生物可吸收聚（DL-丙交酯-ε-己内酯）对实验性创伤性急性中耳黏膜损伤愈合的影响。
Effect of Bioabsorbable Poly (dl-Lactide ε-Caprolactone) on Healing of Experimentally Injured Acute Traumatic Middle Ear Mucosa Damage.
机构信息
Department of Otorhinolaryngology, Sakarya University Faculty of Medicine, Sakarya, Turkey.
Department of Histology and Embryology, Sakarya University Faculty of Medicine, Sakarya, Turkey.
出版信息
J Int Adv Otol. 2023 Jun;19(3):206-211. doi: 10.5152/iao.2023.22883.
BACKGROUND
Postoperative adhesion is an important complication after middle-ear surgeries. Although many materials have been tried to prevent this complication, the use of Poly (dl-lactide ε-caprolactone) as an anti-adhesive material after middle-ear surgery has not yet been reported. The aim of this study was to evaluate the anti-adhesive effect of poly (dl-lactide ε-caprolactone) on the ears of rats with middle-ear mucosa damage.
METHODS
In our study, 14 Wistar albino rats and 28 ears in total were used. The rats were randomly divided into 4 groups. Middle ear mucosa damage was performed in all groups with a transcanal approach under otomicroscopy in sterile conditions. The effects of poly (dl-lactide ε-caprolactone), silicone sheet, and absorbable gelatin sponge were compared histologically with the secondary healing group. In addition, hearing evaluation was performed before the procedure and on the 28th postoperative day.
RESULTS
No significant difference was observed in transient otoacoustic emission and distortion product otoacoustic emissions tests performed before and after the surgical procedure when the groups were compared. While adhesion was observed in the tympanic membrane in the absorbable gelatin sponge group, no adhesion was observed in the other groups. In the absorbable gelatin sponge group, increased fibroblastic activity, inflammation, and neovascularization were observed in the middle-ear mucosa. No significant difference was observed in silicone sheet, poly (dl-lactide ε-caprolactone), and control groups in terms of fibroblastic activity, inflammation, and neovascularization.
CONCLUSION
It can be concluded that absorbable poly (dl-lactide ε-caprolactone) is nonototoxic and biocompatible with the rat's middle ear cavity by short-term evaluation.
背景
术后粘连是中耳手术后的一种重要并发症。尽管已经尝试了许多材料来预防这种并发症，但聚（DL-丙交酯ε-己内酯）作为一种中耳手术后的防粘连材料尚未被报道。本研究旨在评估聚（DL-丙交酯ε-己内酯）对中耳黏膜损伤大鼠耳朵的防粘连效果。
方法
在我们的研究中，使用了 14 只 Wistar 白化大鼠和总共 28 只耳朵。大鼠随机分为 4 组。所有组均在无菌条件下通过经耳道方法进行中耳黏膜损伤。将聚（DL-丙交酯ε-己内酯）、硅胶片和可吸收明胶海绵的效果与二次愈合组进行组织学比较。此外，在手术前和术后第 28 天进行听力评估。
结果
当比较各组时，在手术前后进行的瞬态耳声发射和畸变产物耳声发射测试中未观察到显著差异。在可吸收明胶海绵组中观察到鼓膜粘连，而在其他组中未观察到粘连。在可吸收明胶海绵组中，中耳黏膜中观察到成纤维细胞活性增加、炎症和新生血管形成。在硅胶片、聚（DL-丙交酯ε-己内酯）和对照组中，成纤维细胞活性、炎症和新生血管形成没有显著差异。
结论
通过短期评估，可以得出结论，可吸收的聚（DL-丙交酯ε-己内酯）对大鼠中耳腔无耳毒性且具有生物相容性。
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