目的:比较含碱性成纤维细胞生长因子(bFGF)的再生治疗(RT)(R组)与常规方法(C组)治疗鼓膜穿孔(TMP)的手术效果。两人都接受了经耳道内窥镜手术。
方法:R组的研究人群包括59例接受RT-TMP治疗的患者的61耳,其中TMP边缘被机械破坏,并将浸入bFGF的明胶海绵插入TMP中。然后将纤维蛋白胶滴在海绵上。C组由13例患者组成,这些患者在采用RT-TMP之前接受了常规手术。患者特征和结果,包括TMP闭合率,在手术后三周或更长时间评估听力水平的变化。
结果:两组的基线特征(包括TMP的大小)无显著差异。尽管R组的手术时间明显短于C组,TMP完全闭合率为69%(9/13)和85%(52/61),分别。空气传导听力阈值显着改善,方差分析表明,除了在8kHz时,R组实现了显著的相互作用,暗示在TMP关闭的情况下有更好的改善。在两组中的所有频率下,空气-骨骼间隙也得到了改善。具体来说,在4kHz时,R组出现了更好的改善趋势。
结论:RT-TMP具有较高的TMP闭合率和良好的听力改善,与传统手术相比无显著差异。这种新疗法既简单又安全,并且需要更少的操作时间,它可以帮助改善TMP患者的生活质量。
OBJECTIVE: To compare surgical outcomes of regenerative treatment (RT) including basic fibroblast growth factor (bFGF) (Group-R) with the conventional method (Group-C) for patients with tympanic membrane perforation (TMP), both of whom underwent transcanal endoscopic ear surgery.
METHODS: The study population of Group-R included 61 ears of 59 patients treated with RT-TMP in which TMP edges were disrupted mechanically and a gelatin sponge immersed in bFGF was inserted into the TMP. Fibrin glue was then dripped over the sponge. Group-C consisted of 13 patients who underwent conventional surgery before adopting the RT-TMP. Patients\' characteristics and outcomes including TMP closure rates, and change in hearing level were evaluated three or more weeks after the surgery.
RESULTS: The baseline characteristics including size of TMP were not significantly different between the two groups. Although Group-R had significantly shorter operating time than Group-C, the complete TMP closure rates were 69 % (9/13) and 85 % (52/61), respectively. Air-conduction hearing thresholds showed significant improvements, and analysis of variance showed that Group-R achieved significant interactions other than at 8 kHz, implying better improvement in cases with TMP closure. The air-bone gaps also improved at all frequencies in both groups. Specifically, at 4 kHz, there was a trend showing better improvement in Group-R.
CONCLUSIONS: RT-TMP had a high TMP closure rate and good hearing improvement, with no significant differences compared with those of conventional surgery. This new therapy is simple and safe, and requires less operating time, and it could help improve the quality of life of patients with TMP.