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

Year 2007, Volume: 17 Issue: 1, 22 - 25, 12.01.2007

Abstract

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.

References

  • Johnson AP, Smallman LA, Kent SE. The mechanism of healing of tympanic membrane perforations. A two- dimensional histological study in guinea pigs. Acta Otolaryngol 1990;109:406-15.
  • Davidson BJ, Morris MS. The perforated tympanic membrane. Am Fam Physician 1992;45:1777-82.
  • Kent SE, Rhys-Evans PH. Thermal myringotomy in guinea pigs. J Laryngol Otol 1987;101:103-15.
  • Johnson A, Hawke M. The function of migratory epi- dermis in the healing of tympanic membrane perfora- tions in guinea-pig. A photographic study. Acta Otolaryngol 1987;103:81-6.
  • Rivas Lacarte MP, Casasin T, Pumarola F, Alonso A. An alternative treatment for the reduction of tympan- ic membrane perforations: sodium hyaluronate. A double blind study. Acta Otolaryngol 1990;110:110-4.
  • Turley EA, Bowman P, Kytryk MA. Effects of hyaluronate and hyaluronate binding proteins on cell motile and contact behaviour. J Cell Sci 1985;78:133-45.
  • O’Daniel TG, Petitjean M, Jones SC, Zogg J, Martinez SA, Nolph MB, et al. Epidermal growth factor binding and action on tympanic membranes. Ann Otol Rhinol Laryngol 1990;99:80-4.
  • Mondain M, Ryan A. Epidermal growth factor and basic fibroblast growth factor are induced in guinea- pig tympanic membrane following traumatic perfora- tion. Acta Otolaryngol 1995;115:50-4.
  • Somers T, Goovaerts G, Schelfhout L, Peeters S, Govaerts PJ, Offeciers E. Growth factors in tympanic membrane perforations. Am J Otol 1998;19:428-34.
  • Ozcan C, Polat G, Gorur K, Talas DU, Bagdatoglu O, Cinel I. The effect of local administration of N-acetyl- cysteine in perforated rat tympanic membrane: an experimental study in myringosclerosis. Pharmacol Res 2002;45:5-9.
  • Felding JU, Rasmussen JB, Lildholdt T. Gas composi- tion of the normal and the ventilated middle ear cavi- ty. Scand J Clin Lab Invest Suppl 1987;186:31-41.
  • Sade J, Luntz M. Dynamic measurement of gas com- position in the middle ear. II: Steady state values. Acta Otolaryngol 1993;113:353-7.
  • Heffner JE, Repine JE. Pulmonary strategies of antiox- idant defense. Am Rev Respir Dis 1989;140:531-54.
  • Butler AR, Flitney FW, Williams DL. NO, nitrosonium ions, nitroxide ions, nitrosothiols and iron-nitrosyls in biology: a chemist’s perspective. Trends Pharmacol Sci 1995;16:18-22.
  • Lipton SA. Distinctive chemistries of no-related species. Neurochem Int 1996;29:111-4.
  • Kampf C, Roomans GM. Effects of hypochlorite on cultured respiratory epithelial cells. Free Radic Res 2001;34:499-511.
  • Pepperl S, Dorger M, Ringel F, Kupatt C, Krombach F. Hyperoxia upregulates the NO pathway in alveolar macrophages in vitro: role of AP-1 and NF-kappaB. Am J Physiol Lung Cell Mol Physiol 2001;280:L905-13.
  • Ovesen T, Paaske PB, Elbroend O. Local application of N-acetylcysteine in secretory otitis media in rabbits. Clin Otolaryngol Allied Sci 1992;17:327-31.
  • Kharazmi A, Nielsen H, Schiotz PO. N-acetylcysteine inhibits human neutrophil and monocyte chemotaxis and oxidative metabolism. Int J Immunopharmacol 1988;10:39-46.
  • Aldavood SJ, Behyar R, Sarchahi AA, Rad MA, Noroozian I, Ghamsari SM, et al. Effect of acetylcys- teine on experimental corneal wounds in dogs. Ophthalmic Res 2003;35:319-23.
  • Ovesen T, Paaske P, Ledet T, Elbrond O. Immunohistochemical quantitation of collagen types I, II, IV and V in the ventilated and non-ventilated rabbit middle ear with otitis media with effusion. Eur Arch Otorhinolaryngol 1994;251:137-42.
  • Ovesen T, Felding JU, Tommerup B, Schousboe LP, Petersen CG. Effect of N-acetylcysteine on the inci- dence of recurrence of otitis media with effusion and re-insertion of ventilation tubes. Acta Otolaryngol Suppl 2000;543:79-81.

