Healing large tympanic membrane perforations using hyaluronic acid, basic fibroblast growth factor, and epidermal growth factor

Abstract

Large tympanic membrane perforations usually require a surgical tympanoplasty for closure. Reducing surgical costs and risks has encouraged investigators to examine nonsurgical office procedures for healing these perforations. Growth accelerators are the most promising agents. We study here the closure of large acute perforations using weekly applications of 1 mg of 1% hyaluronic acid (HA), 0.4 microg basic fibroblast growth factor (bFGF), or 1.0 microg epidermal growth factor (EGF) directly to the tympanic membranes of the experimental ears. Control ears were treated with 0. 1 mL Vasocidin. Complete closure was obtained in 100% of the ears treated with HA and EGF and 85.7% of those treated with bFGF by day 21, compared with 63.6% of the controls by day 32. Moderate-to-severe ipsilateral and contralateral external canal hypertrophy was noted in 14.2% and 37.5% of the ears treated with bFGF and HA, respectively, but was not seen in ears treated with EGF or in the control group.

Comparative study on the effects of EGF and bFGF on the healing of human large traumatic perforations of the tympanic membrane

“…Differences in hearing improvement among the groups were not statistically significant (P > 0. 19). There was no evidence of sensorineural hearing loss (Fig.…”

Regeneration of chronic tympanic membrane perforation using 3D collagen with topical umbilical cord serum

“…However, only bioscaffold showed a limited rate of healing in a chronic TM perforation study, similar to the rate of the paper patch technique. To enhance the healing of chronic TM perforations, biomolecules including growth factors [12,13], hyaluronic acid [14], and pentoxifylline [15] have been used together with good results. To date, chemically recombinant growth factors such as epidermal growth factor (EGF), basic fibroblast growth factor (bFGF), and platelet derived growth factor (PDGF) have been mainly used combined with bioscaffold for TM regeneration [16,17].…”

Hyaluronic Acid Fat Graft Myringoplasty Versus Autologous Platelet Rich Plasma

“…Hyaluronic acid stimulates the endogenous growth factor, epidermal growth factor, insulin growth factor, tumor necrosis factor, and vascular endothelial growth factor in a reported animal study [10]. It plays a role in fibrous tissue regeneration and regulation during healing process of tympanic membrane [11-13]. It promotes the centripetal migration of epithelial tissue over the temporary fat graft support [12].…”

“…It promotes the centripetal migration of epithelial tissue over the temporary fat graft support [12]. Many studies [1, 11-14] showed that these factors promote the revascularization, cell growth and differentiation during healing process of tympanic membrane. Review studies show the success rate of HAFGM in adult and children (Table 4) [4-7, 15, 16].…”