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Protection of tympanomeatal flaps using Visibility Background Material

Published online by Cambridge University Press:  07 April 2010

N B Oozeer  and
A Iyer
N B Oozeer*
Affiliation:
Department of Otolaryngology, Monklands Hospital, Airdrie, UK
A Iyer
Affiliation:
Department of Otolaryngology, Monklands Hospital, Airdrie, UK
*
Address for correspondence: Miss Nashreen Banon Oozeer, ENT Specialty Registrar 5, Department of Otolaryngology, Monklands Hospital, Airdrie ML6 0JS, UK. Fax: +44 (0)1236 760015 E-mail: n.oozeer@googlemail.com
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Abstract

Background:

Over the years, various materials have been used by otologists to protect tympanomeatal flaps from damage by suction equipment or drills.

Objective:

This report aims to describe the use of Mercian's Visibility Background Material® (an inert, silicone-based material licensed for use in the human body, which does not get caught in drill flukes) to protect tympanomeatal flaps.

Conclusion:

We have used this material for over 12 months, without any complications.

Keywords

TympanoplastyOtologic Surgical Procedures
Type
Short Communications
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 9 , September 2010 , pp. 995 - 996
Copyright
Copyright © JLO (1984) Limited 2010

Following elevation of the tympanomeatal flap, otologists have described various methods for protecting the flap from damage. These include using a piece of aluminium foil from the suture material cover, or a circular piece of Silastic® sheeting.Reference Mancini, Russo and Sanna1, Reference Leliever2 Damage to the flap occurs with overzealous use of suction, or when drilling (e.g. whilst fashioning an atticotomy).

Over the last 12 months, the senior author (AI) has used Mercian's Visibility Background Material® (Mercian Surgical Supply, Birmingham, UK) to protect tympanomeatal flaps (Figure 1). No complications have been encountered with this inert material. The skin, when preserved, can assist epithelialisation of the cavity.

Mercian's Visibility Background Material is made of silicone. It is latex-free and contains barium to make it radiopaque (should it be ‘misplaced’). It has been designed and used mainly for microsurgical anastomosis of vessels, to aid visualisation. It is available in three colours: yellow, blue and green. As opposed to such materials as suture packets (used by many), Visibility Background Material is licensed for use inside the human body. In addition, it has a non-reflective surface, which is important when working with an operating microscope.

There are 12 pieces of Visibility Background Material per box, each measuring 50 × 25 mm. The material is economical, at £8 per sheet.

Fig. 1 (a) Visibility Background Material®. (b) & (c) Use of Visibility Background Material to protect a tympanomeatal flap during a right atticotomy.

We use a small piece cut in the shape of the tympanic membrane (diameter approximately 1 cm). Even if touched by a moving burr, Visibility Background Material is not caught in the burr flukes, unlike other materials (e.g. aluminium foil or cottonoids).

We have used Visibility Background Material for over 12 months, without any complications.

References

1Mancini, F, Russo, A, Sanna, M. Grafting techniques for tympanoplasty. Operative Techniques in Otolaryngology-Head and Neck Surgery 1996;7:34–7CrossRefGoogle Scholar
2Leliever, WC. Flap protection in exostosis surgery. Laryngoscope 1985;95:1126–7Google Scholar
Figure 0

Fig. 1 (a) Visibility Background Material®. (b) & (c) Use of Visibility Background Material to protect a tympanomeatal flap during a right atticotomy.