局部地塞米松与中耳炎鼓膜穿孔愈合：一项短期研究。

Topical dexamethasone and tympanic membrane perforation healing in otitis media: a short-term study.

机构信息

Department of Otolaryngology, University of Florida, 1600 SW Archer Rd., Gainesville, FL 32610-0264, U.S.A.

出版信息

Otol Neurotol. 2010 Apr;31(3):519-23. doi: 10.1097/MAO.0b013e3181ca85cc.

DOI:10.1097/MAO.0b013e3181ca85cc

PMID:20010446

Abstract

BACKGROUND

The safety and efficacy of topical corticosteroids have not been established in the treatment of acute otitis media (AOM) with tympanic membrane (TM) perforation. Specific concerns include the risk for nonhealing TM perforations. Previous studies have not been done in models with concurrent AOM. The purpose of this study was to determine whether the addition of dexamethasone to topical ciprofloxacin affects healing of AOM-related TM perforations.

METHODS

Bilateral AOM was induced in chinchillas by transbulla injection of Streptococcus pneumoniae, and TMs were perforated with a CO2 laser 3 to 5 days later. Each animal received ciprofloxacin-dexamethasone in one ear and ciprofloxacin in the other, twice daily for 7 days. Tympanic membranes were assessed for 4 weeks.

RESULTS

Fifteen of 55 ciprofloxacin-treated and 37 of 55 ciprofloxacin-dexamethasone-treated TMs failed to heal within the 4-week study period (p < 0.001). Exposure to dexamethasone increased the odds for persistent perforation by 5.5 (95% confidence interval, 2.4-12.6). At 4 weeks, mean TM perforation diameter was 0.9 mm in ciprofloxacin-treated ears and 2.1 mm in ciprofloxacin-dexamethasone-treated ears (p < 0.001).

CONCLUSION

Topical dexamethasone hinders TM healing in a chinchilla model of AOM at short-term follow-up. Longer follow-up is needed.

摘要

背景

局部皮质类固醇在治疗伴有鼓膜穿孔的急性中耳炎（AOM）方面的安全性和疗效尚未得到证实。具体问题包括鼓膜穿孔不愈合的风险。以前的研究没有在伴有 AOM 的模型中进行。本研究旨在确定在局部环丙沙星中加入地塞米松是否会影响 AOM 相关鼓膜穿孔的愈合。

方法

通过鼓室内注射肺炎链球菌在南美栗鼠中诱发双侧 AOM，并用 CO2 激光在 3 至 5 天后穿孔鼓膜。每只动物在一只耳朵中接受环丙沙星-地塞米松，另一只耳朵接受环丙沙星治疗，每天两次，持续 7 天。在 4 周内评估鼓膜。

结果

在 55 只接受环丙沙星治疗的鼓膜中，有 15 只在 4 周的研究期间未能愈合，而在 55 只接受环丙沙星-地塞米松治疗的鼓膜中，有 37 只未能愈合（p < 0.001）。接触地塞米松使持续性穿孔的可能性增加了 5.5 倍（95%置信区间，2.4-12.6）。在 4 周时，接受环丙沙星治疗的鼓膜穿孔直径平均为 0.9 毫米，而接受环丙沙星-地塞米松治疗的鼓膜穿孔直径为 2.1 毫米（p < 0.001）。