau , K. Van der Gucht Karen , F. L. Wuyts
Institutions:
Department of Otorhinolaryngology and Head & Neck Surgery, GZA Hospitals, Campus St-Vincentius, Antwerp, Belgium; Department of Biomedical Physics/AUREA, University of Antwerp, Antwerp, Belgium; Department of Otorhinolaryngology and Head & Neck Surgery, University ofAntwerp,Antwerp, Belgium
Keywords:
Myringoplasty, allograft, xenograft, tympanosclerosis, tympanic membrane
Pages:
167 - 176
Abstract:
Objective: This study investigated the success rates of xenograft and human allograft materials as alternatives to more common autograft materials like fascia, fat, or cartilage. Study Design: Retrospective cohort study. Patients: The study retrospectively included 71 con-secutive patients who underwent type I tympanoplasty with a bovine xenograft (n = 38) or a human allograft (n = 33). Intervention: Myringoplasty. Main outcome measures: Closure rate and postoperative hearing gain at last follow-up. The analysed independent variables were age, period without ear discharge, smoking habits, perforation size and location, perforation cause, revision or first- time case, the state of the non-operated ear, surgical approach, preoperative state of the middle ear and ossicular chain mobility, follow-up time, and postoperative adverse effects. Pre- and postoperative audiometry results were compared. Setting: General hospital centre. Results: The overall closure rate was 81.6% for xenografts and 78.8% for allografts (p = 0,768), and pure-tone averages and air-bone gaps were equally improved in the two groups. Of the analysed factors, only postoperative myringitis significantly influenced outcome, being more prevalent in the allograft group. This was related to intratympanic tympanosclerosis and ossicular fixation. Conclusions: Bovine xenografts and human allografts can be used safely as graft materials in myringoplasty, have acceptable closure rates, and produce functional results that are similar to those of autografts like fascia or fat. Xenografts or allografts might be less sensitive to graft failure for larger perforations. Postoperative myringitis was more frequently observed with the use of allografts in tympanosclerotic ears and was the only factor that influenced graft outcome.
Issue:
Vol. 13, 2017, 3rd trimester


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Uncomplicated type I tympanoplasty with bovine xenografts versus human allografts: functional results and prognostic factors for graft success