EFEKTIVITAS ASAM RETINOIK PADA PENYEMBUHAN LUKA PERFORASI BARU MEMBRAN TIMPANI HEWAN COBA MARMOT
Introduction: Tympanic membrane (TM) perforation is common in our practice, it may be due to infection or trauma. Retinoic acid (RA) has been studied for its effect on wound healing, it can stimulate angiogenesis and increase the rate of re-epithelialization in wounded skin. The purpose of this study is to determine the effectiveness and the rate of healing of RA in wound closure of acute TM perforations in Guinea pigs
Methods: This is a randomized control trial animal experimental study, twenty Guinea pigs (40 TM) were used. Randomization to determine group for intervention and control was done using the toss coin method. A small perforation using spinal needle G 20 was done. RA was introduced in the intervention group while in the control group, TM was allowed to heal spontaneously. All TM were examined on day 3, 7, 10 and 14. Recording of perforation was done with endoscopic system. Measurement of the TM as well as the perforation was done by using a graphic program (AutoCAD R14).
Results: TM healed completely on day 14 in the intervention group and the control group was 52.9 % and 47.1% respectively with p =0.492. The rate of healing on day 3,7 and 10 in the intervention group and the control group was 0.15 & 0.08; 0.38 & 0.69; 0.29 & 0.58 respectively with p= 0.01; 0.003 and 0.001.
Conclusion: Tympanic membrane with RA treated group showed a significant rate of healing on day 3,7 and 10. However, RA have no significant effect on closure of acute traumatic perforations after day 14
2. Valentine P, Wright T. ANATOMY AND EMBRYOLOGY OF THE EXTERNAL AND MIDDLE EAR. In: Watkinson JC, Clarke RW, editors. Scott-Brown’s Otorhinolaryngology Head and Neck Surgery. 8th ed. Taylor & Francis Group, LLC; 2018. p. 525–43.
3. Johnson AP, Smallman LA, Kent SE. The mechanism of healing of tympanic membrane perforations. Acta Otolaryngol. 1990;109(5–6):406–15.
4. Wang WQ, Wang ZM, Chi FL. Spontaneous healing of various tympanic membrane perforations in the rat. Acta Otolaryngol. 2004;124(10):1141–4.
5. de Araújo MM, Murashima AAB, Alves VM, Jamur MC, Hyppolito MA. Spontaneous healing of the tympanic membrane after traumatic perforation in rats. Braz J Otorhinolaryngol [Internet]. 2014;80(4):330–8. Available from: http://dx.doi.org/10.1016/j.bjorl.2014.05.014
6. Gür ÖE, Ensari N, Öztürk MT, Boztepe OF, Gün T, Selçuk ÖT, et al. Use of a platelet-rich fibrin membrane to repair traumatic tympanic membrane perforations: a comparative study. Acta Otolaryngol. 2016;136(10):1017–23.
7. Lou ZC, Lou ZH, Xiao J. Regeneration of the tympanic membrane using fibroblast growth factor-2. J Laryngol Otol. 2018;132(6):470–8.
8. Gao T, Li X, Hu J, Ma W, Li J, Shao N, et al. Management of traumatic tympanic membrane perforation: A comparative study. Ther Clin Risk Manag. 2017;13:927–31.
9. Li X, Zhang H, Zhang Y. Repair of large traumatic tympanic membrane perforation using ofloxacin otic solution and gelatin sponge. Braz J Otorhinolaryngol [Internet]. 2022;88(1):9–14. Available from: https://doi.org/10.1016/j.bjorl.2020.03.007
10. Polcz ME, Barbul A. The Role of Vitamin A in Wound Healing. Nutr Clin Pract. 2019;34(5):695–700.
11. Hwang PH, Chan JM. Retinoic acid improves ciliogenesis after surgery of the maxillary sinus in rabbits. Laryngoscope. 2006;116(7):1080–5.
12. Elson ML. The role of retinoids in wound healing. J Am Acad Dermatol. 1998;39(2 III):79–81.
13. Zinder R, Cooley R, Vlad LG, Molnar JA. Vitamin A and Wound Healing. Nutr Clin Pract. 2019;34(6):839–49.
14. Leyden J, Stein-Gold L, Weiss J. Why Topical Retinoids Are Mainstay of Therapy for Acne. Dermatol Ther (Heidelb). 2017;7(3):293–304.
15. Lee DH. Re: A Randomised Controlled Trial Comparing Spontaneous Healing, Gelfoam Patching, and Edge-approximation plus Gelfoam Patching in Traumatic Tympanic Membrane Perforation with in-/everted edges. Clin Otolaryngol. 2011;36(4):399–400.
16. Amadasun JEO. An observational study of the management of traumatic tympanic membrane perforations. J Laryngol Otol. 2002;116(3):181–4.
17. Johnson A, Hawke M. The function of migratory epidermis in the healing of tympanic membrane perforations in Guinea-pig: A photographic study. Acta Otolaryngol. 1987;103(1–2):81–6.
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