Lou Z C, Yang J, Tang Y, Fu Y H
Department of Otorhinolaryngology, The Affiliated YiWu Hospital of Wenzhou Medical University, Zhejiang, 322000, China.
Department of pathology, The Affiliated YiWu Hospital of Wenzhou Medical University, Zhejiang, 322000, China.
Clin Otolaryngol. 2016 Dec;41(6):744-749. doi: 10.1111/coa.12627. Epub 2016 Feb 9.
We evaluated the effects of conservative treatment and topical application of epidermal growth factor (EGF) with no scaffold material on the healing of human traumatic tympanic membrane perforations (TMPs).
Prospective, randomised clinical trial.
A prospective analysis was performed between January 2015 and March 2015 for the treatment of human traumatic TMPs. The closure rate, closure time, hearing gain and rate of purulent otorrhoea were compared between the topical application of EGF and conservative treatment.
In total, 97 patients were analysed. The total closure rates did not significantly differ between the observation and EGF groups (83.0% versus 92.0%, P = 0.182). The total average closure time in the observation group was significantly longer than in the EGF group (25.1 ± 10.5 versus 11.7 ± 5.2 days, P = 0.001). When the closure rate was evaluated according to perforation size, no significant difference was seen for medium or large perforations (P = 0.18 and 0.21, respectively). When closure time was evaluated according to perforation size, a significant difference was seen for medium and large perforations (P = 0.001).
This study suggests that topical application of EGF with no scaffold material may significantly shorten the closure time of human traumatic TMPs. Such a shorter recovery time may lead to reduced healthcare costs. This alternative technique to a classic myringoplasty is particularly beneficial and suitable for the closure of large human traumatic TMPs.
我们评估了在不使用支架材料的情况下，保守治疗及局部应用表皮生长因子（EGF）对人类外伤性鼓膜穿孔（TMP）愈合的影响。
前瞻性随机临床试验。
于2015年1月至2015年3月对人类外伤性TMP的治疗进行前瞻性分析。比较了局部应用EGF与保守治疗之间的闭合率、闭合时间、听力增益及脓性耳漏发生率。
共分析了97例患者。观察组与EGF组的总闭合率无显著差异（83.0%对92.0%，P = 0.182）。观察组的总平均闭合时间显著长于EGF组（25.1±10.5天对11.7±5.2天，P = 0.001）。根据穿孔大小评估闭合率时，中、大穿孔未见显著差异（分别为P = 0.18和0.21）。根据穿孔大小评估闭合时间时，中、大穿孔存在显著差异（P = 0.001）。
本研究表明，在不使用支架材料的情况下局部应用EGF可显著缩短人类外伤性TMP的闭合时间。如此短的恢复时间可能会降低医疗成本。这种替代传统鼓膜成形术的技术特别有益，适用于闭合大型人类外伤性TMP。
