Plastic materials for the formation of a neotympanic membrane in tympanoplasty

Introduction. The article addresses the issue of selecting effective materials for tympanoplasty – the surgical restoration of the integrity of the tympanic membrane in cases of chronic purulent tubotympanic middle otitis. The challenge of choosing an effective plastic material (graft) remains unresolved among otosurgeons globally. The primary reason for this issue is that there are no tissues in the human body analogous in structure to the tympanic membrane.

Aim. To conduct a literature review on materials used in tympanoplasty for the closure of tympanic membrane perforations and the formation of a neotympanic membrane, as well as a comparative analysis of their characteristics and properties. Materials and methods. A literature review on tympanic membrane surgery was conducted. The review includes data from surgical guidelines on middle ear surgery.

Results and discussion. Various types of grafts are discussed: autografts (such as the fascia of the temporal muscle and perichondrium of the tragus), allografts (including the dermal matrix AlloDerm), xenografts (such as bovine and equine pericardium), and other non-biological materials. A critical part of the study involves comparing different materials concerning their physical and anatomical properties similar to those of the tympanic membrane. The advantages and disadvantages are analyzed. The article discusses engraftment, mechanical compatibility with the tympanic membrane, provides comparative statistics on the long-term outcomes of tympanoplasty using various types of grafts, and the possibility of their use in complex clinical cases.

Conclusion. The authors emphasize the need for further research to determine the most effective and safe materials for tympanoplasty, which will enable sustainable results in hearing restoration and prevent disease recurrence. Thus, the article presents a comprehensive analysis of the problem of selecting materials for tympanoplasty, substantiating the need for an individualized approach in each clinical case, with a focus on the biological, physical, and functional aspects of the materials used.

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