Homograft Tympanic Membrane Myringoplasty

During a six-year period, homograft tympanic membranes have been used successfully for myringoplasty or tympanoplasty in 85% of 175 cases. This percentage is not as high as might be expected with fascia, and the homografts have not been as dependable in the wet, draining ear. However, the results do show that the homograft is an acceptable grafting material. The eardrums are not suggested as substitutes for fascia, but should be available for difficult cases. Their use is indicated in large or total defects to restore the natural anatomical conical shape of the eardrum, particularly in congenital atresia. The prime indication for their use is a missing malleus, and the malleus handle can be included within the transplant. The eardrum's rigid properties and the possibility of inclusion of ossicles make the homografts valuable in reconstruction of the old mastoid cavity.