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A revolutionary surgical technique for treating perforations of the tympanic membrane in children and adults is as effective as traditional surgery and far less expensive and can be performed in 20 minutes at an outpatient clinic during a routine visit to an ENT specialist. The treatment will make surgery more readily available and substantially reduce waiting lists.
Otolaryngologist Issam Saliba, FRCSC, developed the new technique at the Sainte-Justine University Hospital Centre (UHC), an affiliate of the University of Montreal, in Montreal, Canada.
"In the past five years I've operated on 132 young patients in the outpatient clinic at the Sainte-Justine UHC using this technique, as well as on 286 adults at the University of Montreal Hospital Centre outpatient clinic," said Dr. Saliba, professor of otology and neuro-otology. "Regardless of the size of the perforation, the results are as good as those obtained using traditional techniques, with the incomparable advantage that patients don't have to lose an entire working day or 10 days or more off school in the case of children."
The technique is called hyaluronic acid fat graft myringoplasty (HAFGM). It requires only the basic materials of a scalpel, forceps, probe, small container of hyaluronic acid, small amount of fat taken from behind the ear, and local anesthetic. The operation, which is performed through the ear canal, allows the body to rebuild the entire tympanic membrane after about two months. Patients recover their hearing completely, and recurring cases of ear infection are prevented.
Because the procedure does not require general anesthetic, an operating theater or hospitalization, surgery is much more readily available - particularly outside large hospital centers - and at considerably lower cost.
"With the traditional techniques you have to be on the waiting list for up to a year-and-a-half in order to be operated on," Dr. Saliba said. "Myringoplasty using the HAFGM technique reduces waiting times, cost of the procedure, and time lost by parents and children. What's more, it will help clear the backlogs on waiting lists."
The new technique is based on the results of a four-year prospective cohort study of 208 children and adolescents, 73 of whom were treated using HAFGM (Archives of Otolaryngology-Head and Neck Surgery, Dec. 16, 2011). Previously, Dr. Saliba conducted a similar study involving adult patients (The Laryngoscope, Feb. 12, 2011).
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