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October 1960

Vein Graft Closure of Eardrum Perforations

Arch Otolaryngol. 1960;72(4):445-447. doi:10.1001/archotol.1960.00740010455003

A central or marginal perforation of the eardrum can be closed by placing a small piece of vein graft beneath the perforation in the middle ear and encouraging the epithelium of the drum to proliferate over it.

I discovered this technique while doing a fenestration of the oval window operation in which the drum was accidently torn at the margin while elevating it from its sulcus. A triangular marginal defect resulted with its base on the annulus, about one-tenth the area of the drum. This was in the postero-inferior quadrant of the drum where such perforations are prone to occur during the elevation of the flap. After completing the operation I reapproximated the edges of the defect as completely as possible. I then put a small piece of vein graft just beneath the perforation, the intima toward the middle ear and the adventitia in contact with the undersurface of the