The Role of Fibrinolysis in Adhesive Otitis Media(AOM)

Objective To study the effects of Batroxobin on otitis media with effusion(OME), an early stage of Ad-hesive Otitis Media(AOM), for the purpose of expanding our understanding of the role of fibrinolysis in the patho-genesis of AOM. Method Forty cases of OME(45 ears) were randomly selected to receive intratympanic adminis-tration of Dexamethasone at 5 mg/ml(Group 1 or G1), Batroxobin at 1 BU/ml(Group 2 or G2) or Batroxobin at 2 BU/ml (Group 3 or G3). Pre- and post-treatment changes in clinical symptoms, the Air conduction Hearing Threshold (AHT) in pure tone audiometry and average AHT over 0.25 to 2 kHz were compared. Results Data from 31 eases(33 ears) were available for analysis. AHTs among three groups were similar prior to treatment(P> 0.05). The rate of normal hearing following treatment in G3 was 70% or 7/10, higher than in G1 (41.7% or 5/12) and G2 (54.5% or 6/11)(P < 0.05). The rate of improvement following treatment was 81.8% or 9/11 and 80.0% or 8/10 in G2 and G3, respectively, higher than that in G1 (50.0% or 6/12)(P< 0.05). Conclusions Therapeu-tic effects of intratympanic injection of Batroxobin on OME is superior to traditionally used Dexamethasone. In ad-dition, higher concentration of Batroxobin appears to be superior to lower concentrations. These findings confirm that fibrinolysis plays a pivotal role in the pathogenesis of middle ear adhesion and that fibrinolytic medicine can prevent or reduce adhesion development in the middle ear.