The Tutopatch graft for transcanal myringoplasty

This article describes the technique and the preliminary results of transcanal myringoplasty for small or midsized tympanic membrane perforations with the Tutopatch (Tutogen Medical, Inc., Alachua, FL, USA), a xenograft derived from bovine pericardium.

All procedures started with a Rosen incision. The meatal skin was loosened from the bone up to the fibrous annulus, which was dislocated out of the sulcus, and the tympanic membrane was elevated from the malleus handle. The Tutopatch was placed over the malleus handle, the annulus, and the denuded bone.

Eleven patients were included, and follow-up ranged from 3 to 14 months. Ten of the eleven eardrums were successfully closed. One patient developed myringitis 2 months after the procedure. The average air-bone gap at 0.5, 1, 2, and 4 kHz, of all but one patient was less than 10 dB.

When anatomically feasible, a transcanal myringoplasty with a Tutopatch graft yields similar audiological results compared to fascia temporalis, perichondrium or tragal perichondrium-cartilage, but reduces the surgical trauma, the complications of the autograft harvesting, and the negative cosmetic and psychological impact of this procedure.