Histology of the tympanic perforation and the replacement membrane.

This study shows that the mucocutaneous junction of a perforation of the tympanic membrane may be located at the margin, in the middle ear, or in the ear canal. It is incumbent upon the surgeon performing myringoplasty to identify this junction in order to optimize the success of surgery. About one-third of the healed area following perforation has an intermediate fibrous layer. The membranes in 2 cases of myringoplasty evidenced thicker-than-normal intermediate layers.