Stimulation of epithelial healing in chronic postoperative otorrhea using lyophilized cultured keratinocyte lysates.

Objective: After tympanoplasty, despite a closed tympanic graft, some patients continue to have persistent otorrhea due to insufficient epithelial healing and granulation tissue formation in the depths of the outer ear canal. When all medical therapies fail, many otologists undertake revision surgery, usually with free skin grafting. To avoid surgery, the authors sought to improve this condition with a lysate of lyophilized cultured allogeneic keratinocytes.

Tympanic grafting materials.

The advantages and disadvantages of different tympanic grafting materials are reviewed and discussed. Temporalis fascia and perichondrium autografts remain the most popular grafting material. For special cases, particular for total ossicular replacement problems, tympanic allografts may be useful.

Myringitis granulosa.

Myringitis granulosa is a rare, localized, chronic inflammation of the lateral surface of the tympanic membrane, characterized by the development and persistence of granulation tissue over the involved area. The clinical and pathologic features of the disease are described, different etiopathogenic possibilities proposed, the literature reviewed and a strategy for treatment presented.

Tympanic membrane perforations.

The recent literature on the healing of tympanic membrane perforations is reviewed. Research on the migratory phenomena, epithelial migration and keratin dispersion on top of the tympanic membrane, is discussed. The etiology and pathogenesis of tympanic membrane perforations is then briefly described.

Mastoiditis caused by atypical mycobacteria.

Three case reports of mastoiditis caused by atypical mycobacteria are discussed and a review of the world literature is given. Our aim is to focus the attention of the ENT specialist and the pediatrician on these pathological agents in unilateral recurrent otitis media. The case reports illustrate the importance of histologic and microbiologic examination.