Role of healing promoting factors in healing of tympanic membrane perforations: a meta-analysis study

Abstract

Background and Aim Some healing promoting factors, such as epidermal growth factor (EGF), fibroblast growth factor (FGF), hyaluronic acid (HA), and platelet-rich plasma (PRP), have been in use nowadays to assist healing eardrum perforations. Several trials have been conducted to assess their effectiveness. This meta-analysis was conducted to find out the prognostic effects of these factors.Materials and methods The search methods consist of electronic databases and literature references for published and unpublished studies, besides the reference lists of all relevant studies. Selection criteria All types of studies (randomized controlled trials, prospective, retrospective, or case–control). Data collection and analysis Eighteen articles were included after screening by titles and/or abstracts and full-text assessment. They were categorized according to the used healing promoting factor. Data were extracted and analyzed via Cochrane Collaboration’s Review Manager Software.Results EGF and FGFs significantly improved the rate of closure, healing duration, and increased hearing gain. On the contrary, the overall effects of HA and PRP were nonsignificant in this respect.Conclusion EGF and FGF can increase the rate of closure of tympanic membrane perforations, shorten healing duration, and improve hearing gain. PRP and HA do not have a significant effect. This can be attributed to heterogeneity of the studies included to assess the role of each of these two factors.