Tissue Engineering of the Tympanic Membrane

Abstract

Tympanic membrane (TM) perforations are common, with current treatments for chronic perforations involving surgery, using various graft materials, from autologous cartilage or fascia through to paper patch. Recent research developments in this field have begun applying the principles of tissue engineering, with appropriate scaffolds, cells, and bioactive molecules (BMs). This has revolutionized the therapeutic approach due to the availability of a wide range of materials with appropriate compatibility and mechanical properties to regenerate the membrane acoustics and may also represent a paradigm shift in the management of TM perforations in an outpatient setting without surgery. However, many factors need to be considered in the fabrication of a bioengineered TM. This review discusses the issues associated with current treatment and examines TM wound healing relevant to the construction of a bioengineered TM. It also describes the tissue-engineering approach to TM regeneration by summarizing currently used scaffolds, BMs, and cells in TM wound healing. Finally, it considers the design of scaffolds, delivery of BMs, and cell engraftment toward potential clinical application.

Platelet-Rich Plasma Application for Acute Tympanic Membrane Perforations

“…Although acute TMPs are reported to heal within 7-10 days [1] , 10%-20% of the patients have persistent TMPs that become chronic. The mechanism underlying the presence of persistent perforations is unknown.…”

“…Most acute TMPs heal within 7-10 days [1] . Overall, 10%-20% of TMPs do not heal within 3 months and reach a clinically chronic state [2,3] .…”

“…For cost effectiveness, avoiding the risks associated with general anesthesia, limiting the intra-operative time, and preventing the requirement of care and sick leaves after surgery, simpler therapeutic strategies are being investigated [2] . Various biomaterials and molecules are being studied for the evaluation of their unknown safety and efficacy profiles with respect to the healing process of tympanic membranes (TMs) and in animal models before clinical trials [1,4] . In the present study, we aimed to assess the efficacy of the application of platelet-rich plasma (PRP) in the healing process of acute TMPs.…”

What is new in tympanoplasty?

“…Surgical placement of 3D printed eardrum grafts will require consideration of graft orientation to allow for a reliable connection to the ossicular chain 9 . Finally, the testing performed during this investigation was done in vitro.…”

A prospective cohort study of the silk fibroin patch in chronic tympanic membrane perforation

“…6 Recent advances in tissue engineering and biomaterial research have suggested alternative material for TM regeneration. 7 Silk, collagen, chitosan, and calcium alginate have been studied as TM patching materials and have shown favorable results in animal and clinical studies of acute traumatic TM perforation. [7][8][9] Among these options, silk fibroin has high biocompatibility and can heal the perforated TM in animal models.…”