Regeneration of the tympanic membrane using fibroblast growth factor-2

Zc, Lou; Zh, Lou; Xiao, Jian

doi:10.1017/s002221511800083x

Cited by 18 publications

(21 citation statements)

References 56 publications

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“…However, all of these autografts have their own limitations; an ideal graft material is yet to be identified (10,31). Moreover, patients who undergo surgeries undertake the risks of general anesthesia, high medical costs, surgical complications, and loss of productivity (9,12). Hence, various alternatives have been explored to promote TM regeneration.…”

Section: Discussionmentioning

confidence: 99%

“…With the advancement in the field of tissue engineering, various bioscaffolds and bioactive molecules have been applied with encouraging results (10,11). Among them, basic fibroblast growth factor (bFGF) is one of the most commonly used bioactive molecules (12). Until recently, a majority of the studies were in animal models.…”

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confidence: 99%

“…Although a majority of trials reported promising benefits, the perforation closure rates varied across the different studies, and there does not appear to be a consensus for hearing benefits. Recently, a literature review (12) supported the role of bFGF in the repair of TM perforation, but to the best of our knowledge, no quantitative analysis has been performed to evaluate the effectiveness of bFGF.…”

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confidence: 99%

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The Effectiveness of bFGF in the Treatment of Tympanic Membrane Perforations: A Systematic Review and Meta-Analysis

Huang

Teh

Eikelboom

et al. 2020

Otology &Amp; Neurotology

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Objective: To investigate the effectiveness of basic fibroblast growth factor (bFGF) versus placebo or no intervention in the treatment of tympanic membrane (TM) perforations from randomized controlled trials (RCTs), prospective and retrospective studies. Data Sources: PubMed, EMBASE, and Cochrane databases were screened from their inceptions to June 2019. Study Selection: Inclusion criteria: 1) English language; 2) observational (retrospective or prospective) or treatment (RCT) studies; 3) reported the outcomes on the application of bFGF in adult or pediatric population. Exclusion criteria: 1) studies without a control group; 2) animal studies, in vitro studies, review studies, and case reports. Data Extraction: Number of patients, cause of TM perforation, perforation size, treatment, mean age, follow-up time, sex, closure rate, healing time, mean air-bone gap improvement. Data Synthesis: A total of 14 studies were included, including seven RCTs and seven non-RCTs with a total of 1,072 participants. The odds ratio for closure rate of bFGF treatment was 7.33 (95% confidence interval [CI], 4.65 to 11.53; p < 0.01; I 2 ¼ 44%) and the standardized mean difference (SMD) for healing time was-5.89 (95% CI:-7.85 to-3.93, p < 0.01, I 2 ¼ 98%), suggesting bFGF application has a significant effect on closure of TM perforations. However, no significant change in hearing (SMD: 0.08, 95% CI:-0.11 to 0.27, p ¼ 0.39, I 2 ¼ 0%) was seen as a result of bFGF treatment. Conclusions: Our meta-analysis has revealed that the application of bFGF can significantly enhance the closure rate as well as shorten the healing time for TM perforations. In terms of hearing, there is as yet no evidence that bFGF has a significant effect. Given its ease, availability, and safety, bFGF can be used effectively for TM repair.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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The Effectiveness of bFGF in the Treatment of Tympanic Membrane Perforations: A Systematic Review and Meta-Analysis

Huang

Teh

Eikelboom

et al. 2020

Otology &Amp; Neurotology

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“…Given the relative maturity of this field, we discuss here the randomized controlled studies conducted in humans. Recent reviews provide more discussion of preclinical and exploratory clinical studies of tympanic membrane regeneration 127128131132133. A noteworthy challenge in the field is the lack of a standardized animal model for chronic TMP 127134135…”

