Early Experiences with Endoscopic Use of Porcine Collagen Matrix Graft in Middle Ear Surgery

By June 7, 2019

Dezso, Attila1; Zafar, Mohammed1; Fussey, Jonathan2; Nassimizadeh, Abdul2
1 ENT Department Walsall Manor Hospital Walsall West Midlands UK;
2 Specialist Registrar in ENT West Midlands Deanery Birmingham UK.

Endoscopic ear surgery (EES) in well-selected cases has the potential to minimise soft tissue dissection and incision size, which results in lower levels of post-operative pain, quicker discharge from hospital and greater patient satisfaction.The use of autologous tissue for middle ear reconstruction necessitates an incision. Porcine collagen matrix grafts (PCMG) have been used for many years in other anatomical sites, and their use in the middle ear facilitates completely incision-free EES.

– Study Design: Retrospectve  series. Single surgeon
– Setting: Secondary care, district  hospital
– Patients: Patients entered the study by choice after informed consent at the time of listing. Muslim and Jewish patients were excluded if religious objections  were raised. Mean age  39.4 years.
– Interventions: Endoscopic repair of middle ear defects with porcine collagen matrix graft

– Main Outcome Measure: Graft take rate. Percentage of closed TM / attic defects.
– Results: 55 patients were deemed appropriate candidates for reconstruction with PCMG.
1st follow up – 1 month after surgery
2nd follow up – latest follow up (up to a year after surgery)
48/55 of the patients had intact graft
4/55 – had perforations due to post-operative complications (infection)
3/55 – no follow up was recorded on the case notes.
Overall success rate of 87%

The use of PCMG in EES allows for an  incision-free and bandage-free operation, with short duration of stay and high TM perforation closure rate. In our early experience                      with this technique we have encountered no adverse outcomes, and graft success rates like those in published series using autologous graft materials. Further work is required to explore                  long-term outcomes.