鼓膜外伤性穿孔愈合的上皮移行模式

Epithelium Migration Pattern of Traumatic Tympanic Membrane Perforation Healing

目的观察鼓膜外伤性穿孔愈合过程上皮移行模式及其疗效。方法耳内镜下动态观察183例183耳鼓膜外伤性穿孔的自然愈合过程中上皮移行模式,基于与穿孔中心的位置,将其分为向心性移行、向外移行和向内移行模式。结果 183例中,131例(71.6%)穿孔缘上皮向心性移行,52例(39.4%)向外移行,未见向内移行。两组鼓膜穿孔闭合率分别为96.9%和94.2%,差异无显著性(P>0.05);平均闭合时间分别19.3±2.8天和38.1±7.2天(P<0.05)。结论 耳内镜下可见鼓膜上皮两种移行模式:向心性移行和向外移行。上皮向外移行并没有影响愈合率,但延长穿孔闭合时间。

Objective To observe the epithelium migration pattern during the spontaneous healing process and to evaluate the out- come. Methods The clinical records of traumatic TMP patients who met the case selection criteria were retrieved and categorized based on the documented migration pathways of the proliferating epithelial cells at the perforation margins into two groups： centripetal migration and outward migration. The demographic data and spontaneous healing outcomes （ i. e. , healing rate and time） of these two types of TMP were analyzed using the chi - square test or t - test. The otoendoscopic features were characterized. Results In all, 183 cases were ana- lyzed. During the spontaneous healing process, perforations were associated with centripetal epithelial cell migration in 131 cases （71.3%） and with outward epithelial cell migration in 52 cases （28.4%）. The overall perforation closure rates at the end of 6 months were 96.9% and 94. 2% for the centripetal and outward migration groups, respectively （P 〉 0.05）. The average perforation closure times were 19.3 ~ 2.8 and 38.1 ~ 7.2 days, respectively （P 〈 0.05）. Conclusion Two patterns of epithelium migration were found by endotoscpe. The outward epithelial migration did not affect the perforation spontaneous healing rate, however, it prolonged substantially the time to traumatic eardrum perforation closure.