Repair of large traumatic tympanic membrane perforation using ofloxacin otic solution and gelatin sponge

Abstract Introduction Traumatic large tympanic membrane perforations usually fail to heal and require longer healing times. Few studies have compared the healing and hearing outcomes between gelatin sponge patching and ofloxacin otic solution. Objectives To compare the healing outcomes of large traumatic tympanic membrane perforations treated with gelatin sponge, ofloxacin otic solution, and spontaneous healing. Methods Traumatic tympanic membrane perforations >50% of the entire eardrum were randomly divided into three groups: ofloxacin otic solution, gelatin sponge patch and spontaneous healing groups. The healing outcome and hearing gain were compared between the three groups at 6 months. Results A total of 136 patients with large traumatic tympanic membrane perforations were included in analyses. The closure rates were 97.6% (40/41), 87.2% (41/47), and 79.2% (38/48) in the ofloxacin otic solution, gelatin sponge patch, and spontaneous healing groups, respectively (p = 0.041). The mean times to closure were 13.12 ± 4.61, 16.47 ± 6.24, and 49.51 ± 18.22 days in these groups, respectively (p < 0.001). Conclusions Gelatin sponge patch and ofloxacin otic solution may serve as effective and inexpensive treatment strategies for traumatic large tympanic membrane perforations. However, ofloxacin otic solution must be self-applied daily to keep the perforation edge moist, while gelatin sponge patching requires periodic removal and re-patching.

摘要 引言：创伤性大鼓膜穿孔（traumatic large tympanic membrane perforations）通常难以自行愈合，且愈合周期较长。目前鲜有研究对比明胶海绵贴敷（gelatin sponge patching）与氧氟沙星滴耳液（ofloxacin otic solution）的愈合及听力预后效果。
研究目的：对比明胶海绵、氧氟沙星滴耳液治疗与自发愈合三种方案对创伤性大鼓膜穿孔的愈合效果。
研究方法：将鼓膜穿孔面积占整个鼓膜面积50%以上的创伤性鼓膜穿孔患者随机分为三组：氧氟沙星滴耳液组、明胶海绵贴敷组及自发愈合组。于治疗后6个月对比三组的愈合效果与听力改善情况。
研究结果：本研究共纳入136例创伤性大鼓膜穿孔患者进行数据分析。氧氟沙星滴耳液组、明胶海绵贴敷组与自发愈合组的鼓膜闭合率分别为97.6%（40/41）、87.2%（41/47）与79.2%（38/48）（p=0.041）。三组的平均愈合时间分别为13.12±4.61天、16.47±6.24天与49.51±18.22天（p<0.001）。
研究结论：明胶海绵贴敷与氧氟沙星滴耳液均可作为创伤性大鼓膜穿孔有效且经济的治疗策略。但氧氟沙星滴耳液需每日自行滴用以维持穿孔边缘湿润，而明胶海绵贴敷则需定期移除并重新贴敷。