人脱细胞真皮异体移植补片治疗外伤性鼓膜穿孔。

Dong-Han Lee, Cha-Dong Yeo, Young Ho Kim
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引用次数: 2

摘要

背景:本研究旨在探讨外伤性鼓膜穿孔患者使用同种异体真皮补片与传统纸质补片的疗效对比。方法回顾性研究2013年4月至2020年6月,41例(42耳)急性外伤性鼓膜穿孔患者采用22块人脱细胞真皮异体移植和20块纸贴片治疗。手术是在局部麻醉下,在修剪穿孔边缘后,应用人类脱细胞真皮移植或纸贴片进行的。分析患者的年龄、性别、原因、持续时间、穿孔的侧边、部位、大小及愈合情况。如果有听力或计算机断层扫描数据,也进行了调查。结果两组患者在性别、年龄、患侧比例、穿孔大小及持续时间、恢复确认时间、听力学结果等方面差异无统计学意义。成功组和失败组在穿孔的大小和持续时间上没有显著差异。同种异体人脱细胞真皮移植组与纸质贴片组在恢复确认时间(70.7±42.3天vs 89.9±119.4天,P = .486)和恢复率(95.5% vs. 85.0%, P = .333)方面差异无统计学意义。然而,人类脱细胞异体真皮移植组的贴片维持时间比纸质贴片组更长(32.9±14.9天vs 15.6±19.9天,P = .001)。在多变量回归分析中,贴片材料是唯一与贴片维持时间相关的参数(P = 0.002)。结论人脱细胞同种异体真皮移植治疗外伤性鼓膜穿孔疗效优于或相近于纸质贴片。这种材料的重要优点是在原位保持足够的时间而不被分离,直到成功愈合。
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Human Acellular Dermal Allograft Patch on Traumatic Tympanic Membrane Perforation.

Background: This study aimed to investigate the outcome of using the human acellular dermal allograft patch compared with the conven- tional paper patch in traumatic tympanic membrane perforation.

Methods: This was a retrospective study including 41 patients (42 ears) treated with 22 human acellular dermal allografts and 20 paper patches for acute traumatic tympanic membrane perforation from April 2013 to June 2020. The procedure was performed by applying human acellular dermal allograft or paper patches after trimming of perforation margins under local anesthesia. Patient's age, sex, cause, duration, side, location, size of perforation, and the result of healing was analyzed. The audiologic or computed tomography data were also investigated when available.

Results: There was no significant difference in sex, age, affected side ratio, size and duration of perforation, recovery confirmation time, and audiogram results between the two groups. There was no significant difference in the size or duration of perforation between the success and failure groups. The human acellular dermal allograft and paper-patch groups showed no significant difference in the recovery confirmation time (70.7 ± 42.3 vs. 89.9 ± 119.4 days, P = .486) and recovery rate (95.5% vs. 85.0%, P = .333). However, the patch maintenance time of the human acellular dermal allograft group was statistically longer than the paper-patch group (32.9 ± 14.9 vs. 15.6 ± 19.9 days, P = .001). On multivariable regression analysis, patch material was the only parameter associated with patch maintenance time (P = .002).

Conclusion: Treatment outcomes of traumatic tympanic membrane perforation using human acellular dermal allograft showed better or similar therapeutic efficacy compared to paper patch. The important advantage of this material is to stay in situ for a sufficient time without being detached until successful healing.

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