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目的探讨自体脂肪组织即时修补鼓膜穿孔后的组织愈合特点及时间。方法选取鼓膜正常成年兔15只(30耳),随机分为3组,每组5只(10耳),分别制作成不同大小的外伤性鼓膜穿孔动物模型,其中,第一组双耳鼓膜紧张部直径2 mm中央型穿孔;第二组:双耳鼓膜紧张部直径3~4 mm中央型穿孔;第三组:双耳鼓膜紧张部直径>4 mm中央型穿孔。各组动物分别用自体脂肪组织修补鼓膜穿孔,2周后观察鼓膜生长情况,取再生鼓膜做免疫组化染色,观察新生鼓膜的组织学结构。结果第一、二组鼓膜穿孔外观全部生长良好,第三组有2只(3耳)移植脂肪部分液化,遗留穿孔。第一、二组鼓膜穿孔愈合耳数与第三组比较差异有统计学意义(P<0.05)。再生鼓膜组织免疫组化染色显示共有三层结构,上皮层细胞与黏膜层的细胞生长良好,与正常鼓膜细胞基本一致,中间的纤维层较正常鼓膜纤维层薄,上皮层和纤维层之间疏松,有一定的间隙。结论新生的鼓膜在2周时已经完成生长,组织结构接近正常鼓膜。
Objective To investigate the characteristics and time of tissue healing after autologous repair of perforation of tympanic membrane with autologous adipose tissue. Methods Fifteen normal adult rabbits (30 ears) were randomly divided into 3 groups (5 ears each), which were made into traumatic tympanic membrane perforation animal models of different sizes. Among them, the first group suffered from binaural tympanic membrane tension Department of central 2mm diameter perforation; second group: 3 to 4mm diameter central ear hole Ministry of tympanic membrane perforation; the third group: the Ministry of the central ear tympanic membrane diameter> 4mm perforation. Each group of animals were used to repair the perforation of the tympanic membrane with adipose tissue. The growth of the tympanic membrane was observed two weeks later. The histology of the nasal eardrum was observed by immunohistochemical staining. Results The appearance of perforation of the tympanic membrane in the first group and the second group all grew well. In the third group, 2 (3 ears) of the fat graft partially liquefied with perforation left. The first and second group of tympanic membrane perforation healing ear number compared with the third group was statistically significant (P <0.05). Immunohistochemical staining showed that the cells in the epithelial cells and the mucosa grew well, which was basically the same as the normal eardrum cells. The middle fibrous layer was thinner than the normal tympanic membrane and the loose between the epithelium and the fibrous layer , There is a certain gap. Conclusions The nasal eardrum has been completed at 2 weeks and its structure is close to the normal eardrum.