Tang I P, Prepageran N, Raman R, Sharizhal T
Department of Otorhinolaryngology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
J Laryngol Otol. 2009 Dec;123(12):1321-4. doi: 10.1017/S0022215109990806. Epub 2009 Oct 16.
To determine whether epithelial migration in the atelectatic tympanic membrane (secondary to any pathology) occurs in a similar fashion to that in the normal (non-pathological) tympanic membrane, by calculating and comparing the epithelial migration rate and pattern.
Prospective, non-randomised, case-control study. This study was a pilot study. We included patients with an atelectatic pars tensa region of the tympanic membrane and a healthy contralateral tympanic membrane (the latter used as the control).
Otorhinolaryngology out-patient clinic. The study was conducted from January 2006 to January 2008.
A total of 40 patients (80 ears) were included based on their otoscopic appearance and tympanography findings. All patients' ears were examined under an operating microscope. A dot of methylene blue dye was applied in the immediate vicinity of the umbo of the atelectatic tympanic membrane, and in the same position on the tympanic membrane of the control ear. Patients were then followed up weekly until the dye dot had migrated to reach the annulus.
Direction and rate of epithelial migration.
In the atelectatic tympanic membranes, epithelial migration proceeded from the centre of the retraction pocket toward the annulus in a lateral, radiating manner. Thirty-three (82.5 per cent) of the 40 patients showed a similar migratory pattern in both the study and control ears. Sixty per cent of the retracted tympanic membranes showed no migration in the first week after methylene blue staining. After the first week, the migration rate was nearly constant from the umbo towards the periphery, in both the study and control ears. The mean daily epithelial migration rate in the study and control ears was 62.6 and 64.7 microm/day, respectively; however, this difference was statistically insignificant (p = 0.202, independent samples t-test).
There is no difference in the epithelial migration rate or pattern, comparing atelectatic tympanic membranes and normal tympanic membranes. However, there may be a significant difference in the epithelial migration rate with increased grades of tympanic membrane atelectasis.
通过计算和比较上皮迁移速率及模式，确定萎缩性鼓膜（继发于任何病理情况）中的上皮迁移是否与正常（非病理）鼓膜中的上皮迁移方式相似。
前瞻性、非随机、病例对照研究。本研究为一项试点研究。我们纳入了鼓膜紧张部有萎缩区域的患者以及对侧健康鼓膜（后者用作对照）。
耳鼻喉科门诊。研究于2006年1月至2008年1月进行。
根据耳镜检查外观和鼓室图检查结果共纳入40例患者（80只耳）。所有患者的耳朵均在手术显微镜下进行检查。在萎缩性鼓膜脐部附近以及对照耳鼓膜的相同位置涂抹一滴亚甲蓝染料。然后每周对患者进行随访，直至染料点迁移至环行皱襞。
上皮迁移的方向和速率。
在萎缩性鼓膜中，上皮迁移以横向、放射状方式从回缩袋中心向环行皱襞推进。40例患者中有33例（82.5%）在研究耳和对照耳中表现出相似的迁移模式。60%的回缩鼓膜在亚甲蓝染色后的第一周未出现迁移。第一周后，研究耳和对照耳从脐部向周边的迁移速率几乎恒定。研究耳和对照耳的平均每日上皮迁移速率分别为62.6微米/天和64.7微米/天；然而，这种差异无统计学意义（p = 0.202，独立样本t检验）。
比较萎缩性鼓膜和正常鼓膜，上皮迁移速率或模式没有差异。然而，随着鼓膜萎缩程度增加，上皮迁移速率可能存在显著差异。
