Jang Chul Ho, Park Haekyun, Cho Yong Bum, Choi Cheol Hee
Department of Otolaryngology, Chonnam National University Medical School, South Korea.
Int J Pediatr Otorhinolaryngol. 2008 Nov;72(11):1603-8. doi: 10.1016/j.ijporl.2008.07.012. Epub 2008 Sep 2.
BACKGROUND & OBJECTIVE: The presence of adhesions after middle ear surgery is not uncommon. Fibrosis can cause conductive hearing loss and it contributes to retraction of the tympanic membrane in the post-surgery patient. The purpose of this study was to evaluate the anti-adhesive effect of Seprafilm and MeroGel in the abraded mucosa of a guinea pig's middle ear.
Fifteen pathogen-free adult male albino guinea pigs weighing 250-300g each were used. Under an aseptic condition, the middle ear mucosa was abraded using a pick through a myringotomy incision. Seprafilm, MeroGel and Gelfoam, respectively, were then packed into guinea pigs' middle ear cavities. Auditory brainstem responses (ABRs) were assessed preoperatively and 3 weeks after operation.
The ABR results at postoperative week 3 showed no statistically significant difference for the myringotomy and postpacking, except for the MeroGel packing. However, there was no significant threshold on the 6 weeks' postoperative ABR. The Gelfoam group demonstrated extensive fibrosis and adhesion within the bulla cavity. The Seprafilm and MeroGel groups showed no adhesion in the middle ear cleft after abrasion of the mucosa.
From these results, we suggest the use of Seprafilm and MeroGel to improve the results of otosurgery.
中耳手术后粘连的情况并不少见。纤维化可导致传导性听力损失,并促使术后患者鼓膜内陷。本研究旨在评估施沛特和美洛凝胶对豚鼠中耳黏膜擦伤后的抗粘连效果。
选用15只体重250 - 300克的无特定病原体成年雄性白化豚鼠。在无菌条件下,通过鼓膜切开术切口用探针擦伤中耳黏膜。然后分别将施沛特、美洛凝胶和明胶海绵植入豚鼠中耳腔。术前及术后3周评估听觉脑干反应(ABR)。
术后第3周的ABR结果显示,除美洛凝胶植入组外,鼓膜切开术及植入后无统计学显著差异。然而,术后6周的ABR无显著阈值。明胶海绵组在鼓泡腔内出现广泛纤维化和粘连。施沛特组和美洛凝胶组在黏膜擦伤后中耳裂未见粘连。
根据这些结果,我们建议使用施沛特和美洛凝胶来改善耳外科手术效果。