External Skin Research Articles

Chimeric Lateral Arm Free Flap to Treat Pharyngocutaneous Fistula After Total Laryngectomy.

Pharyngocutaneous fistula is a major complication after total laryngectomy, leading to a severe adverse impact for the patient and social activity. The reported incidence ranges from 9% to 25% in the last decade. In this paper, the authors present our experience using chimeric lateral arm free flap for reconstruction of the pharyngo-esophageal segment. Eight patients with pharyngocutaneous fistula were treated with this technique. The flap has 2 skin islands, each one supplied by a perforator coming from the main pedicle. One skin island is used as a patch for pharynx closure and the other is used for anterior soft tissue coverage. The follow-up period ranged from 8 months to 3 years. All flaps survived. There was 1 small fistula that was sutured. External skin wound dehiscence was present in 1 case and it was secondary closed by itself. All patients were able to eat by mouth and there were no signs of stricture. The authors preferred this type of flap because both defects are simultaneously closed and each skin paddle is supplied by a perforator coming from the main pedicle. It has a better color match than other free flaps. The skin island is thin and remains thin even after the patients gain weight.

Evaluation of Outcome Between Excisional Haemorrhoidectomy and Longo's Technique (PPH)

Objective: The introduction of a Longo’s technique for the treatment of haemorrhoids has the potential for less postoperative pain, a short operating time, rapid healing and an early return to full activity. The outcome of Longo’s technique was compared with that of current standard surgery in a randomized controlled study, and followed up two years.
 Methods: In a prospective randomized study, 140 patients requiring surgical treatment for haemorrhoids grade 2, 3 and 4 were assigned to either MMF (Milligan-Morgan, Park Ferguson) or PPH (Procedure for prolapse and haemorrhoids) 70 each. Operating time, frequency of postoperative analgesic intake, hospital stay, time to return to normal activity and postoperative complications were also recorded.
 Results: The Longo’s group had a shorter operating time, less frequent postoperative analgesia intake, and earlier return to normal activity. Postoperative pain at rest and during defecation was less important after PPH if no resection of external piles or skin tags was associated. After a mean follow-up of 24 months (12-46), recurrent haemorrhoidal symptoms, mostly mild and temporary, were reported after both MMF and PPH (Table-3). Four patients (5.71 %) complained of recurrent prolapse and/or external swelling after PPH, requiring re-do surgery in 3 of them between 18 to 32 months. Recurrent prolapse or external piles were also observed in 5 patients (7.14%) after MMF and re-do surgery was needed in 3 of them between 14 and 41 months. Long term patient's satisfaction after PPH was more or less same like after MMF. None of the patients had anal stenosis, incontinence, fecal urgency or sepsis.
 Conclusions: Postoperative pain is less after PPH. This advantage disappears if any resection is associated with the stapling. Use of a Longo's technique in the treatment of haemorrhoidal disease promotes rapid healing, shorter hospital stay and early return to normal activities.
 Journal of Surgical Sciences (2013) Vol. 17 (2) :66-72

Acquired Full-Thickness Nasal Ala Defects: General Principles and Reconstruction Options

The article presents the data of scholarly publications on the general principles and organizational solutions for nasal ala reconstruction of full-thickness defects. The reconstruction of the full-thickness nasal ala defect includes restoration of the external skin and internal covering epithelium, formation of support structures to achieve a stabile shape and position of the alar subunit. With this end in view, plastic material in the form of composite grafts from the auricle is applied, and each tissue layer is formed separately in the region of the defect. The external skin is most often reconstructed with medial cheek cutaneous flaps. The support structures are formed with cartilage autografts. The reconstruction of the internal lining defect is performed with local mucosal or skin flaps, more rarely mucosal or skin grafts. The limiting factors are: risk for ischemic complications, surgical trauma, and secondary surgical correction. The agenda do not only include achievement of acceptable anatomical and functional results but also the quality of perioperative life, shorter time and duration of the surgical intervention and minimum changes in the donor site.

