ABSTRACT
OBJECTIVE: We evaluated the effects of epidermal growth factor (EGF) and ofloxacin otic drops on the healing of large human traumatic tympanic membrane perforations (TMPs). STUDY DESIGN: Case series with chart review. SETTING: Tertiary university hospital. METHODS: Retrospective case review of patients with traumatic TMP larger than 25% of the TM seen between February 2007 and December 2008. Patients were stratified into EGF drops, ofloxacin drops, and observation groups. The closure rate, closure time, and hearing level were compared among the three groups at 6months. RESULTS: In total, 120 patients met the inclusion criteria. The total closure rate was 89.2% (107/120) and the total mean closure time was 22.6±7.4days. The closure rates of perforation in the EGF, ofloxacin otic drops, and observation groups were 93.5%, 92.0%, and 82.2%, respectively. The closure rates among the three groups were not statistically different (p=0.19). The mean perforation closure times were 12.6±6.9, 12.9±5.1, and 35.7±9.2days for the EGF, ofloxacin otic drops, and observation groups, respectively. The average closure time in the observation group was significantly longer (p=0.01) than that in the EGF and ofloxacin otic drops groups. However, the closure times in the EGF and ofloxacin otic drops groups were not significantly different (p=0.84). CONCLUSIONS: The study surprisingly found that both topical application of EGF and ofloxacin otic drops result in more rapid closure compared with spontaneous healing for human large traumatic TMPs. The benefit would be great as a shorter recovery time may reduce health care costs. Therefore, ofloxacin otic drops should be considered in clinics.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Epidermal Growth Factor/therapeutic use , Ofloxacin/therapeutic use , Tympanic Membrane Perforation/therapy , Administration, Topical , Adult , Female , Humans , Male , Retrospective Studies , Time Factors , Treatment Outcome , Wound HealingABSTRACT
<p><b>OBJECTIVE</b>To retrospectively study the clinical effects of eardrum flap area on the healing outcome following traumatic perforation.</p><p><b>METHODS</b>Totally 291 traumatic eardrum perforations with in-/everted edges were included in this study. They were randomly divided into three groups and received conservative treatment, epidermal growth factor (EGF) via Gelfoam patching, or edge-approximation plus Gelfoam patching respectively. Patients in each group were further divided into two subgroups according to the eardrum flap area less than or equal to 1/2 or >1/2 of the perforation size. The healing rate and mean closure time after tympanic membrane perforation were evaluated at three months.</p><p><b>RESULTS</b>Of the total 291 participants, 281 were included in the final statistical analysis. The area of curled edge did not affect the healing outcome significantly in any groups (P>0.05). The healing rate varied slightly: 90.7% vs 92.3% in spontaneous healing group, 98.2% vs 97.4% in EGF via Gelfoam patching group, and 96.5% vs 100% in edge-approximation plus Gelfoam patching group. In addition, in all groups the area of curled edge did not affect the mean closure time significantly (P>0.05). The closure time was (32.3+/-2.4) d vs (30.6+/-3.1) d in sponaneous healing group, (13.4+/-2.5) d vs (13.1+/-1.9) d in EGF via Gelfoam patching group, and (11.9+/-3.1) d vs (12.2+/-2.1) d in edge-approximation plus Gelfoam patching group.</p><p><b>CONCLUSION</b>The eardrum flap area of traumatic eardrum perforation does not significantly affect the clinical outcomes.</p>