Hydrocortisone Delay of Tissue Repair of Experimental Tympanic Membrane Perforations

Abstract

The effects of topically applied hydrocortisone on experimental tympanic membrane (TM) perforations in rats were evaluated by otomicroscopy and light microscopy. Standardized TM perforations, occupying the whole upper rear quadrant, were performed, and a 2% hydrocortisone suspension (CORT) was applied once daily for 10 consecutive days. Application of CORT caused a delayed healing pattern, and even at 1 month only 2 of 12 perforations had healed. The keratinizing squamous epithelial cells of the TM appeared hypertrophic, whereas hyperplasia, characterizing a nontreated healing TM perforation, was less prominent. The connective tissue layer of the CORT-treated TM was invaded by abundant inflammatory cells, mainly polymorphonuclear leukocytes. Also, when applied to an intact TM, CORT caused hypertrophy of the epidermal cells and an inflammatory reaction within the TM.

Keywords

hydrocortisone keratinizing squamous epithelium perforation tympanic membrane

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References

Swedish Adverse Drug Reactions Advisory Committee (SADRAC) 1971; 15: 1023.

Armstrong

. Traumatic perforations of the tympanic membrane: Observe or repair?. Laryngoscope 1972; 82: 1822–30.

Schöpf

. Side effects from topical corticosteroid therapy. Review article. Ann Clin Res 1975; 7: 353–67.

Spandow

Anniko

Hellström

. Hydrocortisone applied into the round window niche causes electrophysiological changes of the inner ear. ORL J Otorhinolaryngol Relat Spec 1989; 51: 94–102.

Taylor

McMinn

RMH

. Healing of experimental perforations of the tympanic membrane. J Laryngol Otol 1965; 79: 148–58.

McIntire

Benitez

. Spontaneous repair of the tympanic membrane. Histopathological studies in the cat. Ann Otol Rhinol Laryngol 1970; 79: 1129–31.

Clawson

Litton

. The healing process of tympanic membrane perforations. Trans Am Acad Ophthalmol Otolaryngol 1971; 75: 1302–12.

Reijnen

CJH

Kuijpers

. The healing pattern of the drum membrane. Acta Otolaryngol [Suppl] (Stockh) 1971(suppl 287).

Boedts

. The tympanic epithelium in normal and pathological conditions. Acta Otorhinolaryngol Belg 1978; 32: 329–407.

10.

Stenfors

L-E

Carlsöö

Salen

Winblad

. Repair of experimental tympanic perforations. Acta Otolaryngol (Stockh) 1980; 90: 332–41.

11.

Nacht

Garzon

. Effects of corticosteroids on connective tissue and fibroblasts. Adv Steroid Biochem Pharmacol 1974; 4: 157–87.

12.

Uitto

Mustakallio

. Effect of hydrocortisone acetate, fluocinolone acetonide, fluclorone acetonide, betamethasone-17-valerate and fluprednyliden-21-acetate on collagen biosynthesis. Biochem Pharmacol 1971; 20: 2495–503.

13.

Blumenkrantz

Asboe-Hansen

. Cortisone effect on collagen biosynthesis in embryonic explants and in vitro hydroxylation of protocollagen. Acta Endocrinol (Copenh) 1976; 83: 665–72.

14.

Manthorpe

Helin

Kofod

Lorenzen

. Effects of glucocorticoid on connective tissue of aorta and skin in rabbits. Biochemical studies on collagen, glycosaminoglycans, DNA and RNA. Acta Endocrinol (Copenh) 1974; 77: 310–24.

15.

Baxter

Forsham

. Tissue effects of glucocorticoids. Am J Med 1972; 53: 573–89.

16.

Oikarinen

Uitto

Oikarinen

. Glucocorticoid action on connective tissue: From molecular mechanism to clinical practice. Review article. Med Biol 1986; 64: 221–30.

17.

Dombi

. Collagen fibril formation in the presence of dexamethasone disodium phosphate. Connect Tissue Res 1986; 15: 257–68.

18.

Lehmann

Zheng

Lavker

Klingman

. Corticosteroid atrophy in human skin. A study by light, scanning, and transmission electron microscopy. J Invest Dermatol 1983; 81: 169–76.

19.

Saarni

Tami

Daherty

. Decreased hyaluronic acid synthesis, a sensitive indicator of cortisol action on fibroblasts. J Pharm Pharmacol 1978; 30: 200–1.

20.

Laurent

Fraser

. The properties and turnover of hyaluronan. In: Evered

Whelan

, eds. Functions of the proteoglycans. CIBA Foundation Series. Vol 124. Chichester, England: Wiley, 1986: 9–29.

21.

Stenfors

L-E

Berghem

Bloom

Hellström

Söderberg

. Exogenous hyaluronic acid (Healon) accelerates the healing of experimental myringotomies. Auris Nasus Larynx 1985; 12: 214–5.

22.

Hellström

Laurent

. Hyaluronan and healing of tympanic membrane perforations. An experimental study. Acta Otolaryngol [Suppl] (Stockh) 1987(suppl 442): 54–61.

23.

Laurent

Hellström

Fellenius

. Hyaluronan improves the healing of experimental tympanic membrane perforations. A comparison of preparations with different rheological properties. Arch Otolaryngol 1988; 114: 1435–41.

24.

O'Donoghue

. Epithelial migration on the guinea-pig tympanic membrane: The influence of perforation and ventilating tube insertion. Clin Otolaryngol 1983; 8: 297–303.