Lou Zihan, Lou Zhengcai, Jin Kangfeng, Sun Junzhi, Chen Zhengnong
Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China.
Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China.
Stem Cells Int. 2021 May 15;2021:5583046. doi: 10.1155/2021/5583046. eCollection 2021.
A total of 29 patients consisting 13 in the bFGF alone group and 16 in the myringoplasty group were finally included in the analysis. Of the 13 patients in the bFGF alone group, the perforations were small in 6 and medium in 7; the etiology was secondary to COM in 11 and to trauma in 2. One patient with an unhealed perforation continued bFGF treatment until 6 months, while the others stopped at 3 months. Of the seven medium-sized perforations, none of the five COM perforations closed, while the two traumatic perforations achieved complete closure within 2 and 4 weeks, respectively. The successful closure rate was 28.6% (2/7). Successful closure was achieved in 66.7% (4/6) of the six small perforations with COM, with a mean closure time of 4.75 weeks. Of the 16 patients in the myringoplasty group, all perforations were medium-sized and were secondary to COM in 15 cases and traumatic in 1 case; all achieved complete closure.
bFGF alone facilitated the repair of chronic traumatic perforations and small perforations with COM, but not medium-sized perforations with COM. These observations indicated that the regenerative conditions of traumatic perforations are better than those of COM perforations when using bFGF alone, and that graft materials could play a critical role in the regeneration of larger-sized chronic perforations with COM.
最终纳入分析的共有29例患者,其中单纯碱性成纤维细胞生长因子(bFGF)组13例,鼓膜成形术组16例。在单纯bFGF组的13例患者中,穿孔小的有6例,中等大小的有7例;病因继发于慢性中耳炎(COM)的有11例,继发于外伤的有2例。1例穿孔未愈合的患者持续bFGF治疗至6个月,其他患者在3个月时停止治疗。在7例中等大小的穿孔中,5例COM穿孔均未闭合,而2例外伤性穿孔分别在2周和4周内完全闭合。成功闭合率为28.6%(2/7)。6例继发于COM的小穿孔中有66.7%(4/6)成功闭合,平均闭合时间为4.75周。在鼓膜成形术组的16例患者中,所有穿孔均为中等大小,15例继发于COM,1例继发于外伤;所有患者均实现完全闭合。
单独使用bFGF有助于慢性外伤性穿孔和继发于COM的小穿孔的修复,但对继发于COM的中等大小穿孔无效。这些观察结果表明,单独使用bFGF时,外伤性穿孔的再生条件优于COM穿孔,并且移植材料在继发于COM的较大尺寸慢性穿孔的再生中可能起关键作用。