Effect of Hormone Treatment, Coating Material and Ethylene Absorber on the Shelf Life of Mangosteen

Several factors affect the shelf life of mangosteen fruit, such as the low quality of fruit at harvest time or poor storage and transportation precise conditions before the fruit is consumed. Cause of poor quality of mangosteen fruit for export due to hardening of fruit skin after harvest and harvesting through matures caused by the lack of proper handling of harvest and postharvest. The objective of the research was to study the effect of hormone treatment, coating material and ethylene absorber to the shelf life of mangosteen. Treatments were implemented by coating process using a combination of GA3 hormone treatment and coating materials (chitosan and wax). The other treatments used were combination of plastic and teabag packaging containing KMNO4. The study was designed using a completely randomized design. Observations included external visuals, internal visuals, weight loss, color, texture, and skin structure. The data analysis was performed using SPSS 2.1 software. At first week, the condition of treated mangosteen fruit were still resembles with fruit on day-0. This was due to the cooling factor, assisting in the process of maintaining the freshness of the mangosteen fruit.

Perianal Dermatology.

The proctodeum represents the embryologic fusion of the integumentary tissues surrounding the anus to hindgut giving rise to the perianal, anal canal, and distal rectal regions in humans. It is a diminutive zone encompassing less than 1% of the total body. The anorectum represents remarkable feet of evolutionary engineering. The proctodeum is an important anatomic transition zone that is host to diseases of the anorectum as well as the surrounding external skin and soft tissues. Colorectal surgeons are significantly more familiar with the former than the latter.

Building Cladding using Liner Trays: Experimental and Numerical Approach

Liner trays are large channel-type thin-walled steel sections with two narrow flanges, two webs and one wide flange, very frequently used in practice both to resist perpendicular uniformly distributed loading from wind and create a diaphragm effect at the level of buildings cladding. Such cladding systems are normally built using a required number of horizontally laid inter-connected adjacent liner trays plus an external skin of sinusoidal or trapezoidal sheeting installed perpendicularly to their direction (with vertical corrugations). This results in a stiff metal cellular system (as outer wall of the building) having its inner space filled with thermo insulating material. When trying to evaluate the resistance of such elements by experiment, the specific constructional details play a major role and create quite complex problems in establishing a correct experimental procedure. Thus an experimental setup made of three joined liner trays is proposed with adequate detailing to match the real situation of such claddings. The investigation on liner trays was conducted by a joint team belonging to The Romanian Academy (Timisoara Branch), The Politehnica University of Timisoara (CEMSIG Laboratory) and The National Institute for Research and Development (INCD-URBAN-INCERC)–Timisoara Division. Aspects related to the experimental setup, test results (in terms of found collapse modes) experimentally and numerically determined resistances are emphasized. A comparison with code based theoretical results and FE simulation is presented and discussed in the final part.

Measurement of the Water Content in Semi-solid Formulations Used to Treat Pressure Ulcers and Evaluation of Their Water Absorption Characteristics.

We investigated the water contents in commercial semi-solid preparations used for pressure ulcer (PU) treatment using near-IR spectroscopy (NIRS) and compared the results with those measured using the Karl Fischer (KF) method. The aim of this study was to determine a standard method and select the appropriate topical preparation with the optimal moisture for PU treatment. The water absorption properties of bases and formulations were evaluated with a time-dependent factor using Transwell as the model membrane. KF and NIRS were applicable as measurement methods of the water content in semi-solid formulations. NIRS was shown to be a useful, simple, nondestructive tool that is more advantageous than the KF method. The water absorption characteristics tested using Transwell revealed that the rate of and capacity for water absorption are determined not only by the absorption ability of the polymer base but also by other factors, such as the osmotic pressure exerted by additives. KF and NIR measurements can be used to choose external skin preparations to control the amount of water in PU treatment.

