The method of obtaining tympanoplasties transplant


(57) Abstract:

The invention relates to medicine, namely to otorhinolaryngology and may find application in chronic suppurative otitis media with tympanoplasty. The method of obtaining tympanoplasties material is that used Vartanov jelly, fragments of which are placed on a nylon mesh, forming monoplast necessary area for 5 h carry out the exposure by ultraviolet rays of the spectrum. After 3 h from the start of exposure on the surface of this layer is applied 1 ml of 1% solution dioksidina, then the resulting film is removed with a nylon base. The resulting material is acellular collagen-elastic formation with polymerized amorphous matrix with elasticising properties, low immunogenic properties and optimal physical qualities anatomical and functional tissue replacement. 1 C.p. f-crystals.

The invention relates to medicine, namely to otorhinolaryngology and may find application in chronic suppurative otitis media.

Long-term clinical experience of the use of tympanoplasty different grafts (the wall of the vein, litestat, allosterically graft, scar membrane, polymeric materials) demonstrate a significant percentage of rejections(1, 2, 3, 5).

The existence of a large number of different materials for tympanoplasty, as well as the ongoing search for new fabrics testifies to their imperfection and lack of decisive advantages of one or another of the graft in terms of his healing.

Therefore, the development of new effective materials for tympanoplasty is the actual problem.

Currently, the most common in clinical practice material for tympanoplasty is the fascia of the temporal muscle of the patient (autopaste), the application of which leads to the most optimal anatomical and functional results(6, 7, 9, 10).

The advantages of autowaschanlage transplant include: the ability to create thin, easily drying, simulated and laid transplant. In addition, mesoderm its origin excludes the formation of secondary cholesteatoma, epidermal cysts. Elastic fibers that form various sizes and shapes, the network is well stretched, that attaches to the fascia elastischem (4).

However, taking the fascia of the temporal muscle is additional operating trauma for the patient, sometimes with a number of complications (bleeding, purulent infection) and in the subsequent occurs the limit reuse of this material in case of relapse.

Along with many positive properties autowaschanlage graft and good long-term results when it is used, there are reports of the possibility of necrosis in transplanted graft followed by the formation of the perforation, the development of granulation tissue and fibrous thickenings (4).

The novelty of the proposed solution is that the authors first used the cords Vartanova jelly of the umbilical cord of the fetus mammals in order to obtain a graft for tympanoplasty.

This object is achieved in that the material for transplant use film obtained by coating the strands Vartanova jelly of the umbilical cord of the fetus on a nylon mesh carry out the exposure for 5 hours by the rays of the ultraviolet spectrum. After three hours from the start of exposure on the surface of this layer is applied 1 ml of 1% solution dio the ski transplant.

As the source material used tissue elements (Vartanov jelly) full-term umbilical cord fetal mammals.

Within 20 hours after birth resetinput the site of the umbilical cord of the fetus, which is thoroughly washed with saline solution, wring out from blood clots from umbilical veins and arteries. After the longitudinal cutting of the umbilical cord and separation of vascular cells produce layerwise separation Vartanova jelly in the form of individual fibers (thickness up to 3 mm and a length of 40 mm), which are then placed on a nylon mesh so as to form monoplast rounded necessary surface area. For polymerization of the laid strands within 5 hours carry out the exposure by ultraviolet rays of the spectrum. To impart antibacterial qualities tympanoplasties material in three hours from the start of exposure on the surface of this layer is applied 1 ml of 1% solution dioksidina. In the end, forms a transparent film of a thickness of 0.5 mm with elastic properties.

Moreover, we observed that the polymerization cords Vartanova jelly takes place only in case of availability of oxygen in the air from two sides (upper and lower surfaces of the graft)th microscopy of this material with the use of dyes was determined by the following picture: the absence of cells; the presence of intercellular substance, represented by three types of concentrically arranged fibers (elastic, reticular, collagen) and hydrophilic rich amorphous matrix.

This material contains collagen matrix, which serves as the basis for the growing epithelium. In its composition does not include cellular elements, on the membrane surface which, as you know, are antigenic system (8), which generally excludes immunological response of transplant rejection.

Thus, we can conclude that this material is acellular collagen-elastic formation of polymerized with an amorphous matrix having elasticity.

The proposed method for tympanoplasties material allows you to create a graft for tympanoplasty with low immunogenic properties and optimal physical qualities anatomical and functional tissue replacement.


1. Bystrany A. C. - Growing cicatricial membrane, replacing missing the eardrum. - //The Bulletin of torinla., 1986-N6-N-32-34.

2. Zabirov R. A. and others - Results of surgical treatment of the sick who .18-19.

3. Zabirov R. A. and others - Myringoplasty in patients with chronic mesotympanum. - In the book: Proceedings of the I Congress of torinla. Proc.Dokl.. Bishkek - 1999 - S. 41-42.

4. Kulakov, L. A. Abstract.Kida.Diss... M, 1990.

5. Ovchinnikov A. Y., Ball, I. A. - the Use of canned flap to form natinonally membranes in tympanoplasty. In the book: IX Congress of torinla. Proc.Dokl., Chisinau - 1988-N-286.

6. Palacina O. K. - Surgical rehabilitation of patients with conductive hearing loss. In the book: VIII Congress of torinla. Proc.Dokl., M, - 1982 - N-21-23.

7. Transfiguration N. A. Modern state and ways of improving microsurgery of the ear. in the book: VIII Congress of torinla. Proc.Dokl., M, - 1982 - S. 37-42.

8. A. Rout fundamentals of immunology. M. Mir 1991, S. 55-57.

9. Perrin, A. , R. Mendosa, Baril Ch. et.all. - Resultats anatomigues a long terme des homogreffes tympanigues. A propos de 170 cas. //Ann. Otolaryngol. chir. cervicovas. 1987-65-1-S. 26-28.

10. Shenoi P. M. - Autogenous temporaus fascia grafts. //J. Laryng. - 1982-96-N4-S 801-810.

1. The method of obtaining tympanoplasties transplant, including the production of a material with elastic properties, characterized in that use fibers Vartanova jelly, fragments of which are placed on a nylon mesh, forming monoplast required area, t is I.

2. The method according to p. 1, characterized in that after 3 h from the start of exposure on the surface of monoplast put 1 ml of a 5% solution dioksidina.


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