Vol.103 No.1 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 103 No. 1 January 2010
Histological Stability of the Autologous Fibrin Membrane and Fibrin Gel
-New Materials for Myringoplasty-
Yoichi Matsuda, Tomoyuki Kurita, Yoshihisa Ueda,
Shinsuke Ito and Tadashi Nakashima
(Kurume University)
The simple underlay myringoplasty has evolved, enabling it to be performed more easily and safely. However, this procedure needs fibrin glue that is made from donated blood. Furthermore, a skin incision is necessary to take the subcutaneous connective tissue graft. There are some reports regarding the methods of using a collagen sheet or chitinous substance membrane as a substitute for the subcutaneous connective tissue graft. However, no report has appeared regarding a myringoplasty using a membrane made from the patient's own blood. The aim of this study is to establish the procedure of less invasive myringoplasty from the aspect of safety using autologous blood from the patient.
We have developed a procedure to make the autologous fibrin membrane and gel. We evaluated the histological stability of the fibrin membrane and gel using image analysis equipment. The density of the fibrin fiber was measured at the time of production, after 24 hours, 48 hours, 72 hours, 1 week, and 2 weeks. Welch's t-test was used for the statistical analysis.
The fibrin membrane had less microscopic changes even at the 2-weeks assessment. There was no statistically significant difference between the density of the fibrin membrane fiber and the fascia at 2 weeks. In contrast, the fibrin gel had melted and disappeared at 1 week.
It is thought that the fibrin membrane might produce a scaffold for the regeneration of the tympanic membrane as a substitue for the subcutaneous connective tissue or fascia. These results indicate that myringoplasty using the fibrin membrane could be a safer and less invasive procedure.
Key words :autologous fibrin membrane, autologous fibrin gel, myringoplasty, image analysis equipment