The use of sclera in tympanic membrane reconstruction

Sclera appears to be an appropriate grafting material because of its high density, high tensile strength, and low antigenicity. Preserved donor sclera has been used for myringoplasty in 125 cases over a 4 year period with an overall success rate for complete closure of the perforation of 96%. Several simple techniques for creating flanges to hold the graft in place were used. The size of the perforations ranged from several millimeters to 80% of the eardrum surface. Most of the cases have been done as outpatients, the adults with local anesthesia and the children with general anesthesia. The advantages of the procedure are: A. readily available graft material; B. high tensile strength of sclera maintains scaffolding effect for long periods of time; C. the flange technique holds the graft at the perforation site and prevents graft lateralization or medialization; D. the procedure can be performed as an outpatient health care costs.