Comparison of biodegradable synthetic polyurethane foam versus Gelfoam packing in cartilage graft myringoplasty procedures.

Objective: To compare cartilage graft rates and graft morphologies when biodegradable Synthetic Polyurethane Foam (BSPF) and Gelfoam are used to pack the EAC after cartilage graft myringoplasty.

Methods: Eighty-two patients with chronic perforations underwent endoscopic myringoplasty and were randomized to receive Gelfoam or BSPF packing of the middle ear and EAC.The groups were compared with respect to the pre- and postoperative air-bone gap (ABG), graft integrity, graft epithelialization, graft lateralization, and exudate.

Results: Graft success rate was 87.8% in postoperative 3rd month and 87.8% in postoperative 12th month in the Gelfoam group, whereas graft success rate was 97.6% in postoperative 3rd month and 95.1% in postoperative 12th month in the BSPF group, with no statistical significance between two groups in the 3rd (P = 0.089) and 12th (P = 0.236) month after surgery. Comparing the two groups, there was no difference in preoperative or postoperative mean ABG and ABG closure. Graft lateralization or medialization was evident in 6 patients in the Gelfoam group and one in the BSPF group. Re-peroration occured in one patient in the BSPF group.

Conclusions: Although cartilage graft myringoplasty between Gelfoam packing and BSPF packing of EAC achieve similar graft success rate and ABG closure, BSPF packing afford better graft support and less exudation than did Gelfoam, well prevent graft lateralization and promote earlier graft epithelialization.