Application of Regenerative Treatment for Tympanic Membrane Perforation With Cholesteatoma, Tumor, or Severe Calcification
| Autor: | Kaoru Omae, Misaki Yoshida, Rie Kanai, Yuji Kitada, Shigeru Hirano, Shin-ichi Kanemaru |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Basic fibroblast growth factor Perforation (oil well) Pilot Projects Fibrin Tissue Adhesive Regenerative Medicine Tympanoplasty type I Young Adult 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Myringoplasty Humans Medicine Tympanic cavity Child Cholesteatoma 030223 otorhinolaryngology Fibrin glue Ear Neoplasms Aged Tympanic Membrane Perforation business.industry Calcinosis Middle Aged medicine.disease Sensory Systems Surgery Treatment Outcome medicine.anatomical_structure Otorhinolaryngology chemistry Gelatin Female Fibroblast Growth Factor 2 Neurology (clinical) business 030217 neurology & neurosurgery Calcification |
| Zdroj: | Otology & Neurotology. 39:438-444 |
| ISSN: | 1537-4505 1531-7129 |
| DOI: | 10.1097/mao.0000000000001701 |
| Popis: | Objective To apply regenerative treatment for tympanic membrane (TM) perforation to patients with severe calcification of the TM, cholesteatomas, or tumors localized to the tympanic cavity. Study design Controlled clinical pilot study. Setting General hospitals. Patients Forty-five patients (age: 8-85; M = 19, F = 26) were selected from patients with or without TM perforation for the regenerative treatment. Twenty-five patients had cholesteatomas, 3 had tumors, and 17 had severe TM calcification. Patients were classified into three groups based on TM perforation size: less than 1/3 of the TM as Grade I (n = 5), 1/3 to 2/3 as Grade II (n = 19), and over 2/3 as Grade III (n = 21). Twenty patients who underwent standard tympanoplasty type I were selected as historical controls. Materials and methods Materials for the TM repair included gelatin sponge with basic fibroblast growth factor and fibrin glue. After lesions were removed through the TM perforation, gelatin sponge immersed in basic fibroblast growth factor was placed over the perforation. Fibrin glue was then dripped onto the sponge. Treatment efficacy was evaluated 6 months posttreatment. Results Complete closure of the TM perforation was achieved in 91% (n = 41/45) of the patients in this regenerative treatment. Improvement in average hearing levels and air-bone gap were much better with this treatment than in the historical control group. Conclusion This new regenerative therapy is useful not only for patients with simple TM perforations but also for those with cholesteatomas, tumors, or severe calcification without requiring conventional surgical procedures. This regenerative therapy is an easy, safe, cost-effective, and minimally-invasive treatment. |
| Databáze: | OpenAIRE |
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