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The impact of platelet-derived growth factor on closure of chronic tympanic membrane perforations: a randomized, double-blind, placebo-controlled study - Zurich Open Repository and Archive


Röösli, C; von Büren, T; Gassmann, N B; Huber, A M (2011). The impact of platelet-derived growth factor on closure of chronic tympanic membrane perforations: a randomized, double-blind, placebo-controlled study. Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 32(8):1224-9.

Abstract

Objective: Patients with tympanic membrane (TM) perforations often suffer from infections, and repetitive topical treatment may be required. These infections can be prevented by permanent closure of the TM perforation. Different surgical treatment options have been described, but non-invasive techniques may be preferred as they carry less risk than surgery. One non-invasive approach is to induce wound healing by application of growth factors. The effect and clinical utility of applying topical platelet derived growth factor (PDGF) for decrease of size and closure of chronic TM perforations is evaluated.
Study design: Prospective, randomized, placebo controlled, double blind study
Setting: Tertiary referral center.
Patients: Twenty patients suffering with chronic suppurative otitis media without cholesteatoma for more than 3 months.
Intervention: Topical treatment with PDGF or placebo applied weekly to the TM for 6 weeks.
Main outcome measures: Success rate, defined as a reduction of perforation size of 50% or more to determine relative changes of the perforation size; effect of initial size and location of TM perforation on success rate, and air and bone conduction thresholds to determine air-bone gap (ABG) measured before treatment.
Results: Randomization made matching pre-treatment perforation size of the two study groups impossible, and the initial rate perforation/TM was significantly smaller in the PDGF group. No difference between the two groups was found for perforation/TM < 10%. However, success rate did not differ significantly between the two groups (Power=0.8), and the effect of PDGF was found to be small (-2%, +-49% STD). Initial size and position of the TM perforation were not significant factors determining success. Mean ABG for the frequencies of 0.5, 1, 2, and 4 kHz was 22.5 dB.
Conclusion: The topical application of PDGF as an office treatment for chronic otitis media is not a favourable alternative to surgery.

Abstract

Objective: Patients with tympanic membrane (TM) perforations often suffer from infections, and repetitive topical treatment may be required. These infections can be prevented by permanent closure of the TM perforation. Different surgical treatment options have been described, but non-invasive techniques may be preferred as they carry less risk than surgery. One non-invasive approach is to induce wound healing by application of growth factors. The effect and clinical utility of applying topical platelet derived growth factor (PDGF) for decrease of size and closure of chronic TM perforations is evaluated.
Study design: Prospective, randomized, placebo controlled, double blind study
Setting: Tertiary referral center.
Patients: Twenty patients suffering with chronic suppurative otitis media without cholesteatoma for more than 3 months.
Intervention: Topical treatment with PDGF or placebo applied weekly to the TM for 6 weeks.
Main outcome measures: Success rate, defined as a reduction of perforation size of 50% or more to determine relative changes of the perforation size; effect of initial size and location of TM perforation on success rate, and air and bone conduction thresholds to determine air-bone gap (ABG) measured before treatment.
Results: Randomization made matching pre-treatment perforation size of the two study groups impossible, and the initial rate perforation/TM was significantly smaller in the PDGF group. No difference between the two groups was found for perforation/TM < 10%. However, success rate did not differ significantly between the two groups (Power=0.8), and the effect of PDGF was found to be small (-2%, +-49% STD). Initial size and position of the TM perforation were not significant factors determining success. Mean ABG for the frequencies of 0.5, 1, 2, and 4 kHz was 22.5 dB.
Conclusion: The topical application of PDGF as an office treatment for chronic otitis media is not a favourable alternative to surgery.

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10 citations in Web of Science®
7 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Otorhinolaryngology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2011
Deposited On:18 Oct 2011 14:13
Last Modified:05 Apr 2016 15:02
Publisher:UNSPECIFIED
ISSN:1531-7129
Publisher DOI:https://doi.org/10.1097/MAO.0b013e31822e96bc
PubMed ID:21892119

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