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Epithelial migration in the atelectatic tympanic membrane

Published online by Cambridge University Press:  16 October 2009

I P Tang ,
N Prepageran ,
R Raman  and
T Sharizhal
I P Tang*
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
N Prepageran
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
R Raman
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
T Sharizhal
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
*
Address for correspondence: Dr Ing Ping Tang, 66, Lorong Setia Raja 12A1, Taman Stutong Indah, 93350 Kuching, Sarawak, Malaysia. Fax: 602422564 E-mail: ingptang@yahoo.com
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Abstract

Objective:

To determine whether epithelial migration in the atelectatic tympanic membrane (secondary to any pathology) occurs in a similar fashion to that in the normal (non-pathological) tympanic membrane, by calculating and comparing the epithelial migration rate and pattern.

Study design:

Prospective, non-randomised, case–control study. This study was a pilot study. We included patients with an atelectatic pars tensa region of the tympanic membrane and a healthy contralateral tympanic membrane (the latter used as the control).

Setting:

Otorhinolaryngology out-patient clinic. The study was conducted from January 2006 to January 2008.

Intervention:

A total of 40 patients (80 ears) were included based on their otoscopic appearance and tympanography findings. All patients' ears were examined under an operating microscope. A dot of methylene blue dye was applied in the immediate vicinity of the umbo of the atelectatic tympanic membrane, and in the same position on the tympanic membrane of the control ear. Patients were then followed up weekly until the dye dot had migrated to reach the annulus.

Main outcome measures:

Direction and rate of epithelial migration.

Results:

In the atelectatic tympanic membranes, epithelial migration proceeded from the centre of the retraction pocket toward the annulus in a lateral, radiating manner. Thirty-three (82.5 per cent) of the 40 patients showed a similar migratory pattern in both the study and control ears. Sixty per cent of the retracted tympanic membranes showed no migration in the first week after methylene blue staining. After the first week, the migration rate was nearly constant from the umbo towards the periphery, in both the study and control ears. The mean daily epithelial migration rate in the study and control ears was 62.6 and 64.7 µm/day, respectively; however, this difference was statistically insignificant (p = 0.202, independent samples t-test).

Conclusion:

There is no difference in the epithelial migration rate or pattern, comparing atelectatic tympanic membranes and normal tympanic membranes. However, there may be a significant difference in the epithelial migration rate with increased grades of tympanic membrane atelectasis.

Keywords

Tympanic MembraneEpitheliumMigrationRetraction Pocket
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 12 , December 2009 , pp. 1321 - 1324
Copyright
Copyright © JLO (1984) Limited 2009

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