Perforation of ear drum was always caused by infection and trauma. It could cause the acute and repeated attack of otitis media, thus caused different levels of hearing loss. 

As a result, eliminate inflammation and improve hearing are key issues in treating this kind of wounds.

Maintain the smooth condition of the auditory tube was an important issue in successful ear drum treatment. Functional impairment of auditory tube could easily cause exudative otitis media and affected the healing of ear drum. As a result, maintain the auditory tube smooth was very important in treating chronic inflammational perforations.

Infection could affect healing. After secondary infection, inflammational exudation increased and this would cause hyperplasy of fibrous tissues in the perforated wounds thus affected healing. In cases of traumatic perforation, early treatment was necessary to decrease the possibility of regional secondary infection. In the first week after operation, antibiotics and multi-vitamins supplements should be taken orally to prevent infection and improve the cellular oxidation and differentiation capabilities.

Once the perforation edges were covered by epithelial lamina again after operation, re-scoraping was necessary before attachment to remove the epithelial tissues. Otherwise the therapeutic effects would be affected.

The main component of MEBO was Β-sitosterin. Besides anti-infection effects, it had strong affinity to the wounds and could maintain a physiological moist environment in the wounds. It could improve regional microcirculation, create an environment for the growth of epithelial tissues and promote the healing in the wounds. At the same time, it could absorb the exudants in the wounds and alleviate and inflammation.

In a word, compared with other methods to treat small perforation of ear drum, MEBO cotton pad attachment method had unique superiority thus deserved generalization.

Methods: 

After the patients got seated, normal skin disinfection was carried out in acoustic duct. 

In case of fresh traumatic perforation in 7 days, blood scab was cleaned first. Then a cotton pad (1~2mm bigger than the perforation) should be made in aseptic conditions according to the size of perforation. 

MEBO was spread on the cotton pad, which was later attached to the perforation area. 

An aseptic cotton ball was filled in external auditory canal opening. In case of chronic inflammational perforation, 1% caine cotton pad was attached to the surface of remaining peripheral ear drum for 15 minutes under aseptic conditions first.

Later a tiny curette was applied to scorap the surrounding areas (0.5mm~1.0mm) of the perforation. Then a fine needle was applied to prick the edges in multidrops, cut the full-thickness of the ear drum and remove the epithelial tissues in the edges of the perforation in order to create fresh wounds. 

Finally MEBO cotton pad was attached as the same method mentioned above. An aseptic cotton ball was filled in external auditory canal opening.

Full Report: Small Perforation of Ear Drum Treated by MEBO Cotton Pad Attachment Method, Clinical Medical Journal of China, 1999, 6(2): 154