Knowledge of variations in the pattern of epithelial migration across the tympanic membrane can be helpful in the preoperative evaluation of dry, central-type perforations. In a substantial number of such perforations, either because of size or location, some doubt exists as to whether epithelium has invaded the middle ear. Potentially, this question can be answered, without resorting to tympanotomy, simply by observing the migration of tympanic membrane epithelium at intervals after strategic markings with small dots of India ink.
In ears where no invasion is present, these dots can be seen to migrate at varying rates around and away from the periphery of the perforation. When invasion has taken place, properly applied dots can be seen to be carried through the perforation into the middle ear. Two case reports will serve to describe the technique and demonstrate results. Preoperative diagnosis based on these and other observations were confirmed by tympanotomy
SIMMONS FB. Epithelial Migration in Central-Type Tympanic Perforations: Preliminary Report on a Potential Diagnostic Tool. Arch Otolaryngol. 1961;74(4):435–436. doi:10.1001/archotol.1961.00740030444013
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