中耳手術におけるフィブリン膜の使用経験

CLINICAL APPLICATION OF FIBRIN FILM IN MIDDLE EAR SURGERY

　I．はじめに

　中耳手術において鼓膜や病変除去後の組織欠損部の補綴，補強の材料として外耳皮膚，筋膜，静脈，骨膜あるいは軟骨膜などの自家組織や各種の人工材料が広く使用されている。また，外来診療において鼓膜穿孔閉鎖の目的で，和紙などの紙状の材料が貼付されて，穿孔部をおおい，表皮化を促し，同部の閉鎖が試みられている。今回筆者らはヒト血液から製造された不溶性蛋白質（フィブリン膜）をこれらの目的に使用し，この膜は極めて簡単にデザインができ，かつ何ら副作用を残さない安全なものであることを臨床的に確認し得たので報告する。

　Fibrin film produced from human serum was used as a supporting scaffold for closing the perforated tympanic membrane or a reinforcement material of the fascia in tympanoplasty of 13 patients with chronic otitis media.

　Fibrin film was cut at desired sizes and placed on perforated tympanic membranes or grafted fascias.

　Fibrin film had a tendency to fall spontaneously off from the surface of the tympanic membrane when the epidermization was completed after myringoplasty.

　In tympanoplasty fibrin film was inserted between the epidermis and grafted fascia. Films were absorbed and/or replaced newly formed connective tissues within approximately 4 months.

　There was no sign of tissue reaction nor any delay in the process of wound healing by usage of this material.

　The authors concluded that fibrin film is the safest, most handy and suitable occlusion or reinforcement materials in myringoplasty or tympanoplasty.