the role of fibrinolysis in adhesive otitis media(aom)

(整期优先)网络出版时间:2009-02-12
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ObjectiveTostudytheeffectsofBatroxobinonotitismediawitheffusion(OME),anearlystageofAdhesiveOtitisMedia(AOM),forthepurposeofexpandingourunderstandingoftheroleoffibrinolysisinthepathogenesisofAOM.MethodFortycasesofOME(45ears)wererandomlyselectedtoreceiveintratympanicadministrationofDexamethasoneat5mg/ml(Group1orG1),Batroxobinat1BU/ml(Group2orG2)orBatroxobinat2BU/ml(Group3orG3).Pre-andpost-treatmentchangesinclinicalsymptoms,theAirconductionHearingThreshold(AHT)inpuretoneaudiometryandaverageAHTover0.25to2kHzwerecompared.ResultsDatafrom31cases(33ears)wereavailableforanalysis.AHTsamongthreegroupsweresimilarpriortotreatment(P>0.05).TherateofnormalhearingfollowingtreatmentinG3was70%or7/10,higherthaninG1(41.7%or5/12)andG2(54.5%or6/11)(P<0.05).Therateofimprovementfollowingtreatmentwas81.8%or9/11and80.0%or8/10inG2andG3,respectively,higherthanthatinG1(50.0%or6/12)(P<0.05).ConclusionsTherapeuticeffectsofintratympanicinjectionofBatroxobinonOMEissuperiortotraditionallyusedDexamethasone.Inaddition,higherconcentrationofBatroxobinappearstobesuperiortolowerconcentrations.Thesefindingsconfirmthatfibrinolysisplaysapivotalroleinthepathogenesisofmiddleearadhesionandthatfibrinolyticmedicinecanpreventorreduceadhesiondevelopmentinthemiddleear.