Morphological observation of wound margin during the repair of traumatic tympanic membrane perforation patched by gelatin sponge / 解放军医学杂志

ABSTRACT

Objective To investigate the morphological changes in wound margin during the repair of traumatic tympanic membrane perforation patched by gelatin sponge with the aid of an endoscope in evaluating the prognosis. Methods Twenty-three female patients with traumatic tympanic membrane perforation within 6 hours were patched repaired with therapeutic gelatin sponge patches. Changes in the wound margin of traumatic tympanic membrane and the morphology of healed tympanic membrane were observed with endoscope. Results Among the 23 cases, infection occurred in 2 cases, and 5 were lost for follow-up. In the other 16 cases, the healing time in 11 cases was between 6 days and 20 days. On the first day after treatment, granulation and exudation increased around the wound margin. Hyperaemia was observed in both tympanic annulus and the handle of malleus. On the second day, granulation tissue increased further, and epithelization was observed on the third to sixth day. Hyperplasia of epithelial layer was accompanied by the formation of fibrosis of traumatic tympanic membrane. The initial healed tympanic membrane was thicker than normal and then thinned gradually in the following 3 days to 1 week. The threshold of pure tone audiometry in speech frequency was improved by 25?10dB. In 3 cases of these 16 patients, the healing time was 26-74 days with no hyperplasia of granulation tissue. In the other 2 cases of these 16 patients, the wound margin was surrounded by crust and failed to heal in 3 weeks. Conclusion Granulation hyplasia and increase in exudation can improve the repair of traumatic tympanic membrane by patching of a therapeutic gelatin sponge and shorten the healing time. When the wound margin was surrounded by crust hinders the repair of traumatic tympanic membrane.