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Avaliação da resposta tecidual da mucosa da orelha média de cobaias à presença de celulose bacteriana. estudo experimental
Abstract
Introdução - há biomateriais, como a celulose, usados em diversas áreas sem estudos na orelha média. Objetivo: avaliar a resposta tecidual da mucosa da orelha média na presença de celulose. Material e métodos: 42 cobaias, divididas em: 18 para o grupo MT (implante de membrana de celulose - Bionext®, na MT, subdividido em três grupos com seis cobaias), 20 para o grupo CT (implante de manta de celulose - Bionext®, na cavidade timpânica, subdividido em quatro grupos com cinco cobaias) e quatro
controles do procedimento cirúrgico (dois para cada grupo e sacrificadas no pós-operatório imediato). Em cada cobaia foi implantado o material em apenas uma orelha. Após sete, 15 e 30 dias nas MT das cobaias do grupo MT e de sete, 30, 90 e 180 dias na cavidade timpânica do grupo CT, os ossos temporais foram removidos e estudados parâmetros de inflamação aguda, inflamação crônica, posição e integridade da celulose. Resultados: Neutrófilos e fibrina ocorreram em maior freqüência nas MT das cobaias do
grupo CT que sobreviveram sete dias em relação aos demais (30, 90 e 180 dias) (p=0,006). Além disso, houve maior proliferação conjuntivo-fibrosa
A perfuração da membrana timpânica (MT) é um problema otológico relativamente frequente nos dias atuais, causada, na maioria das vezes, por traumatismos. Esta patologia provoca comprometimento da impermeabilidade da membrana que separa o ouvido externo do médio, sendo que a colocação de um fragmento de celulose bacteriana tornou-se um método eficaz para a recuperação anatómica e fisiológica.
Introduction:
Perforation of the tympanic membrane is a reasonably frequent diagnosis in otorhinolaryngologists' offices. The expectant management is to wait for spontaneous healing, which usually occurs in almost all cases in a few weeks. However, while waiting for healing to be completed, the patients may experience uncomfortable symptoms. Although some research suggests the use of various materials to aid in the recovery of the tympanic membrane, none presented robust evidence of improvement in the cicatricial process. Nevertheless, the occlusion of the perforation with some material of specific texture and resistance can alleviate the patients' symptoms and accelerate the healing process.
Objective:
To evaluate the clinical (symptomatic and functional) improvement after the placement of bacterial cellulose film (Bionext®) on tympanic membrane perforations (traumatic).
Methods:
We evaluated 24 patients, victims of traumatic perforations of the tympanic membrane, who were evaluated in the Otorhinolaryngology Emergency Room. Following otoscopy an audiometric examination was performed, before and after the use of cellulose film occluding the tympanic membrane perforation.
Results:
Twenty-four patients were included, whose degree of overall discomfort caused by the tympanic membrane perforation and the presence of symptoms of autophonia, ear fullness and tinnitus were investigated. The mean score attributed to the overall annoyance caused by tympanic membrane perforation was 7.79, decreasing to a mean value of 2.25 after the film application. Symptom evaluation also showed improvement after using the film: autophonia decreased from a mean value of 6.25 to 2.08, tinnitus from 7 to 1.92 and ear fullness from 7.29 to 1.96. The auditory analysis showed mean threshold values still within the normal range at low and medium frequencies, with slight hearing loss at acute frequencies, but with significant improvement at all frequencies, with the exception of 8000Hz, after film use.
Conclusion:
The use of bacterial cellulose film fragment on traumatic perforations of the tympanic membrane promoted immediate functional and symptomatic recovery in the assessed patients.
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