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Konservatif tedaviye yamt vermeyen seroz otitis mediada, miringotomi ve e~ zamanhventilasyon tiipU tatbiki en etkili cerrahi tedavi yontemidir. Orta kulagm 2-3 hafta·havalanmasmm seroz otitis media tedavisi i9in yeterli olacagt dU~UnUlmektedir. Bununlabirlikte ventilasyon tiipU uygulamasl komplikasyonlannm slkhgl, bu cerrahi giri~imealtematif yeni yontemlerin arayl~ma neden olmu~tur. Son donemde yapllan yah~malar,miringotomilere Mitomisin C veya 5-Florourasil uygulamasmm, perforasyonlarmkapanma zamanlarml uzatabildigini gostermektedir. Bu yah~mada radyofrekans ileolu~turulan miringotomilere topikal uygulanan Mitomisin C ve 5-Florourasil'in,perforasyonlann kapanma zamanlanna etkilerinin kar~da~tIrllmaSI ve elde edilen.verilerle bu teknigin ventilasyon tUpU uygulamasma altematif olup olamayacagmmsorgulanmasl amaylanml~tIr. 0.05). YapIlan kontrollerdehiybir kulak zannda kahcI perforasyon, atrofik skar ve miringoskleroz saptanmadl.Radyofrekans miringotomi sonraSI topikal olarak Mitomisin· C veya5-Florourasil uygulamasl perforasyonlann aylk kalma sUrelerini uzatmakta ve bu teknikozellikle klsa sUreIi tiip uygulanmasl gereken endikasyonlarda altematif bir giri~imolarak onerilebilmektedir.Anahtar Sozciikler: Radyofrekans, Miringotomi, Mitomisin C, 5-Florourasil Myringotomy and ventilation tube insertion is the most effective surgical treatmentmodality of the serous otitis media that is unresponsive to conservative therapy. 2 or 3weeks of continuous aeration of middle ear is thought to be sufficient in treating serousotitis media. However, high incidence of complications of ventilation tube insertion isthe reason for the searching of new alternative surgical procedures. Recent studies haveshowed that application oftopical Mitomycin C or 5-Fluorouracil to myringotomies canlengthen the closure time of perforations. The aim of the present study was to comparethe effects of topically applied Mitomycin C or 5-Fluorouracil on potency time ofperforations created by radiofrequency. unit and investigate whether this technique canbe an alternative procedure to ventilation tube insertion by the infonnation gatheredfrom this study.The study was perfonned on 40 healthy Sprague-Dawley rats. Radiofrequencymyringotomies were perfonned under general anesth.esia. Mitomycin C (0.4 mg/ml)pledgets were applied to the right ears of 20' rats and 50 mg/ml 5-Fluorouracil wereapplied to the right ears of other 20 rats. Thirteen rats were selected from each group andsaline solution applied to·left ears as same fashion to fonn control group. Animals weremonitored using otomicroscopy weekly and Kaplan-Meier survival techniques wereused to compare patency time between groups.The mean patency time was 4.85 weeks in Mitomycin C group, 3.90 weeks in5-Fluorouracil group and 1.30 weeks in control group. The Log-Rank test showed thestudy groups to have significantly longer patency of radio frequency myringotomy thanthe control group (p < o.ooOi). Although the patency rate of Mitomycin C group waslonger than the 5-Fluorouracil group, the difference between these groups was notstatistically significant (p > 0.05). No pennanent perforations, tympanosclerotic plaques,or atrophic scar fonnation occurred during the follow-up.Mitomycin C or 5-Fluorouracil application to radiofrequency myringotomiesprolongs myringotomy patency time and can be proposed as an alternative to theventilation tube insertion technique especially for indications that need short ventilationtime.Keywords: Radiofrequency, Myringotomy, Mitornycin C, 5-Fluorouracil 77 |
