20 years of experience with homografts in ear surgery

Since I introduced the homograft transplantation en bloc in 1959, more than 2,400 patients with chronic middle-ear inflammation and the conditions resulting from an old radical operation have been operated upon. Different kinds of chemical solution for the conservation of the homograft have been used, and experience has shown that the best solution is a combination of Cialit 1:5,000 and formaldehyde 4 per cent, pH. 7.2. The indications for a homograft transplant have to be very precise, and we have divided the indications into two groups: In the first group, belonging to routine ear surgery, we can use homograft fascia, perichondrium, dura, ossicles and cartilage in the same way as in autografts. The second group is indicated when a larger part of the middle ear is destroyed. The healing process and function of the middle ear after homograft transplantation depend on correct indications, on preparation of the middle ear, on the correct fitting of the transplant, and on careful treatment after the transplantation. By using homografts in routine surgery of the middle ear, the structural and functional results are equivalent to those of autografts. In the second group, in which a large part of the middle ear is destroyed, or in which the condition resulting from a radical operation is achieved by an immediate fresh operation on the middle ear, the healing and functional results are much better than with patients after an old radical operation.