ObjectiveTo explore the effect of recombinant human epidermal growth factor (rh-EGF) gel on surgical cavity epithelization in patients with cholesteatoma otitis media (COM) after open radical mastoidectomy, and to analyze its influencing factors for postoperative recurrence. MethodsA total of 322 COM patients undergoing open radical mastoidectomy were selected as the research subjects. Patients were randomly assigned to observation group (197 cases) or control group (125 cases). The control group received otological small gauze infiltrated with hydrocortisone and chloramphenicol ear drops to tightly fill the surgical cavity after operation, and the observation group received otological small gauze infiltrated with rh-EGF to adhere the surgical cavity firstly, and then the surgical cavity was filled based on the aforementioned method. Time for surgical cavity complete epithelization, total effective rate of treatment, and occurrence of postoperative complications and recurrence were compared between patients of the two groups. According to recurrence status, patients were divided into relapsed group or non-relapsed group, and the COX proportional hazard regression model was used to analyze the influencing factors for postoperative recurrence in COM patients after open radical mastoidectomy, and the nomogram prediction model was established. ResultsThe observation group exhibited shorter time for surgical cavity complete epithelization, a higher total effective rate of treatment, and lower incidence rate of postoperative complications and recurrence rate as compared with the control group (all P＜0.05). The results of COX proportional hazard regression analysis revealed that smoking history, incomplete clearance of lesion tissues, incomplete lateral opening of upper tympanum, posterior tympanum lesion, poor drainage of surgical cavity, and non-utilization of rh-EGF after operation were the influencing factors for recurrence of COM patients after open radical mastoidectomy (all P＜0.05). The nomogram prediction model established based on these influencing factors exerted relatively favorable discrimination, accuracy, and effectiveness. ConclusionThe use of rh-EGF in COM patients after open radical mastoidectomy can shorten time for surgical cavity complete epithelization, increase the total effective rate of treatment, and decrease the incidence rate of postoperative complications and recurrence rate. The recurrence of COM patients after open radical mastoidectomy is related to smoking history, incomplete clearance of lesion tissues, incomplete lateral opening of upper tympanum, posterior tympanic lesion, poor drainage of surgical cavity, and non-utilization of rh-EGF after operation.

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