Infrared (IR) thermography as a potential screening modality for carotid artery stenosis

In the present study, an infrared (IR) thermal camera was used to map the temperature of the target skin surface, and the resulting thermal image was evaluated for the presence of carotid artery stenosis (CAS). In the presence of stenosis in the carotid artery, abnormal temperature maps are expected to occur on the external skin surface, which could be captured and quantified using IR thermography. A Duplex Ultrasound (DUS) examination was used to establish the ground truth. In each patient, the background-subtracted thermal image, referred to as full thermal image, was used to extract novel parametric cold thermal feature images. From these images, statistical features, viz., correlation, energy, homogeneity, contrast, entropy, mean, standard deviation (SD), skewness, and kurtosis, were calculated and the two groups of patients (control and diseased: a total of 80 carotid artery samples) were classified. Both cut-off value- and support vector machine (SVM)-based binary classification models were tested. While the cut-off value classification model resulted in a moderate performance (70% accurate), SVM was found to have classified the patients with high accuracy (92% or higher). This preliminary study suggests the potential of IR thermography as a possible screening tool for CAS patients.

Trends in Demographics and Surgical Treatment of Weapon-Related Limb Injuries Over Two Decades in a Resource-Scarce Setting

BackgroundIn the past decades, surgical management of limb injuries in high-resource settings has improved. The possibility of limb salvage has increased. It is not known whether similar changes have transpired in resource-scarce conflict settings.MethodsRetrospective cohort study using routinely collected patient data from the International Committee of the Red Cross hospitals in Pakistan was conducted. Consecutive data from 2009 to 2012 (535 patients) and randomly selected data from 1992 to 1995 (463 patients) were used. Only patients with weapon-related limb injuries were included. Differences in surgical procedures were assessed with logistic regression to adjust for confounding factors.ResultsLess injuries were related to mines in 2009–2012 than in 1992–1995 (3.7% vs. 20.3%, p < 0.0001), but injuries from bombs, shells and fragments were more frequent (38.5% vs. 19.4%, p < 0.0001) as were injuries with only a small degree of tissue damage (42.0% vs. 31.1%, p = 0.0004). In the logistic regression, the time period did not affect the risk of amputation, debridement, length of hospital stay or in-hospital mortality. The use of external fixation (OR 0.56, 95% CI 0.33–0.96, p = 0.04), split skin grafts (OR 0.31, 95% CI 0.21–0.45, p < 0.0001) and blood transfusion (OR 0.43, 95% CI 0.28–0.66, p = 0.0001) was less frequent in 2009–2012.ConclusionIn this resource-scarce conflict setting, the risk of amputation appears unchanged over time, while the use of external fixation and split skin grafts was less common in 2009–2012 than in 1992–1995. These results contrast with the improved limb salvage results seen in high-resource settings. It likely reflects the challenges of providing advanced limb-preserving techniques in a resource-scarce setting.

Effect of carotid artery stenosis on neck skin tissue heat transfer

The buildup of plaque in the carotid artery leads to the narrowing of the arterial lumen, known as stenosis. Arterial stenosis affects the supply of blood to the brain and may result in stroke if the plaque is dislodged. This study aims to evaluate stenosis influenced hemodynamics of the carotid artery and its effect on the bio-heat transfer to the external neck skin surface. Systolic and Diastolic carotid artery flow inlet conditions, using a finite volume numerical scheme, are simulated with the inclusion of varied stenosis degree in the carotid model (25%–90%). A 3-dimensional (3D) conjugate heat transfer study is performed on an idealized carotid artery geometry, encapsulated in a tissue model resembling the human neck. With no significant difference in the average external neck skin temperature, variation in the temperature contours is observed between stenosed and non-stenosed cases. With the increase in the carotid artery stenosis, a quantitative change, the presence of a colder region called ‘cold feature’, in external neck skin temperature features is reported. This numerical study will prove to be a strong basis for future patient-specific evaluations.

Anal fissures

An anal fissure is a tear in the anal mucosa, most often caused by trauma, such as passing a large bowel movement. Fissures of less than 6–8 weeks’ duration are acute, and those persisting longer are chronic. Chronic fissures are associated with external sentinel skin tags, exposed internal

Microvascular Reconstruction of the Nose with the Radial Forearm Flap: A 17-Year Experience in 47 Patients.

