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The Journal of Laryngology and Otology Jul 2017To review the history of moist therapy used to regenerate traumatic tympanic membrane perforations. (Comparative Study)
Comparative Study Review
OBJECTIVE
To review the history of moist therapy used to regenerate traumatic tympanic membrane perforations.
STUDY DESIGN
Literature review.
METHODS
The literature on topical agents used to treat traumatic tympanic membrane perforations was reviewed, and the advantages and disadvantages of moist therapy were analysed.
RESULTS
A total of 76 studies were included in the analysis. Topical applications of certain agents (e.g. growth factors, Ofloxacin Otic Solution, and insulin solutions) to the moist edges of traumatic tympanic membrane perforations shortened closure times and improved closure rates.
CONCLUSION
Dry tympanic membrane perforation edges may be associated with crust formation and centrifugal migration, delaying perforation closure. On the contrary, moist edges inhibit necrosis at the perforation margins, stimulate proliferation of granulation tissue and aid eardrum healing. Thus, moist perforation margins upon topical application of solutions of appropriate agents aid the regeneration of traumatic tympanic membrane perforations.
Topics: Epidermal Growth Factor; Fibroblast Growth Factor 2; Hyaluronic Acid; Intercellular Signaling Peptides and Proteins; Myringoplasty; Ofloxacin; Ointments; Regeneration; Solutions; Tympanic Membrane; Tympanic Membrane Perforation; Wound Healing
PubMed: 28502255
DOI: 10.1017/S0022215117001001 -
Clinical Toxicology (Philadelphia, Pa.) Nov 2017Cyanoacrylate (Super Glue) exposures are commonly reported to poison control centers, but little has been published in the medical literature regarding these exposures.... (Observational Study)
Observational Study
INTRODUCTION
Cyanoacrylate (Super Glue) exposures are commonly reported to poison control centers, but little has been published in the medical literature regarding these exposures. We sought to characterize cyanoacrylate exposures reported to a poison control system.
METHODS
We performed a retrospective review of a poison system's database for all cases of single-substance human exposure to cyanoacrylate-containing products from 2005 to 2015. Data collected included age, gender, route of exposure, clinical effects, treatments recommended and medical outcome.
RESULTS
There were a total of 893 patients, 505 (56.6%) of which were female. Patient ages ranged from 6 months to 88 years with a median of 11 years. The vast majority of exposures (n = 871, 97.5%) were unintentional, but a small number of exposures (n = 22, 2.5%) were due to intentional misuse (such as trying to stop a bleeding cut) or malicious intent (such as purposefully gluing a person's eyes shut as a prank). Routes of exposure included: ingestion, n = 337 (37.7%); ocular, n = 322 (36.1%); dermatologic, n = 285 (31.9%); inhalation, n = 16 (1.8%); nasal, n = 1 (0.1%); and otic, n = 1 (0.1%); some patients had multiple routes of exposure. Treatments recommended by the poison center included irrigation (n = 411), petroleum jelly (n = 143), mineral oil (n = 131), topical antibiotic ointment (n = 82), peanut butter (n = 6), acetone (n = 4) and WD-40 (n = 2). A total of 657 patients (73.6%) were managed on-site, while 236 (26.4%) were seen in a health care facility. Among all exposures, effects were classified as none (n = 287), minor (n = 529) and moderate (n = 77). No major effects or deaths were reported.
CONCLUSIONS
In this case series, the majority of cases occurred in children and most exposures did not result in significant morbidity. Notably, there was wide variation in terms of recommended treatments; further study is needed to determine the optimal treatment method and to standardize poison center recommendations for treating patients with cyanoacrylate exposures.
Topics: Accidents; Adhesives; Adolescent; Adult; Aged; Aged, 80 and over; California; Child; Child, Preschool; Cyanoacrylates; Female; Humans; Infant; Male; Middle Aged; Poison Control Centers; Poisoning; Retrospective Studies; Risk Factors; Treatment Outcome; Young Adult
PubMed: 28535077
DOI: 10.1080/15563650.2017.1327067 -
Veterinary Dermatology Apr 2018Hearing loss (HL) is classified as conductive when sound transmission is compromised in the ear canal or middle ear, or sensorineural when there is an abnormality of the...
BACKGROUND
Hearing loss (HL) is classified as conductive when sound transmission is compromised in the ear canal or middle ear, or sensorineural when there is an abnormality of the receptor cells of the cochlea or auditory pathway. Hearing in dogs is evaluated using the brainstem auditory evoked response (BAER) test.
HYPOTHESIS/OBJECTIVES
Our objective was to characterize BAER findings pre- and post-ear flushing in four dogs with acute HL following application of an ointment-based otic medication containing betamethasone, clotrimazole and gentamicin in a mineral oil-based system containing a plasticized hydrocarbon gel.
ANIMALS
Dogs, ranging from 9 to 11 years old, that had been treated with the otic medication for one to three weeks prior to hearing loss and on otoscopic examination had evidence of medication in the horizontal ear canals.
METHODS
Dogs were anaesthetized for an ear flush to remove the medication from the ear canals. Hearing was assessed using BAER testing, measurements were initiated with 116 decibel peak equivalent sound pressure level (dBpeSPL) click. Estimated threshold was defined as the lowest intensity in dB in which wave V was still present.
RESULTS
Post-ear flush the estimated threshold improved in both ears of all dogs (mean 22.3 dB; range 13-41 dB), confirming conductive HL due to the otic medication. All owners noted an improvement in their dog's hearing post-ear flush, validating the BAER findings.
CONCLUSIONS AND CLINICAL IMPORTANCE
These results emphasize the importance of an ear flush to remove otic medications in dogs that experience acute HL, to determine if the HL is conductive, and if so, to restore hearing.
PubMed: 29664150
DOI: 10.1111/vde.12542