Adjunctive Serum Drops to Paper Patch for Tympanic Membrane Perforation

To evaluate the effectiveness of autologous serum drops combined with paper patch myringoplasty in enhancing tympanic membrane (TM) perforation closure among patients with prior patch failure.

This retrospective chart review included 81 patients with chronic TM perforations unresponsive to initial paper patching. Patients were divided into 2 groups: the experimental group received autologous serum drops alongside secondary paper patching, while the control group received patching alone. The primary outcome was TM closure at 8 weeks. Kaplan-Meier survival analysis and Cox regression were used to evaluate time-to-closure and the effect of patient variables.

Closure rates were significantly higher in the experimental group (54.5%) compared to the control group (21.6%; P = .002). The addition of serum drops was associated with improved healing outcomes, even in cases unresponsive to initial patching. Perforation size and location influenced closure, with smaller and posterior TM perforations showing higher success. No significant associations were found between healing and age, sex, race, comorbidities, or perforation etiology. No adverse effects from serum drops were reported.

Autologous serum drops significantly improve TM closure rates when added to paper patch myringoplasty, offering a safe, cost-effective, and non-surgical option for managing chronic perforations. Further studies with larger sample sizes and long-term follow-ups are warranted.