UA139985U - METHOD OF NONSURGICAL CLOSURE OF THE PERFORMATION OF THE DRUM - Google Patents

Abstract

Method of non-surgical closure of tympanic membrane perforation by application of autologous platelet growth factors. In the biotechnological laboratory by cryolysis receive individualized preparation of autologous platelet cryolysate in the form of drops, which are instilled into the affected ear 2-3 drops 4 times a day, every day for 21 days, in patients with perforation area over 2/3, if incomplete closure has occurred, therapy is extended for another 21 days.

Description

A useful model belongs to medicine, namely to otorhinolaryngology, and can be used to close acquired perforations of the tympanic membrane.

Violation of the integrity of the tympanic membrane, which occurred due to trauma or as a result of acute otitis media, leads to a deterioration in the mobility of the membrane, a decrease in pressure in the middle ear, and contributes to the entry of harmful bacteria. All this leads to hearing impairment and even deafness, in some cases, perforation can cause imbalance.

It is known that two types of surgical interventions are used to close a large or perforated tympanic membrane that does not heal for a long time - "myringoplasty" or "tympanoplasty".

However, despite significant achievements in the field of reconstructive and restorative surgery of the middle ear, restoring the integrity of the tympanic membrane with the help of these surgical methods has the following disadvantages: - the need for additional incisions in the behind the ear or temporal areas, which leads to an increase in the trauma of the operation and the operating time; - the possibility of transplant rejection due to blood circulation disorders, the need for additional consideration of local immunity or a violation of the operating technique; - the possibility of excessive development of connective tissue and sclerosing of the graft.

The technique of tympanic membrane plastic surgery is also known, when a graft made of adipose tissue, which is a source of stem cells and at the same time a matrix for development, is installed in the perforation hole after scarification of the edges. Over time, the perforation heals (11.

But this technique has the following disadvantages: - it can only be used to close small perforations (up to 2 mm); - lack of factors contributing to the survival of transplant cells; - lack of factors that stimulate the regeneration of components of the eardrum (vessels, nerves, etc.).

The closest to the claimed method of treatment is the development in which platelet-enriched plasma is used as a support placed under the tympanic membrane graft

From the membrane during tympanoplasty |21.

However, the development, which is taken as the closest analogue, has technological complexity of implementation, trauma, and the likelihood of complications inherent in surgical techniques among its drawbacks.

The basis of the useful model is the task of improving the method of closing the perforation of the tympanic membrane due to the use of autologous platelet growth factors obtained by cryolization.

The task is solved by the fact that, according to a useful model, in the conditions of a biotechnological laboratory, by means of cryolization, an individualized preparation of autologous cryolizate of platelets is obtained in the form of drops, which are instilled into the affected ear 2-3 drops 4 times a day, every day, for 21 days. at the same time, in patients with a perforation area of more than 2/3, if incomplete closure occurred, the therapy is extended for another 21 days.

The method is performed as follows.

First, a video endoscopic diagnosis is performed and the size of the perforation of the tympanic membrane is determined. Next, venous blood is collected in the amount of 100 ml to obtain cryolizate of platelets in the conditions of a biotechnological laboratory.

Platelet growth factors are available biological material, the introduction of which the body does not respond with negative reactions. The cryolization procedure helps to obtain the maximum amount of platelet growth factors with high indicators of biological completeness. Growth factors released from platelet alpha granules are known to play an important positive role in the regeneration of damaged tissues. IZI They have local activity and contribute to the initiation of the process of mitosis and regeneration. In addition, these polypeptide growth factors are in a biologically determined ratio. The main factors of platelet growth include RO-ESE - riaie!vi-dehimeid erideptai agouli Tasiog, ROS - Riaie!vi-dehimide dgouli Tasiog, IS - Ipvyip-iKe dgoulaA Tasioi, MESE - Mazsshciag epaoiNeiiia! dgoullyi Tasioi, ESaBe -

Epaoineiia! seiYi dgouli Tasiog, BRSE - Vavis Prgoriabi dgoulip Tasiog, which play a leading role in stimulating the regeneration of the tympanic membrane.

The cryolization method allows to release the maximum amount of growth factors from the alpha granules of platelets. Next, the obtained individualized preparation of platelet cryolizate is instilled into the affected ear 2-3 drops 4 times a day, every day, for 21 days, depending on the size of the perforation.

