1
|
Speed OE, Bareiss A, Patel VA, Mangan A, Dornhoffer J, Saadi RA. Otologic use of porcine small intestinal submucosal graft (biodesign): A MAUDE database review. Am J Otolaryngol 2023; 44:103961. [PMID: 37343508 DOI: 10.1016/j.amjoto.2023.103961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 06/11/2023] [Indexed: 06/23/2023]
Abstract
OBJECTIVE To review and summarize reported adverse events related to the use of porcine small intestine submucosal grafts (Biodesign™) in otologic procedures. STUDY DESIGN Retrospective cross-sectional analysis. SETTING Food and Drug Administration's Manufacturer and User Facility Device Experience (MAUDE) database. MATERIAL AND METHODS The MAUDE database was queried for all medical device reports (MDR) related to otologic use of Biodesign™ (Cook Medical, Bloomington, IN) from January 2016 to November 2022. Adverse events (AEs) were identified by reviewing all reports with the basic search term "Biodesign" and "Biodesign, Otologic". Reports were individually reviewed and categorized with special attention to AEs. RESULTS A total of 500 reports were reviewed. Since FDA approval of Biodesign™ in 2016, there have been 5 adverse events reported for use of Biodesign™ during otologic surgery (tympanoplasty, n = 3; stapes surgery, n = 2). All reported events described patient injury, and all cases required at least one revision surgery. Four cases described significant foreign body inflammatory reactions. Complications included hearing loss (n = 3), severe otalgia (n = 2), persistent perforation (n = 2), vertigo (n = 2), and facial paralysis (n = 1). CONCLUSION The use of porcine small intestinal submucosal graft has been thought to be a safe and effective option for otologic surgery, with the advantage of availability without graft harvest in minimally invasive endoscopic surgery. However, foreign body or granulomatous reactions have been documented and should be considered prior to its use in otologic surgery.
Collapse
Affiliation(s)
- Olivia E Speed
- Department of Otolaryngology - Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Anna Bareiss
- Department of Otolaryngology - Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Vijay A Patel
- Department of Otolaryngology - Head and Neck Surgery, University of California San Diego, La Jolla, CA, USA; Division of Pediatric Otolaryngology, Rady Children's Hospital - San Diego, San Diego, CA, USA
| | - Andrew Mangan
- Department of Otolaryngology - Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - John Dornhoffer
- Department of Otolaryngology - Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA; Department of Otolaryngology - Head and Neck Surgery, Arkansas Children's Hospital, Little Rock, AR, USA
| | - Robert A Saadi
- Department of Otolaryngology - Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA; Department of Otolaryngology - Head and Neck Surgery, Arkansas Children's Hospital, Little Rock, AR, USA.
| |
Collapse
|
2
|
Ghanad I, Polanik MD, Trakimas DR, Knoll RM, Castillo-Bustamante M, Black NL, Kozin ED, Remenschneider AK. A Systematic Review of Nonautologous Graft Materials Used in Human Tympanoplasty. Laryngoscope 2020; 131:392-400. [PMID: 33176008 DOI: 10.1002/lary.28914] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 06/01/2020] [Accepted: 06/12/2020] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Nonautologous graft materials may solve several dilemmas in tympanoplasty by obviating the need for graft harvest, facilitating consistent wound healing, and permitting graft placement in the clinical setting. Prior studies of nonautologous grafts in humans have shown variable outcomes. In this systematic review, we aim to 1) summarize clinical outcomes and 2) discuss limitations in the literature regarding nonautologous grafts for tympanoplasty in humans. METHODS A literature review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. The study size, etiology and duration of perforation, type of nonautologous graft, and postoperative closure rate were assessed. RESULTS The PRISMA approach yielded 61 articles, including 3,247 ears that met inclusion criteria. Studies evaluated nonautologous grafts including paper patch, gelatin sponge, growth factors, porcine small-intestinal submucosa, among others. Traumatic perforations (62.3%) were most commonly studied, whereas postinfectious perforations (31.9%) and other etiologies (5.8%) comprised a minority of cases. Acute perforations of <8 weeks duration constituted just over half of all treated ears. Overall closure rate was 82.1%, with significantly higher closure rates in acute (89.9%) versus chronic perforations (64.9%, P < .01), regardless of material. A median postoperative air-bone gap of 5.6 dB was found in the 23% of studies reporting this metric. CONCLUSIONS The majority of publications reviewing nonautologous materials in tympanoplasty evaluate acute or traumatic perforations, and few rigorously report hearing outcomes. Given available data, porcine submucosa and basic fibroblast growth factor may hold promise for chronic perforation closure. Future studies should report closure rates and hearing outcomes in perforations >8 weeks duration. Laryngoscope, 131:392-400, 2021.
Collapse
Affiliation(s)
- Iman Ghanad
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A.,Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Marc D Polanik
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A.,Department of Otolaryngology, University of Massachusetts Medical School, Worcester, Massachusetts, U.S.A.,Department of Otolaryngology, UMass Memorial Medical Center, Worcester, Massachusetts, U.S.A
| | - Danielle R Trakimas
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, U.S.A
| | - Renata M Knoll
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A
| | | | - Nicole L Black
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A
| | - Elliott D Kozin
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A.,Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Aaron K Remenschneider
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A.,Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, U.S.A.,Department of Otolaryngology, University of Massachusetts Medical School, Worcester, Massachusetts, U.S.A.,Department of Otolaryngology, UMass Memorial Medical Center, Worcester, Massachusetts, U.S.A
| |
Collapse
|