The Gelfoam® plug: an alternative treatment for small eardrum perforations

Area of Science:

• Otolaryngology
• Surgical Innovation
• Tympanic Membrane Repair

Background:

• Small eardrum perforations are common and can affect hearing.
• The fat plug technique is a standard treatment, but alternatives are sought for simplicity and speed.
• Gelfoam® is a biocompatible material used in various surgical applications.

Purpose of the Study:

• To evaluate the efficacy of Gelfoam® plugs combined with surgical perforation edge removal for treating small eardrum perforations.
• To compare this novel technique with the established fat plug method.
• To assess the closure rate and hearing outcomes.

Main Methods:

• A prospective study included 17 patients with persistent central eardrum perforations (2-4 mm diameter).
• The procedure involved surgical removal of perforation edges followed by Gelfoam® plug insertion.
• Patients were followed for over 3 months post-surgery.

Main Results:

• An 83% (15/18) closure rate of the eardrum was achieved.
• Pure tone average (PTA) improved from 19 dB preoperatively to 16 dB postoperatively.
• The Gelfoam® technique demonstrated comparable closure rates to the fat plug method.

Conclusions:

• Gelfoam® plug insertion with edge debridement is a viable and potentially superior alternative for small eardrum perforations.
• This method is simpler and faster than the traditional fat plug technique.
• Randomized controlled trials are warranted to definitively compare the Gelfoam® plug technique with the fat plug technique.