Sazegar A A, Karimi Yazdi A, Amanpoor S, Doolabi K,
Volume 62, Issue 1 (4-2004)
Abstract
Background: Tympanic membrane perforation as a sign of different otologic disorders have multiple causes, for example trauma .Traumatic perforations heal spontaneously in most cases but in large and stable perforation otolarngologist intervention is necessary . In the stable perforation of tympanic membrane , if there isn’t infection in the tympanic cavity , the paper patch or myringoplasty may be used. These procedures need remedy charge and time and may be with morbidity and other complications. Recently materials like hyaluronic acid and epidermal growth factors has been used to speed healing of tympanic membrane perforation, and their effect has been proved. Pentoxifylline an anti-thrombotic drug has positive effect on increasing perfusion and wound healing in pathological conditions. Alike we have used pentoxifylline to show it’s effect on the healing of guinea pig perforated tympanic membrane.
Materials and Methods: This study has been done prospectively, on 32 guinea pig ears.
Results & Conclusion: Final otomicroscopic study after three weeks showing no significant difference in the healing rate of tympanic membrane in pentoxifylline group versus control group.
Mirvakili S.a, Baradaranfar M.h, Karimi Gh, Labibi M,
Volume 65, Issue 2 (3-2008)
Abstract
Background: Traumatic tympanic membrane (TM) perforation is a common injury of the ear with a high rate of spontaneous healing if the patients strictly adhere to water precautions. The purpose of this study was to determine the factors involved in the spontaneous healing of traumatic TM perforations in order to ascertain the best treatment plan including observation, paper patch and finally surgery.
Methods: In this correlative–descriptive study, we recorded the outcome of each patient with three-month follow up. Included in this study were a total of 202 forensic medicine patients from the Dept. of Otolaryngology Head & Neck Surgery at the Yazd University of Medical Sciences, Yazd, Iran. All patients included in this study had traumatic TM perforation. Based on otoscopic examination, the perforations were classified as pinpoint or large. All patients received an audiometry exam and were followed for three months. The data was collected using a special form and analyzed by chi-square test, Fisher exact test and ANOVA.
Results: This study consisted of 118 male and 84 female patients with a mean age of 23.6 years (6-48 years). The types of trauma included compression injury (104 patients), instrumental injury (59 patients), burn–slag injury (2 patients) and blast injury (1 patient). One hundred and eighty patients had pinpoint TM perforations, 99.4% of which healed spontaneously by the second month, and 32 patients had large TM perforations, 50% of which healed spontaneously by the second month. During the first month, 87.3% of the patients observing water precautions had healed, however the healing rate was only 5.6% in patients not adhering to water precautions, who suffered from otorrhea. Therefore, during this study, 185 (91.58%) patients had spontaneous healing by two months and only 6 patients of remaining 17 patients healed with paper patch. The mean hearing loss at 500, 1000 and 2000 Hz was 10.55 dB (5-30 dB).
Conclusion: In our experience, patients with traumatic TM perforations have higher spontaneous healing rate when observing water precautions. Furthermore, we recommend observation and paper patching for three months before attempting any surgical intervention in such patients.
