McGhee M A, Dornhoffer J L
Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock 72205, USA.
Am J Otol. 1999 Nov;20(6):712-6.
Gelfilm offers protection against fibrosis in the middle ear when used in combination with Gelfoam.
Gelfoam is used routinely as a support structure in the middle ear cleft when ossicular reconstruction and tympanic membrane grafts are performed. It has been recognized that fibrosis may occur in this setting if the middle ear mucosa is denuded. Materials have been used to protect the mucosa in an attempt to prevent scar bands, adhesions, and fibrosis and its potential detriment on hearing. These materials have included Teflon, Silastic, and Gelfilm. Concerns have arisen regarding this mode of therapy and its benefit.
This study looks at the effects of implanting Gelfoam independently and Gelfoam and Gelfilm concurrently in the bulla cavity of the Mongolian Gerbil. The temporal bones were harvested and evaluated histologically using hemotoxylin and eosin staining for fibrosis.
Results demonstrated a decrease in the amount of fibrosis in the animals in which Gelfilm was used to protect the denuded mucosa. No evidence of fibroblast ingrowth or scar bands penetrating the Gelfilm was identified.
These results suggest that Gelfoam can be used safely in the middle ear cleft to support ossicular prosthesis and tympanic membrane grafts when Gelfilm is used to protect denuded mucosa.
当与明胶海绵联合使用时，明胶膜可预防中耳纤维化。
在进行听骨链重建和鼓膜移植时，明胶海绵通常用作中耳裂的支撑结构。人们已经认识到，如果中耳黏膜被剥脱，在这种情况下可能会发生纤维化。已经使用了多种材料来保护黏膜，试图预防瘢痕带、粘连和纤维化及其对听力的潜在损害。这些材料包括聚四氟乙烯、硅橡胶和明胶膜。人们对这种治疗方式及其益处产生了担忧。
本研究观察了在蒙古沙鼠的鼓泡腔中单独植入明胶海绵以及同时植入明胶海绵和明胶膜的效果。采集颞骨，并用苏木精和伊红染色进行组织学评估以检测纤维化情况。
结果表明，使用明胶膜保护剥脱黏膜的动物中，纤维化程度有所降低。未发现有成纤维细胞向内生长或瘢痕带穿透明胶膜的迹象。
这些结果表明，当使用明胶膜保护剥脱的黏膜时，明胶海绵可安全地用于中耳裂以支撑听骨假体和鼓膜移植物。
