Lou Zhengcai, Huang Peng, Yang Jian, Xiao Jian, Chang Jiang
Department of Otorhinolaryngology, Affiliated Yiwu Hospital of Wenzhou Medical University, Zhejiang, China.
Department of Otorhinolaryngology, Binzhou Centre Hospital, Shandong, China.
Am J Otolaryngol. 2016 Mar-Apr;37(2):156-61. doi: 10.1016/j.amjoto.2015.11.004. Epub 2015 Nov 17.
To investigate the feasibility of direct application of basic fibroblast growth factor (bFGF) without edge trimming on human subacute traumatic tympanic membrane perforation (TMP).
A total of 29 patients with traumatic TMPs beyond 1 month after trauma were enrolled. Patients were placed into two groups: an observation group (n=17) and a bFGF-treated group (n=12). The bFGF-treated group was treated by direct application of bFGF, in which the margin of the perforation was not trimmed. All patients were followed at least once per week until the perforation was completely closed or for up to 6 months. The closure rate and closure time were estimated.
At 6 months, 11/12 (91.7%) perforations achieved complete closure after bFGF treatment. The mean closure time was 18.1 ± 11.4 days (range=3-65 days). Purulent otorrhea was found after treatment in five patients, but resolved after oral amoxicillin and ofloxacin ear drops. Of these five patients, four achieved complete closure. However, only 9/17 (52.9%) perforations achieved complete spontaneous closure in the observation group. FGF-treated groups had significantly improved closure rates compared to the observation group (91.7% vs. 52.9%, respectively, P=0.03).
Although the margin of the perforation was not trimmed, direct application of bFGF on human subacute TMP was feasible, and it could significantly improve the closure rate of the subacute TMPs. The technique was simple and convenient. Thus, direct application of bFGF should be recommended pre-myringoplasty.
探讨在不修剪边缘的情况下直接应用碱性成纤维细胞生长因子(bFGF)治疗人亚急性创伤性鼓膜穿孔(TMP)的可行性。
纳入29例创伤后1个月以上的创伤性TMP患者。将患者分为两组:观察组(n = 17)和bFGF治疗组(n = 12)。bFGF治疗组采用直接应用bFGF的方法治疗,其中穿孔边缘未进行修剪。所有患者每周至少随访1次,直至穿孔完全闭合或长达6个月。评估闭合率和闭合时间。
6个月时,bFGF治疗后12例穿孔中有11例(91.7%)实现完全闭合。平均闭合时间为18.1±11.4天(范围 = 3 - 65天)。5例患者治疗后出现脓性耳漏,但口服阿莫西林和氧氟沙星滴耳液后症状缓解。这5例患者中,4例实现完全闭合。然而,观察组中只有9/17(52.9%)的穿孔实现完全自发闭合。与观察组相比,FGF治疗组的闭合率显著提高(分别为91.7%和52.9%,P = 0.03)。
尽管未修剪穿孔边缘,但在人亚急性TMP上直接应用bFGF是可行的,并且可以显著提高亚急性TMP的闭合率。该技术简单方便。因此,在鼓膜成形术前应推荐直接应用bFGF。