The Effect of Topical Insulin on Healing of Small Central Tympanic Membrane Perforations and Hearing Threshold

Abstract

Background: This study is a prospective cross-sectional study, Six months, starting from July 2020 till December 2020. The sample size  was estimated to be 24 cases. As the expected number of patients attending at otorhinolaryngology surgery department and fulfilling the  inclusion criteria is about 4 patients /month (24 / 6 months), and all of them were included in the as a comprehensive sample  

Results: The mean age of cases was 36.42 years (range, 16 – 63 years). Females constituted 58.3% of the study group, whereas the  remaining portion was occupied by males. The duration of perforations had a mean value of 2.76 months. Most cases had only one  perforation, but overall, their number ranged between 1 and 4. Trauma was the commonest cause in the current study (58.3%), followed  by chronic suppurative otitis media (41.7%). The right sided perforations were more prevalent as it was affected in 66.7% of cases.History  of ear discharge was positive in 10 cases (41.7%). It was positive in cases with positive history of otitis media. The number of topical  insulin installations ranged between 4 and 14 (mean = 8.29). Over the scheduled follow up visits, the perforation size showed a significant  decrease from 1.48 mm at baseline down to 0.89, 0.67, and 0.54 at 1-week, 1-, and 2-month visits (p < 0.001).

Conclusions: Based on our  findings, topical insulin therapy appears to be a hopeful and safe option for small central tympanic perforations, with more favorable  outcomes in traumatic versus infective cases.