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

Year 2007, Volume: 17 Issue: 1, 22 - 25, 12.01.2007

Abstract

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

References

  • Johnson AP, Smallman LA, Kent SE. The mechanism of healing of tympanic membrane perforations. A two- dimensional histological study in guinea pigs. Acta Otolaryngol 1990;109:406-15.
  • Davidson BJ, Morris MS. The perforated tympanic membrane. Am Fam Physician 1992;45:1777-82.
  • Kent SE, Rhys-Evans PH. Thermal myringotomy in guinea pigs. J Laryngol Otol 1987;101:103-15.
  • Johnson A, Hawke M. The function of migratory epi- dermis in the healing of tympanic membrane perfora- tions in guinea-pig. A photographic study. Acta Otolaryngol 1987;103:81-6.
  • Rivas Lacarte MP, Casasin T, Pumarola F, Alonso A. An alternative treatment for the reduction of tympan- ic membrane perforations: sodium hyaluronate. A double blind study. Acta Otolaryngol 1990;110:110-4.
  • Turley EA, Bowman P, Kytryk MA. Effects of hyaluronate and hyaluronate binding proteins on cell motile and contact behaviour. J Cell Sci 1985;78:133-45.
  • O’Daniel TG, Petitjean M, Jones SC, Zogg J, Martinez SA, Nolph MB, et al. Epidermal growth factor binding and action on tympanic membranes. Ann Otol Rhinol Laryngol 1990;99:80-4.
  • Mondain M, Ryan A. Epidermal growth factor and basic fibroblast growth factor are induced in guinea- pig tympanic membrane following traumatic perfora- tion. Acta Otolaryngol 1995;115:50-4.
  • Somers T, Goovaerts G, Schelfhout L, Peeters S, Govaerts PJ, Offeciers E. Growth factors in tympanic membrane perforations. Am J Otol 1998;19:428-34.
  • Ozcan C, Polat G, Gorur K, Talas DU, Bagdatoglu O, Cinel I. The effect of local administration of N-acetyl- cysteine in perforated rat tympanic membrane: an experimental study in myringosclerosis. Pharmacol Res 2002;45:5-9.
  • Felding JU, Rasmussen JB, Lildholdt T. Gas composi- tion of the normal and the ventilated middle ear cavi- ty. Scand J Clin Lab Invest Suppl 1987;186:31-41.
  • Sade J, Luntz M. Dynamic measurement of gas com- position in the middle ear. II: Steady state values. Acta Otolaryngol 1993;113:353-7.
  • Heffner JE, Repine JE. Pulmonary strategies of antiox- idant defense. Am Rev Respir Dis 1989;140:531-54.
  • Butler AR, Flitney FW, Williams DL. NO, nitrosonium ions, nitroxide ions, nitrosothiols and iron-nitrosyls in biology: a chemist’s perspective. Trends Pharmacol Sci 1995;16:18-22.
  • Lipton SA. Distinctive chemistries of no-related species. Neurochem Int 1996;29:111-4.
  • Kampf C, Roomans GM. Effects of hypochlorite on cultured respiratory epithelial cells. Free Radic Res 2001;34:499-511.
  • Pepperl S, Dorger M, Ringel F, Kupatt C, Krombach F. Hyperoxia upregulates the NO pathway in alveolar macrophages in vitro: role of AP-1 and NF-kappaB. Am J Physiol Lung Cell Mol Physiol 2001;280:L905-13.
  • Ovesen T, Paaske PB, Elbroend O. Local application of N-acetylcysteine in secretory otitis media in rabbits. Clin Otolaryngol Allied Sci 1992;17:327-31.
  • Kharazmi A, Nielsen H, Schiotz PO. N-acetylcysteine inhibits human neutrophil and monocyte chemotaxis and oxidative metabolism. Int J Immunopharmacol 1988;10:39-46.
  • Aldavood SJ, Behyar R, Sarchahi AA, Rad MA, Noroozian I, Ghamsari SM, et al. Effect of acetylcys- teine on experimental corneal wounds in dogs. Ophthalmic Res 2003;35:319-23.
  • Ovesen T, Paaske P, Ledet T, Elbrond O. Immunohistochemical quantitation of collagen types I, II, IV and V in the ventilated and non-ventilated rabbit middle ear with otitis media with effusion. Eur Arch Otorhinolaryngol 1994;251:137-42.
  • Ovesen T, Felding JU, Tommerup B, Schousboe LP, Petersen CG. Effect of N-acetylcysteine on the inci- dence of recurrence of otitis media with effusion and re-insertion of ventilation tubes. Acta Otolaryngol Suppl 2000;543:79-81.
There are 22 citations in total.

