Arif ŞANLI, Mehmet EKEN, Cenk EVREN, Günay ATEŞ, H. Mustafa PAKSOY

Miringotomi sonras› uygulanan topikal N-asetilsistein ciddi otore sebebi midir?

Amaç: Akut, deneysel, travmatik timpan membranperforasyonlarının iyileşmesinde N-asetilsistein kullanımının etkileri incelendi.Gereç ve Yöntem: Çalışmada 20 hayvan guineapig kullanıldı. İntraperitoneal ketamin anestezisi altında, düz otolojik hook yardımıyla timpan membranların posterosuperior kadranlarına insizyonel miringotomi yapıldı. Perforasyonların çapı yaklaşık 2 mmidi. Kobaylar iki gruba ayrıldı. Kontrol grubuna 10hayvan, 20 kulak 0.1 ml %0.09 NaCl emdirilmişspongostanlar, çalışma grubuna ise 0.6 mg/0.1 mlN-asetilsistein emdirilmiş sponglar her gün değiştirilerek üç gün boyunca dış kulak yolundan perforasyon üzerine yerleştirildi. Her iki grubun timpanmembranları 3, 5, 7 ve 9. günlerde kulak mikroskobu ile değerlendirildi.Bulgular: Kontrol grubundaki perforasyonların tamamının dokuzuncu günde kapandığı izlendi. Nasetilsistein uygulanan grupta perforasyonların ancak %40’ı kapandı, geri kalan kulakların tümündeüçüncü günden itibaren otore izlendi.Sonuç: Timpan membran perforasyonlarının iyileşmesinde N-asetilsistein kullanımı yoğun otore sebebi olabilir. Bu konuyla ilgili histopatolojik incelemeleri de içeren daha kapsamlı çalışmalar gerekmektedir

Anahtar Kelimeler:

Asetilsistein, orta kulak/cerrahi, orta kulak ventilasyonu, timpanoplasti.

Does topical N-acetylcysteine application after myringotomy cause severe otorrhea?

Objectives: The effect of topical N-acetylcysteine NAC application was investigated on the healing of acute experimental tympanic membrane perforations.Materials and Methods: Twenty guinea pigs were used in this study. Under intraperitoneal ketamine anesthesia, incisional myringotomies were per-formed in the posterosuperior quadrant of the tympanic membranes with a straight otologic hook. The diameter of the perforations was approximate-ly 2 mm. Perforations in both ears were treated with freshly prepared sponges soaked in either 0.1 mİ 0.9% NaCI solution 10 control animals or 0.6 mg/0.1 mİ NAC 10 animals for three consecutive days. AH the tympanic membranes were examined by otomicroscopy on the third, fifth, seventh, and ninth days.Results: İn the control group, ali the perforations were completely closed at the end of nine days. During the same period, only 40% of the perforations were completely closed in the NAC group. The remaining ears exhibited otorrhea by the third day. Conclusion: N-acetylcysteine may cause severe otorrhea in the healing process of tympanic membrane perforations. Further studies including histopathological examinations are required to eluci-date this condition.

Keywords:

Acetylcysteine ear, middle/surgery, middle ear ventilation, tympanoplasty,

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