Spiegel Jeffrey H, Kessler Joshua L
Department of Otolaryngology-Head and Neck Surgery, Boston University School of Medicine, Boston, Massachusetts, USA.
Otol Neurotol. 2005 Jul;26(4):563-6. doi: 10.1097/01.mao.0000169636.63440.4e.
To evaluate the efficacy of acellular porcine small intestine submucosa in the repair of chronic tympanic membrane perforations. Although tympanoplasty with autologous temporalis fascia and cartilage is common practice in the repair of chronic tympanic membrane perforations, these materials are associated with increased operative time and have variable availability and quality in individual patients. Recently, new materials for tympanoplasty have been explored, including acellular human dermis. Small intestine submucosa (Surgisis) is an inexpensive and readily available alternative to autologous and cadaveric grafts. In this study, we examined the use of small intestine submucosa in the repair of chronic tympanic membrane perforations in a chinchilla model.
Prospective pilot study using 10 adult chinchillas.
Chronic tympanic membrane perforations were created in 10 adult chinchillas for a total of 20 perforations. Each animal underwent observation in one ear and repair with either autologous cartilage or small intestine submucosa in the opposite ear with Type I tympanoplasty.
A total of 20 chronic membrane perforations were created, with zero healing spontaneously after 8 weeks. In tympanoplasties performed in five chinchillas with small intestine submucosa, five of five (100%) remained healed 6 weeks postoperatively, whereas three of five (60%) remained healed with cartilage repair. Histologic analysis was performed in both successful cartilage and small intestine submucosa repairs.
These results suggest that small intestine submucosa is a viable alternative to autologous and cadaveric grafts in tympanoplasty. A larger randomized study in humans is indicated to evaluate this material in clinical practice.
评估脱细胞猪小肠黏膜下层在修复慢性鼓膜穿孔中的疗效。虽然采用自体颞肌筋膜和软骨进行鼓室成形术是修复慢性鼓膜穿孔的常用方法，但这些材料会增加手术时间，且在个体患者中其可用性和质量存在差异。最近，人们探索了用于鼓室成形术的新材料，包括脱细胞人真皮。小肠黏膜下层（Surgisis）是一种价格低廉且易于获取的自体和尸体移植物替代品。在本研究中，我们在栗鼠模型中研究了小肠黏膜下层在修复慢性鼓膜穿孔中的应用。
对10只成年栗鼠进行前瞻性初步研究。
在10只成年栗鼠身上制造慢性鼓膜穿孔，共形成20个穿孔。每只动物的一只耳朵进行观察，另一只耳朵采用I型鼓室成形术，分别用自体软骨或小肠黏膜下层进行修复。
共制造了20个慢性鼓膜穿孔，8周后无自发愈合情况。在5只采用小肠黏膜下层进行鼓室成形术的栗鼠中，术后6周5只（100%）均保持愈合，而采用软骨修复的5只中有3只（60%）保持愈合。对成功进行软骨和小肠黏膜下层修复的样本均进行了组织学分析。
这些结果表明，在鼓室成形术中，小肠黏膜下层是自体和尸体移植物的可行替代品。需要在人类中进行更大规模的随机研究，以在临床实践中评估这种材料。