21 days after the start of therapy, repeated video endoscopic diagnosis is performed and the degree of recovery of the tympanic membrane is assessed. In patients with a large perforation, if incomplete closure has occurred, the therapy is extended for another 21 days.

The essence of the method is explained by the following examples.

Example Mo 1.

Hvora H., born in 1986. Complaints of pain in the ear, feeling of stuffiness in the ear, impaired hearing, ringing in the ear, which occurred after a deep dive (more than 30 meters). A complete video-endoscopic diagnostic examination was performed and the cause of hearing impairment was revealed - barotrauma with the formation of a perforation of the tympanic membrane, which was more than 2/3 of the entire tympanic membrane, with a central localization in the anterior-lower quadrant, with thin edges that were fibrotic at the time of consultation. 18 months have passed since the injury.

Treatment was carried out according to the stated method. In the ENT office, an individualized platelet cryolizate was instilled, 2-3 drops into the affected ear. Next, the patient independently performed instillations of an individualized preparation of cryolizate of platelets once a day, 2 drops 4 times a day, in the affected ear for 21 days.

21 days after the start of the treatment, a full video endoscopic examination was performed, with the help of which an incomplete, scarless restoration of the tympanic membrane was recorded, the perforation was practically closed.

The therapy was extended for another 21 days. For this purpose, another portion of drops of autologous cryolizate of platelets was prepared. At the end of the treatment, a control video endoscopic examination was carried out, with the help of which a complete, scarless restoration of the tympanic membrane was recorded, with restoration of hearing, a positive Valsalve test.

Example Mo 2

Khvora Kh., born in 1988. Complaints about discomfort in the ear, hearing impairment, noise in the ear. From the anamnesis: 2 months ago, there was an ear injury after an incorrect toilet of the external auditory meatus, with a cotton swab. A complete video-endoscopic diagnostic examination was conducted and the cause of hearing impairment was revealed - persistent perforation of 1/3 of the entire tympanic membrane, in the front-upper quadrant.

Zo The treatment was carried out according to the stated method. In the ENT office, instillation of an individualized preparation of cryolizate of platelets was performed, subsequent instillations of 2-3 drops in the affected ear 4 times a day, for 21 days, the patient did it on her own.

21 days after the start of the treatment, a complete video endoscopic examination was performed, with the help of which a scar-free, 100 95 closure of the perforation of the tympanic membrane and restoration of its functions were recorded. Subjectively, the patient felt an improvement in her hearing, as well as the absence of noise.

A total of 8 patients were treated according to the stated method, of which 5 were men, the rest were women, aged from 27 to 55 years. In all cases, positive dynamics were observed, with complete closure of the perforation of the tympanic membrane, restoration of its physiological properties and improvement of hearing.

In comparison with the closest analogue, the declared method of non-surgical closure of perforation of the tympanic membrane allows to avoid the risks inherent in surgical methods of treatment, minimizes the probability of side effects, in a short period of time ensures the achievement of a long-lasting, full-fledged clinical result, closure of perforation of the tympanic membrane, as well as a functional result in in the form of hearing improvement, allows to relieve the state of psychological discomfort and improve the quality of life of patients.

Sources of information: 1. Vipdepregu 9U.b. Rai dgai iutraporiaviu/ 9U.S. Vipdepregu // Iagupdozsore. 1962. Rer., 72:188-92 2. Patent 2479276 Russia, Method of ossiculoplasty / Semenov V.F. 3. Apisha M, za'pspe E, Mygaep A, Mygaep R, Ogime b, Apala I. Memu/ ipzidniv ipFo apa pomei arriisayopz og riaiteiei-hisn Yabhip (Pegariev5. Ttepaz Vioyesppoi!. 2006. - 24(5). - 227-34.

Claims (1)

USEFUL MODEL FORMULA The method of non-surgical closure of perforation of the tympanic membrane by the use of autologous platelet growth factors, which is distinguished by the fact that in the conditions of a biotechnological laboratory, by means of cryolization, an individualized preparation of autologous cryolizate of platelets is obtained in the form of drops, which are instilled into the affected ear 2-3 drops 4 times per day, every day, for 21 days, while in patients with a perforation area of more than 2/3, if incomplete closure has occurred, the therapy is extended for another 21 days.