Healing Human Moderate and Large Traumatic Tympanic Membrane Perforations Using Basic Fibroblast Growth Factor, 0.3% Ofloxacin Eardrops, and Gelfoam Patching

• Published in: Otology & neurotology Vol. 37; no. 6; p. 735
• Main Authors: Lou, Zheng-Cai, Lou, Zi-Han, Liu, Ya-Chao, Chang, Jiang
• Format: Journal Article
• Language: English
• Published: United States 01.07.2016
• Subjects: Adult; Anti-Bacterial Agents - therapeutic use; Female; Fibroblast Growth Factor 2 - therapeutic use; Gelatin Sponge, Absorbable - therapeutic use; Humans; Male; Middle Aged; Ofloxacin - therapeutic use; Prospective Studies; Treatment Outcome; Tympanic Membrane - drug effects; Tympanic Membrane Perforation - drug therapy; Wound Healing - drug effects; Young Adult
• DOI: 10.1097/MAO.0000000000001080

The goal of this study was to evaluate the effects of basic fibroblast growth factor (bFGF), 0.3% ofloxacin eardrops (OFLX), and Gelfoam patching on the healing of human moderate and large traumatic tympanic membrane perforations (TMPs). A prospective, quasi-randomized, controlled clinical study. A University-affiliated teaching hospital. We performed a quasi-randomized prospective analysis between January 2010 and December 2014. All patients had traumatic TMPs covering areas >25% of the entire tympanic membrane. The closure rates, closure times, hearing gains, and rates of otorrhea in patients who underwent conservative observation, Gelfoam patching, topical bFGF application, and direct application of OFLX were compared. We ultimately included 185 patients. Closure rates did not significantly differ among the four groups (p = 0.257). Post-hoc multiple comparisons also showed that the closure rates did not differ between any two groups (p > 0.083). The mean closure times were 25.6 ± 13.32, 12.3 ± 8.15, 14.3 ± 5.44, and 13.97 ± 8.82 days for the observation, bFGF, Gelfoam patch, and OFLX groups, respectively. The closure times of the four groups differed significantly (p < 0.001). Post-hoc multiple comparisons showed that the differences between the observation group and each of the other groups were significant (p < 0.001). No other between- or among-group differences were significant (p > 0.0083). The findings of this study suggest that OFLX, bFGF, and Gelfoam patching accelerated the closure of human moderate and large traumatic TMPs. Hence, treatment of human traumatic TMPs should be revisited clinically. Topical application of OFLX may be recommended, because OFLX is more easily available and convenient than bFGF or Gelfoam patch for otology outpatients.