Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Seoul, Republic of Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea.
J Int Adv Otol. 2022 May;18(3):243-251. doi: 10.5152/iao.2022.21272.
This study aimed to investigate the outcome of using the human acellular dermal allograft patch compared with the conven- tional paper patch in traumatic tympanic membrane perforation.
This was a retrospective study including 41 patients (42 ears) treated with 22 human acellular dermal allografts and 20 paper patches for acute traumatic tympanic membrane perforation from April 2013 to June 2020. The procedure was performed by applying human acellular dermal allograft or paper patches after trimming of perforation margins under local anesthesia. Patient's age, sex, cause, duration, side, location, size of perforation, and the result of healing was analyzed. The audiologic or computed tomography data were also investigated when available.
There was no significant difference in sex, age, affected side ratio, size and duration of perforation, recovery confirmation time, and audiogram results between the two groups. There was no significant difference in the size or duration of perforation between the success and failure groups. The human acellular dermal allograft and paper-patch groups showed no significant difference in the recovery confirmation time (70.7 ± 42.3 vs. 89.9 ± 119.4 days, P = .486) and recovery rate (95.5% vs. 85.0%, P = .333). However, the patch maintenance time of the human acellular dermal allograft group was statistically longer than the paper-patch group (32.9 ± 14.9 vs. 15.6 ± 19.9 days, P = .001). On multivariable regression analysis, patch material was the only parameter associated with patch maintenance time (P = .002).
Treatment outcomes of traumatic tympanic membrane perforation using human acellular dermal allograft showed better or similar therapeutic efficacy compared to paper patch. The important advantage of this material is to stay in situ for a sufficient time without being detached until successful healing.
本研究旨在探讨人脱细胞真皮基质补片与传统纸补片在外伤性鼓膜穿孔中的治疗效果。
这是一项回顾性研究，纳入了 2013 年 4 月至 2020 年 6 月期间接受 22 例人脱细胞真皮基质补片和 20 例纸补片治疗的 41 例（42 耳）急性外伤性鼓膜穿孔患者。所有患者均在局部麻醉下修剪穿孔边缘后，应用人脱细胞真皮基质补片或纸补片。分析患者的年龄、性别、病因、穿孔持续时间、侧别、位置、大小及愈合结果。若有听力或 CT 数据，也一并进行分析。
两组患者的性别、年龄、患耳比例、穿孔大小和持续时间、愈合确认时间及听力结果差异均无统计学意义。愈合成功组和失败组患者的穿孔大小和持续时间差异均无统计学意义。人脱细胞真皮基质补片组和纸补片组的愈合确认时间（70.7 ± 42.3 比 89.9 ± 119.4 天，P =.486）和愈合率（95.5%比 85.0%，P =.333）差异均无统计学意义。然而，人脱细胞真皮基质补片组的补片维持时间明显长于纸补片组（32.9 ± 14.9 比 15.6 ± 19.9 天，P =.001）。多变量回归分析显示，补片材料是唯一与补片维持时间相关的参数（P =.002）。
与纸补片相比，人脱细胞真皮基质补片治疗外伤性鼓膜穿孔的疗效更好或相似。该材料的重要优势在于在成功愈合之前，它能够原位保留足够的时间而不脱落。