Microvascular reconstruction of the nose was pioneered in China in the early 1970s using the radial forearm flap. Since then, different flaps, methods, and flap designs have been used to improve outcomes. Microvascular tissue transfer has become the first step of multistage reconstruction, which includes rebuilding the nasal framework, transferring a forehead flap for external skin coverage, and sculpting the nose for improved appearance and breathing. In this article, the authors present their long-term experience in microvascular reconstruction of the nose using the infolded radial forearm flap for full-thickness nasal defects, and a single circumferential flap for inner lining only. Fifty microvascular nasal reconstruction procedures were performed on 47 patients between 2000 and 2017 using the radial forearm flap. The reconstructions included total/subtotal nasal defects using a trapezoid-shaped forearm flap folded in one or two planes, and a rectangular flap positioned internally and circumferentially for lining only. The nasal defects were caused by cancer resection, trauma, infection, cocaine abuse, and failed attempts at nasal reconstruction. Forty-seven flaps were transferred successfully for nasal reconstruction, with two immediate failures (4 percent) caused by flap insetting complications and one late loss. Forty-six patients completed the multistage nasal reconstruction. Follow-up was 1 to 17 years (average, 6 years). The radial forearm flap infolding technique is the authors' method of choice for microvascular reconstruction of the nose because it allows placement of a primary dorsal cartilage graft for optimal vascularization, and uses the excess dorsal skin during forehead resurfacing to modify the lining inset and shape the nostrils. Therapeutic, IV.

The effects of a double-skin façade on the cladding pressure around a tall building

Cladding damage of tall buildings often occurs during hurricane events, and the damage is not only costly but also impacts the economy, and more importantly, threatens lives. One solution to reduce the cladding pressure is the application of modified double-skin facade (DSF) which is already of great interest to architects due to improving building energy efficiency. This paper investigates the effects on the cladding pressures of a building fitted with a DSF with vertical openings in the external skin mounted in front of the windward face of the building. The effects of the vertical openings on the building's surface pressure were investigated by conducting pressure measurements in the wind tunnel. The associated flow mechanisms were revealed by using particle image velocimetry technique. The DSF without opening increases both the mean suctions and fluctuating pressures on both side and leeward faces, and hence this common façade configuration leads to an undesirable effect on building claddings under strong winds. In contrast, the DSF with the opening(s) can effectively reduce wind pressures on the side and leeward faces. Therefore, creating vertical openings on the external skin of DSF is a practical approach to enhance the wind-resistance performance of building claddings.

The Potential of Giving Silage Feed Based on Corn Plant Waste (Zea mays) Using Local Microorganisms (Indigenous Microorganism) Against the Percentage of Non-Carcass on Local Sheep

This study aims to examine the effect of complete corn waste based on silagefeed on the percentage of non carcasses on local sheep. The study was conducted at theLaboratory of Animal Biology at the University of North Sumatra in May - August2018. The design used was a Completely Randomized Design (CRD) with 4 treatmentsand 3 replications using sheep with an average initial weight of 11.2 ± 0.4 kg. Thetreatments consisted of four levels of complete silage feed based on corn waste P1(20%), P2 (40%), P3 (60%), and P4 (80%).The parameters observed were: weight,head, foot, skin, tail, trachea and lungs, liver, heart, blood, and digestive tract.Theresults showed that complete feed based corn waste silage did not have a significanteffect (P&gt; 0.05) on the percentage of non-carcass weight such as skin, tail, trachea andlungs, blood and digestive tract, but gave a non-significant effect on the percentage noncarcass weights such as head, feet, heart and liver. The conclusion of complete feedsilage based on corn waste can have a significant influence on the internal non carcass(liver and heart) and external (head and foot) parts of male local sheep. In addition itgives a non significant influence on the non-internal carcass parts (trachea and lungs,blood and digestion) and the external (skin and tail) of male local sheep.