Details

Primary Language English
Journal Section Research Article
Authors

Arif Şanlı This is me

Mehmet Eken This is me

Cenk Evren This is me

Günay Ateş This is me

H. Mustafa Paksoy This is me

Publication Date January 12, 2007
Published in Issue Year 2007 Volume: 17 Issue: 1

Cite

APA Şanlı, A., Eken, M., Evren, C., Ateş, G., et al. (2007). Does topical N-acetylcysteine application after myringotomy cause severe otorrhea?. The Turkish Journal of Ear Nose and Throat, 17(1), 22-25.
AMA Şanlı A, Eken M, Evren C, Ateş G, Paksoy HM. Does topical N-acetylcysteine application after myringotomy cause severe otorrhea?. Tr-ENT. January 2007;17(1):22-25.
Chicago Şanlı, Arif, Mehmet Eken, Cenk Evren, Günay Ateş, and H. Mustafa Paksoy. “Does Topical N-Acetylcysteine Application After Myringotomy Cause Severe Otorrhea?”. The Turkish Journal of Ear Nose and Throat 17, no. 1 (January 2007): 22-25.
EndNote Şanlı A, Eken M, Evren C, Ateş G, Paksoy HM (January 1, 2007) Does topical N-acetylcysteine application after myringotomy cause severe otorrhea?. The Turkish Journal of Ear Nose and Throat 17 1 22–25.
IEEE A. Şanlı, M. Eken, C. Evren, G. Ateş, and H. M. Paksoy, “Does topical N-acetylcysteine application after myringotomy cause severe otorrhea?”, Tr-ENT, vol. 17, no. 1, pp. 22–25, 2007.
ISNAD Şanlı, Arif et al. “Does Topical N-Acetylcysteine Application After Myringotomy Cause Severe Otorrhea?”. The Turkish Journal of Ear Nose and Throat 17/1 (January 2007), 22-25.
JAMA Şanlı A, Eken M, Evren C, Ateş G, Paksoy HM. Does topical N-acetylcysteine application after myringotomy cause severe otorrhea?. Tr-ENT. 2007;17:22–25.
MLA Şanlı, Arif et al. “Does Topical N-Acetylcysteine Application After Myringotomy Cause Severe Otorrhea?”. The Turkish Journal of Ear Nose and Throat, vol. 17, no. 1, 2007, pp. 22-25.
Vancouver Şanlı A, Eken M, Evren C, Ateş G, Paksoy HM. Does topical N-acetylcysteine application after myringotomy cause severe otorrhea?. Tr-ENT. 2007;17(1):22-5.