This retrospective Belgian study looked at the success rates of xenograft and human allograft materials as alternatives to more common autograft materials like fascia, fat or cartilage. A total of 71 consecutive patients who underwent type 1 tympanoplasty were included, with 38 patients having a bovine xenograft (Tutopatch®, a collagen membrane extracted from bovine pericardium and sterilised with gamma radiation), and 33 patients having a human allograft. All patients underwent the post auricular approach for tympanoplasty with an underlay graft secured with fibrin glue. The overall closure rate was 81.6% for xenografts and 78.8% for allografts and pure-tone averages were equally improved in both groups. Multiple factors, such as perforation size and location, and period without ear discharge, were analysed, but only postoperative myringitis significantly influenced outcome, being more prevalent in the allograft group. This was related to intratympanic tympanosclerosis and ossicular fixation. This study has demonstrated that bovine xenografts and human allografts can be used safely as graft materials in myringoplasty with acceptable closure rates. However, it would have been useful to compare the success rates to more traditional graft materials such as fascia and cartilage. 

Uncomplicated type 1 tympanoplasty with bovine xenografts versus human allografts: functional results and prognostic factors for graft success.
Declau F, Karen KVdG, Wuyts FL.
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Sunil Sharma

Alder Hey Children's Hospital, UK.

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