Phase change material blind system for double skin façade integration: System development and thermal performance evaluation

Double skin facades (DSFs) are often applied as energy reducing elements in modern buildings, but do experience overheating problems in warm seasons which may contribute to increase in cooling loads. There are currently various thermal management devices being used in DSF but have limitations such as secondary thermal transmittance and low energy storage capacity. In this paper, a novel laminated composite phase change material (PCM) blind system with high thermal energy storage capacity has been developed and evaluated in a typical DSF building. The results showed that the integrated PCM blind system was able to keep the average air temperature in the DSF below 35 °C during the monitored period in summer and showed no significant increase as compared with the ambient temperature. The surface temperature of the inner skin of the DSF was also reduced up to about 2.9 °C as compared with the external skin surface temperature thus reducing heat transfer into the building. By using validated numerical models, the PCM blind was found to perform thermally better than a conventional aluminium blind. Finally, design and operational parameters of the PCM blind including the blind tilt angle and its position were optimised. Further comparative studies against other integrated DSF systems are however being encouraged to establish the full effectiveness of the developed PCM blind system.

RETRACTED:Theoretical mechanism to breakdown of photonic structure to design a micro PV panel

Abstract The photon structure has been modeled and reconstructed to design and micro PV (photovoltaic) panel. Bose–Einstein photondistribution theory recommends that under low-temperature conditions, photonic-band-gap state photons are locally induced and remain in a steady condition due to long-lived equilibrium particles known as discrete energy state photons. I therefore assume that once a photon is in a thrilling relativistic thermal condition, it is not going to comply with Bose–Einstein discrete energy state theory. Owing to the highest relativistic thermal conditions, the photonic band gap volume is going to be naturally raised in its vicinity and the discrete energy state photon is going to be agitated with the highest relativistic thermal fluctuations. Therefore, the Bose–Einstein photonic dormant state is going to be broken down in its region and thus generate numerous photons. Simply, a single discrete energy state photon will be converted from the crossover phenomenon equilibrium state to a non-equilibrium state with the aim of exponentially generating numerous photons, here known as Hossain nonequilibrium photons ( HnP − ). Computations disclose the fact that in a situation where only 0.00008 percent of a building’s external skin curtain wall is applied as a micro PV panel of converting Bose–Einstein equilibrium photons into HnP − , it is going to generate sufficient clean energy that satisfies the building’s total energy demand.

(Invited) Facile Nickel Phosphate Nano/Micro Structure As the High-Performance Electrode for Non-Enzymatic Glucose and pH Sensors

The commonly used glass pH probe is sensitive, stable, and lasts for a relatively long period of time but it is not a practical sensor for pH measurements in all environments, particularly in wearable ambulatory settings [1]. Similarly, measuring glucose level from external skin sweat is very difficult in terms of applicability. A wide range of nanostructured metal oxide based (IrO2, Ni(OH)2, CuO, ZnO, etc.)) pH and glucose sensors were proposed [2-5]. In general they have good electrical conductivity, fast responses to changes in pH and can achieve equilibrium with the analyte solution without being dissolved. However, there are issues with these probes depending on the metal and the fabrication technique that are more sensitive to redox reagents and temperature which can be a problem for its long range applications. Furthermore, stability, repeatability and bio-fouling are the prominent issues in these pH electrodes, which are needed to be resolved. And they are non-stoichiometric, which means that consistent fabrication of electrodes may be problematic. Hence, the developments of multi-analyte sensor that can measure both pH and/or glucose with low cost material are being needed in particular for human sweat based sensor fabrication. Thereby, in this work we investigate a nanostructured Ni3(PO4)2·8H2O based non-enzymatic glucose/ pH sensor, which shows an exceptional sensitivity (24.39 mA mM–1cm–2) with a low detection limit of 97 nM (S/N = 3) towards glucose. As a pH sensor, the electrode based on nickel phosphate on nickel foam is capable of detecting human sweat pH ranging from 4 to 7 [6]. This nanoporous three dimensional transition metal phosphate shows excellent electrochemical performance and thus should provide a novel material design philosophy for bifunctional electrocatalysts for glucose and pH sensing. Acknowledgment The authors acknowledge financial support from Science Foundation Ireland under the Technology Innovation and Development Award no. 14/TIDA/2455. This work has received funding from the European Union’s Horizon 2020 research and innovation programme project SmartVista, under grant agreement No. 825114. Reference Jones L, Atkins P, Chemistry: Molecules, Matter, and Change. TPB, 2004.Huang, W.-D.; Cao, H.; Deb, S.; Chiao, M.; Chiao, J.-C. A, Flexible pH Sensor Based on the Iridium Oxide Sensing Film. Sens. Actuators, A 2011, 169, pp. 1−11.Natan, M. J.; Belanger, D.; Carpenter, M. K.; Wrighton, M. S. pH-Sensitive Nickel(II) Hydroxide-Based Microelectrochemical Tran-sistors. J. Phys. Chem. 1987, 91, pp. 1834−1842.Zaman, S.; Asif, M.; Zainelabdin, A.; Amin, G.; Nur, O.; Willander, M. CuO Nanoflowers as an Electrochemical pH Sensor and the Effect of pH on the Growth. J. Electroanal. Chem. 2011, 662, pp. 421−425.Zhang, Q.; Liu, W.; Sun, C.; Zhang, H.; Pang, W.; Zhang, D.; Duan, X. On-Chip Surface Modified Nanostructured ZnO as Functional pH Sensors. Nanotechnology 2015, 26(35), pp. 355202.Padmanathan, N.; Shao, H ; Razeeb, K. M., Multifunctional Nickel Phosphate Nano/Microflakes 3D Electrode for Electrochemical Energy Storage, Nonenzymatic Glucose, and Sweat pH Sensors. ACS Appl. Mater. Interfaces, 2018, 10 (10), pp. 8599–8610.

