Homograft sclera in tympanoplasty.

Homograft sclera was used as a supporting scaffold of the tympanic membrane and reinforcement for the fascia in 43 tympanoplasties. Fresh sclera donated for corneal transplantation to the eye bank in the ophthalmology department of the School of Medicine of Keio University was preserved in 70% alcohol after being stripped of uveal tissue. The sclera was cut as an interdigited method in grafting technique and the short process and the upper part of the manubrium of the malleus were exposed. The fascia was placed lateral to the sclera to cover the exposed mallus. Twenty-four cases have been observed for more than 6 months and ten cases for 3--6 months after surgery. Although the results of the long-term follow-up cannot be judged until after many years, there have been so far no recognizable complications, and it seems quite possible that this technique can reduce the complications as lateral healing and anterior blunting of the fascia alone. The postoperative closure rate of the tympanic membrane was 90% in all the cases except Type IV (two cases). The indications for the use of sclera were discussed.