Section: Regenerative Medicine Advances In Oto-hnsmentioning

confidence: 99%

Advances in regenerative medicine for otolaryngology/head and neck surgery

McPhail

Janus

Lott

2020

BMJ

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Head and neck structures govern the vital functions of breathing and swallowing. Additionally, these structures facilitate our sense of self through vocal communication, hearing, facial animation, and physical appearance. Loss of these functions can lead to loss of life or greatly affect quality of life. Regenerative medicine is a rapidly developing field that aims to repair or replace damaged cells, tissues, and organs. Although the field is largely in its nascence, regenerative medicine holds promise for improving on conventional treatments for head and neck disorders or providing therapies where no current standard exists. This review presents milestones in the research of regenerative medicine in head and neck surgery.

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“…Many of these areas are already starting to bear fruit. [2][3][4][5] The article provides a fascinating overview of emerging (and sometimes disruptive) technologies. It is apparent from reading this article that as more non-surgical, advanced, biological methods of curing middle-and inner-ear diseases are discovered, management of implanted devices will likely become a progressively more dominant component of otology.…”

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confidence: 99%

What does the future hold for otology?

Fishman¹,

Fisher²,

Hussain³

2019

J. Laryngol. Otol.

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The field of otology is increasingly at the forefront of innovation in science and medicine, and he argues that we can expect much progress in the field of inner-ear drug delivery systems, auditory genetics, ototoxic chemoprevention, organ of Corti regeneration, artificial intelligence and the rise of robots, among other areas, in the years to follow. Many of these areas are already starting to bear fruit. [2][3][4][5] The article provides a fascinating overview of emerging (and sometimes disruptive) technologies. It is apparent from reading this article that as more non-surgical, advanced, biological methods of curing middle-and inner-ear diseases are discovered, management of implanted devices will likely become a progressively more dominant component of otology. The evolution of technological advances will be driven by our creativity, perseverance, and especially our ability to recruit experts in other fields of science and technology to engage in innovation relevant to hearing and balance.Two articles in this month's issue revisit coblation tonsillectomy. Lieberg et al. compared the extent of tissue damage produced by conventional cold steel and coblation tonsillectomy by histopathologically evaluating excised tonsils. 6 The authors conclude that coblation tonsillectomy is superior in terms of decreased early post-operative pain and less damage to surrounding tissues. The authors hypothesise that the reduction in postoperative pain may be due to lower mast cell degranulation in coblation tonsillectomy. Junaid et al. compare extracapsular and intracapsular coblation approaches, and conclude that intracapsular techniques result in lower post-operative pain scores and reduced overall morbidity. 7 However, as the authors point out, the main disadvantage of the intracapsular technique is the increased likelihood of remnant tonsil tissue with the future risk of tonsillar regrowth and recurrent tonsillitis requiring further tonsillectomy. Both these articles concur with a previously published prospective, randomised, single-blind study comparing coblation and bipolar tonsillectomy techniques published in this journal last year. 8 A study estimating the cost-effectiveness of coblation, also published last year, appeared to show that coblation is as least as cost-effective an intervention as cold steel techniques for adult and paediatric patients. 9 Finally, Cayir et al., in this month's issue, investigate the effects of nasal surgery on sexual function in patients with perceived nasal obstruction. 10 The authors conclude that surgical treatment of nasal obstruction by septoplasty, endoscopic sinus surgery, concha bullosa excision or radiofrequency can significantly improve sexual performance in patients with perceived nasal obstruction. Future studies assessing the effects of nasal surgery on quality of life should therefore consider this also as a quality of life measure.

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Regeneration of the tympanic membrane using fibroblast growth factor-2

Cited by 18 publications

References 56 publications

The Effectiveness of bFGF in the Treatment of Tympanic Membrane Perforations: A Systematic Review and Meta-Analysis

The Effectiveness of bFGF in the Treatment of Tympanic Membrane Perforations: A Systematic Review and Meta-Analysis

Advances in regenerative medicine for otolaryngology/head and neck surgery

What does the future hold for otology?

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