These include the overlay tympanoplasty, (5) the underlay tympanoplasty, (6) over underlay tympanoplasty, (7) Gelfilm
sandwich tympanoplasty, (4) Crown cork tympanoplasty, (8) swinging door tympanoplasty, (9) laser assisted spot welding techniques, (10) and microclip techniques (11) and others like the fascial pegging, (12) annular wedge tympanoplasty, (13) loop tympanoplasty (14) which are but modifications of the basic technique.
Profiles in hemostasis: Strengths and weaknesses of topical agents Agent Composition Forms Mechanism of (brands) available action Physical agents Gelatin Porcine- Sponge, Provides physi- matrix derived film, cal matrix for (Gelfoam, collagen powder clot formation Gelfilm
, Surgifoam) Oxidized Wood pulp Mesh or Provides physi- regenerated packed cal matrix for cellulose fibers clot forma- (Surgicel tion; acidic pH Fibrillar, causes hemo- Surgicel lysis and local Nu-Knit) clot formation Microfibril- Bovine-de- Powder, Absorbable lar collagen rived collagen non- acid salt.
disc was used to cover the denuded promontory.
These problems occurred in spite of the use of gelfilm
, stents, and other spacers, he said.
A drop of autologous PRP was placed on the Gelfilm
to make it wet and to be adherent to the tympanic membrane (Figure 3).
Younis: Gelfoam, Gelfilm
, paper, and tape have all been used to patch perforations following tube removal, and I don't know if there is any consensus as to whether one is better than another.
The absorbable dressings may be derived from number of materials and include Blood products (Fibrin glue, Floseal), Animal based (Hyaluronic acid based products like Sepragel, Merogel, Gelfilm
, Surgiflo), Plant based (Surgicel, carboxy methyl cellulose), Synthetic (Nasopore).
At the end of the procedure, a rolled-up Gelfilm
splint can be inserted into the surgically widened middle meatus to help keep the space open (figure, D).
* Others: Topical haemostatic drugs used to achieve haemostasis include bone wax, ostene, acrylates, ferric subsulfate solution, gelatin (gelfoam, gelfilm
), microfibrillar collagen, poly-n-acetyl glucosamine, kaolinite, pro QR powder, thrombin etc.
splints were then placed between the middle turbinate and the lateral nasal wall on both sides (figure, C and F).
can be rolled into a multilayered stent and placed in the middle meatus (figure, A).
The tympanostomy can be closed with a [3-mm.sup.2] piece of Gelfilm
impregnated with an antibiotic ointment.