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New eardrum perforation technique may replace long and costly procedure 

TORONTO – Childhood ear infections left Benjamin Cote’s ear drum 50 per cent open and his middle ear so exposed that he couldn’t shower normally or go swimming with his friends due to the risk of infection.

His hearing also suffered. Traditional techniques to fix his eardrum would have been costly and time consuming.

Thanks to a new surgical technique called hyaluronic acid fat graft myringoplasty (HAFGM), he was able to have a quick and cost-effective surgery.

Myringoplasty is a surgical procedure to repair the eardrum when it has been perforated or punctured.

The new technique, developed by Dr. Issam Saliba at the University of Montreal’s Saint Justine’s Children’s Hospital, requires only basic materials: a scalpel, forceps, a probe, a small container of hyaluronic acid, a small amount of fat taken from behind the ear, and a local anesthetic.

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“In other techniques, it’s about an hour or an hour and a half in the operating room,” said Dr. Saliba. “We can do this technique without any hospitalization..under local anesthesia in 20 minutes.”

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“It’s safe and we can save more than $1,500.”

The operation, which is performed through the ear canal, allows the body to rebuild the entire tympanic membrane by itself after about two months.

“The hyaluronic acid can improve healing of tissues, the fat plays the role of the support for the migration of cells from the ear drum remnant,” said Dr. Saliba. “What happened with prior cells, if you just use the hyaluronic acid with no support, the cell [was] dead.”

Dr. Saliba says the technique is starting to be known by Americans and Europeans. Interests in using the technique in Toronto have also been rising.

Dr. Vincent Lin at Sunnybrook Health Sciences Centre in Toronto says he’s looking at using this technique as wait times can be long.

“For surgery, it would take a year and a half to get this done,” said Lin. “If I could do this in the office, then I could get it done in 3 to 6 months.”

The success rate of the operation has been promising. In adult patients, it is a 92.6 per cent success rate, while in children like Benjamin, it is 85.6 per cent.

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The research is based on a four-year study of 208 children and adolescents, 73 of whom were treated using the new HAFGM technique.

This study was published on December 16, 2011 in the scientific journal Archives of Otolaryngology.

 

 

 

 

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