Hyakusoku Hiroshi, Aoyama Jun, Aoki Toshimasa, Kamoshida Risa, Nakayama Meijin
Otolaryngology, Yokosuka Kyosai Hospital, Yokosuka, JPN.
Cureus. 2024 Dec 7;16(12):e75259. doi: 10.7759/cureus.75259. eCollection 2024 Dec.
Objective We evaluated the outcomes of tympanic membrane regenerative treatment using gelatin sponge, recombinant basic fibroblast growth factor (bFGF), and fibrin glue at Yokosuka Kyosai Hospital. Methodology We enrolled a total of 42 patients with tympanic membrane perforations (TMPs) (44 ears; right:left = 21:23) that were treated using gelatin sponge, recombinant bFGF, and fibrin glue between July 2020 and December 2023 at Yokosuka Kyosai Hospital. TMP closure rates, improvement of hearing level, and complications were retrospectively included in the evaluation items. TMP was evaluated at least one month after surgery. The treatment was repeated up to four times until the TMP was completely closed. Results The perforation size distribution was as follows: grade I, 30 ears (68.1%); grade II, 11 ears (25.0%); and grade III, three ears (6.8%). The overall closure rate for TMP was 84.1% (37/44). Closure was achieved in 72.7% (32/44) after the first treatment and 11.4% (5/44) after the second treatment. No closures were achieved after the third and fourth treatments. Factors contributing to the incomplete closure of TMPs included patient refusal of surgery more than once, and the disappearance of the gelatin sponge one week after each surgery. Mean air-conduction thresholds and mean air-bone gaps improved after TMP closure in successful patients; however, no change in mean bone-conduction thresholds was observed at any frequency. No serious complications were observed. Conclusions We found high success rates for TMP closure, good hearing recovery, and no severe complications. Our findings suggest that our novel technique has favorable outcomes.
目的 我们在横须贺急救医院评估了使用明胶海绵、重组碱性成纤维细胞生长因子（bFGF）和纤维蛋白胶进行鼓膜再生治疗的效果。方法 我们纳入了2020年7月至2023年12月期间在横须贺急救医院使用明胶海绵、重组bFGF和纤维蛋白胶治疗的42例鼓膜穿孔（TMP）患者（44耳；右耳：左耳 = 21:23）。评估项目包括TMP闭合率、听力水平改善情况及并发症。术后至少1个月对TMP进行评估。治疗可重复进行多达4次，直至TMP完全闭合。结果 穿孔大小分布如下：I级，30耳（68.1%）；II级，11耳（25.0%）；III级，3耳（6.8%）。TMP的总体闭合率为84.1%（37/44）。首次治疗后72.7%（32/44）实现闭合，第二次治疗后11.4%（5/44）实现闭合。第三次和第四次治疗后均未实现闭合。TMP未完全闭合的因素包括患者不止一次拒绝手术，以及每次手术后1周明胶海绵消失。成功患者TMP闭合后平均气导阈值和气骨导间距有所改善；然而，在任何频率下均未观察到平均骨导阈值有变化。未观察到严重并发症。结论 我们发现TMP闭合成功率高、听力恢复良好且无严重并发症。我们的研究结果表明，我们的新技术具有良好的效果。
