title: Outcome of children with edge-everted traumatic tympanic membrane perforations following spontaneous healing versus fibroblast growth factor-containing gelfoam patching with or without edge repair.
abstract: OBJECTIVE
  To retrospectively analyze the outcome of children with edge-everted tympanic membrane (TM) perforations following spontaneous healing and fibroblast growth factor-containing gelfoam patching with or without repair of the edge flaps.
  
  
  METHODS
  Medical records of children with TM perforations who underwent spontaneous healing (n = 69) or received fibroblast growth factor (FGF)-containing gelfoam patching treatment (n = 67) were retrieved from the Records Department of the Wenzhou Medical College-Affiliated Yiwu Hospital in China. The demographic data and outcome measures were analyzed and compared between these two groups of patients.
  
  
  RESULTS
  Patching with FGF-containing gelfoams significantly improved the healing rate (P < 0.01) and the average perforation closure time (P<0.01), as compared with spontaneous healing. Repair of the perforation edge flaps did not significantly affect the outcome of gelfoam patching (P>0.05), despite a slightly reduced healing rate (96.4% versus 100%) and a slightly shorter closure time (10.2 ± 2.6 d versus 10.9 ± 3.3 d) observed as compared with no edge repair. The everted perforation edge flaps formed scabs during the process of spontaneous healing whereas they underwent retraction and eventually dissolved during the process of gelfoam patching-facilitated healing.
  
  
  CONCLUSIONS
  As compared with spontaneous healing, FGF-containing gelfoam patching had an improved outcome in children with edge-everted traumatic eardrum perforation. Repair of everted edge flaps did not affect the healing outcome. Our results suggest that growth factor-containing gelfoam patching without eardrum flap repair would offer a feasible option to manage traumatic tympanic membrane perforations in children.
authors.affiliation: Department of Otorhinolaryngology, Yiwu Central Hospital, Zhejiang 322000, China. louzhengcai@126.com
authors.forename: Zhengcai
authors.initials: Z
authors.lastname: Lou
authors.forename: Lianfang
authors.initials: L
authors.lastname: Xu
authors.forename: Jian
authors.initials: J
authors.lastname: Yang
authors.forename: Xiaohong
authors.initials: X
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D005346:Fibroblast Growth Factors / Q000627:therapeutic use*; D005781:Gelatin Sponge, Absorbable / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D009225:Myringoplasty; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D018058:Tympanic Membrane Perforation / Q000209:etiology / Q000473:pathology* / Q000628:therapy*; D014945:Wound Healing
chemical_list: D005346:Fibroblast Growth Factors