JOURNAL READING

”TREATMENT OF TYMPANIC MEMBRANE

PERFORATION USING BACTERIAL CELLULOSE:
A RANDOMIZED CONTROLLED TRIAL”
Oleh:
Dwi Rahma Mutiarani

Pembimbing:
dr. Eman Sulaiman, Sp. THT-KL
Introduction
◦Treatments for tympanic membrane perforation (TMP) have
been studied. Among some alternatives, the use of gelfoamTM
and atelocollagenTM stand out, in association with fibroblast
growth factor (β-FGF), autologous serum, and chitin membranes.

◦Objectives: To investigate the effect of direct application of

bacterial cellulose (BC) graft on healing the perforation,
compared with autologous fascia.
 Method
Sample: 40 patients
Location: Otolaryngology
with tympanic
Service in teaching Time: From 2013 to
membrane perforations
hospital in Pernambuco 2014
caused by otitis media
state, Brazil

Exclusion: patients with

marginal, damp or Evaluated variables:
cholesteatomatous perforations surgical time, hospital
stay, time for
Experimental epithelialization, TMP
group: bacterial closing rate, impedance
cellulose membrane audiometry curve 60
Randomly divided to 2 days post-treatment,
graft
groups and adverse effect
Control
group:
autologous
fascia graft
 Results
◦ From total 40 patients: 20 received BC graft (30% men, 70% women), 20
received autologous fascia graft (40% men, 60% women)
◦ From those who received BC graft, 65% TMP in left ear, while in group
that received autologous fascia graft, 55% were in right ear
◦ Surgical time for the procedure was statistically significant (p<0.001).
Epithelialization time was similar in both groups.
◦ The relative risk (RR) of non-closure tympanic membrane in group treated
with BC graft was lower (50%)
◦ The effectiveness was similar in both groups
Discussion
◦The main objectives of miringoplasty are to regenerate tympanic
membrane, reconstruct the sound transmission mechanism, control
infection, and improve hearing. In literature, the success rate varies
from 65% to 98%
◦In this study, our success rate with the use of BC membrane
was 90% (50% efficiency) compared to 80% with autologous fascia
◦BC also has less operating time because no need for incisions,
removal of fascia, or lifting flaps
◦There was a reduction of 13 times in hospital costs with the use
of BC membrane.
Conclusion
◦Bacterial cellulose graft was proven to be innovative, safe,
efficient, effective, minimally invasive, and low cost option, to
promote TMP regeneration
THANK YOU