Santhi T, Rajan K V
T.D.Medical College Hospital, Vandanam, Alappuzha, Kerala 688005 India ; Chettikkad, Pazhaveedu PO, Alappuzha, Kerala 688009 India.
Indian J Otolaryngol Head Neck Surg. 2012 Dec;64(4):389-92. doi: 10.1007/s12070-011-0425-1. Epub 2011 Dec 15.
To study the effectiveness of chemical cautery with patching on chronic tympanic membrane perforations of the pars tensa. Thirty-eight patients with dry tympanic membrane perforations due to inflammatory or traumatic etiology were selected after treating the primary etiological factors like septal deviation and allergic rhinitis. Fifty percentage silver nitrate was used to cauterize the margin and the perforation was covered with thin sterile aluminium foil as a patch. A maximum number of five applications were made, and the patients were followed up for the next 5 years. In this series of 38 patients, highest success was noted among those patients with traumatic perforation, while larger perforations were reduced to small pinhole sizes which were successfully closed by myringoplasty. An overall success rate of 73.75% was achieved. This is a time tested useful method which was popularized by Derlacki (1953), to close small to moderate sized tympanic membrane perforation and should be considered as a first line management in the treatment of tympanic membrane perforation prior to any surgical intervention. Apart from being a simple and economical mode of treatment, it is associated with minimal complications. Though various materials have been used to modify this technique, the principle remains the same and the results obtained in this study is comparable with the previous ones.
研究化学烧灼联合贴片法治疗紧张部慢性鼓膜穿孔的有效性。在治疗鼻中隔偏曲和过敏性鼻炎等原发性病因后，选择了38例因炎症或外伤病因导致鼓膜干性穿孔的患者。使用50%的硝酸银烧灼穿孔边缘，并用薄无菌铝箔作为贴片覆盖穿孔。最多进行5次治疗，并对患者进行了接下来5年的随访。在这38例患者中，外伤性穿孔患者的成功率最高，而较大的穿孔缩小为小针孔大小，并通过鼓膜成形术成功闭合。总体成功率达到73.75%。这是一种经时间检验的有用方法，由德拉克基（1953年）推广，用于闭合中小尺寸的鼓膜穿孔，在任何手术干预之前，应被视为鼓膜穿孔治疗的一线治疗方法。除了是一种简单且经济的治疗方式外，它还伴有极少的并发症。尽管已使用各种材料对该技术进行改良，但其原理保持不变，本研究获得的结果与之前的研究结果相当。
