Human Acellular Dermal Allograft Patch on Traumatic Tympanic Membrane Perforation

Abstract

BACKGROUND: This study aimed to investigate the outcome of using the human acellular dermal allograft patch compared with the conventional paper patch in traumatic tympanic membrane perforation. METHODS: This was a retrospective study including 41 patients (42 ears) treated with 22 human acellular dermal allografts and 20 paper patches for acute traumatic tympanic membrane perforation from April 2013 to June 2020. The procedure was performed by applying human acellular dermal allograft or paper patches after trimming of perforation margins under local anesthesia. Patient's age, sex, cause, duration, side, location, size of perforation, and the result of healing was analyzed. The audiologic or computed tomography data were also investigated when available. RESULTS: There was no significant difference in sex, age, affected side ratio, size and duration of perforation, recovery confirmation time, and audiogram results between the two groups. There was no significant difference in the size or duration of perforation between the success and failure groups. The human acellular dermal allograft and paper-patch groups showed no significant difference in the recovery confirmation time (70.7 +/- 42.3 vs. 89.9 +/- 119.4 days, P =.486) and recovery rate (95.5% vs. 85.0%, P =.333). However, the patch maintenance time of the human acellular dermal allograft group was statistically longer than the paper-patch group (32.9 +/- 14.9 vs. 15.6 +/- 19.9 days, P =.001). On multivariable regression analysis, patch material was the only parameter associated with patch maintenance time (P =.002). CONCLUSION: Treatment outcomes of traumatic tympanic membrane perforation using human acellular dermal allograft showed better or similar therapeutic efficacy compared to paper patch. The important advantage of this material is to stay in situ for a sufficient time without being detached until successful healing.