Abstract
Tympanic membrane perforations (TMP) are relatively common but are typically not treated in their acute stage, as most will heal spontaneously in 7–10 days. Those cases which fail to heal within 3 months are called chronic TMP which attract surgical intervention (e.g. myringoplasty), typically with a temporalis fascia autograft. New materials for the repair of chronic TMP are being developed to address deficiencies in the performance of autografts by undergoing evaluation in animal models prior to clinical study. However, there is currently a lack of ideal chronic TMP animal models available, hindering the development of new treatments. Various techniques and animal species have been investigated for the creation of chronic TMP with varied success. In the present commentary, we bring to the attention of readers the recent report by Shen et al. in Journal of Translational Medicine. The study reported the creation of a chronic TMP animal model in plasminogen gene deficient mice. However, the short observation time (9, 19 days), lack of success rate and the scarcity of solid evidence (e.g. otoscopic & histologic images) to confirm the chronicity of TMP warrant a more thorough discussion.
Highlights
Tympanic membrane perforations (TMP) are a common problem in otology, resulting from trauma, infection or a sequel after extrusion of tympanostomy tubes
Commentary We read with great interest the recent research article by Shen et al [13] investigating the efficacy of injections of plasminogen on the healing of both acute and chronic tympanic membrane perforations (TMP) in mice with plg gene deficiency
The absence of an ideal chronic TMP animal model in the current literature has been brought to attention in recent years [3,11,12], as this issue hinders development of treatments for chronic TMP in a clinical setting
Summary
Tympanic membrane perforations (TMP) are a common problem in otology, resulting from trauma, infection (e.g., otitis media) or a sequel after extrusion of tympanostomy tubes. Commentary We read with great interest the recent research article by Shen et al [13] investigating the efficacy of injections of plasminogen (plg) on the healing of both acute and chronic tympanic membrane perforations (TMP) in mice with plg gene deficiency (plg–/–). Many publications of chronic TMP animal model have conservatively defined their TMP failing to reach the maximum patency time up to 8 weeks as delayed healing [4,25,26,27,28,29,30,31], including the recently reported study on mice with deficiency in urokinase-type plg activators [25]. Whether ‘true’ chronic TMP were produced in this mouse model given the absence of otoscopic and histologic proof is uncertain
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