Endoscopic Endonasal Resection of Orbital Apex Cavernous Hemangioma: 2-Dimensional Operative Video.

A 52-yr-old woman was referred to a tertiary medical center for evaluation of 2 yr of progressive visual symptoms and 1 yr of retro-orbital pressure. Her ophthalmologic exam was unrevealing except for mild asymmetrical impairment in color perception. A gadolinium contrast-enhanced magnetic resonance image of the head showed a left extraconal orbital apex lesion consistent with cavernous hemangioma. Computed tomography reveled bony remodeling of the medial-inferior orbital walls with superior orbital fissure expansion. The lesion was endoscopically resected and confirmed by pathological analysis. The endoscopic approach is demonstrated in detail, including correlation with cadaveric anatomic specimens‡. During the approach, a rescue nasoseptal flap was raised in case the orbit required further support after tumor resection, but was replaced as this was not needed. This patient had a brief period of postoperative diplopia, which resolved 1 wk after surgery. Her subjective visual deficits and pressure have also resolved. Advantages of the endoscopic approach include improved direct visualization of the lesion, lack of external skin incisions, avoidance of significant neurovascular retraction, and shorter hospital stays than alternative orbitotomy or craniotomy approaches. This 4-handed approach demands endoscopic expertise of 2 surgeons, and is often performed by rhinology-neurosurgery or rhinology-ophthalmology surgical teams. The risk of postoperative diplopia should be discussed with the patient during informed consent. ‡ Anatomic specimen photography courtesy Dr Peris-Celda.

Clinicopathological analysis of 187 cases of external nose skin tumors

Objective:To explore the pathological types, distribution and characteristics of external nose skin tumors, in order to improve the diagnosis and treatment of such diseases, and provide reference for the clinical diagnosis and treatment of external nose skin tumors. Method: The gender, age of onset, lesion location, lesion size, pathological type, course of disease and related risk factors of all 187 cases with external nose skin tumors in our hospital from January 2008 to December 2017 were analyzed retrospectively. Result:The sex ratio of patients with external nasal skin benign tumors was 1.10：1.00, and that of patients with external nasal skin malignant tumors was 0.97：1.00. There was no significant difference in the composition of benign and malignant patients(χ²=0.169,P=0.681). The peak age of skin tumors of the external nose is over 60 years old, accounting for 71.1%(133/187). There was a significant difference in the ratio of benign to malignant tumors among different age groups(χ²=31.378,P<0.001). The ratio of malignant tumors increased with age(χ²trend=28.741, P<0.001). The most common benign external nasal skin tumors were alar nasi(28 cases, 22.2%), nasal root(25 cases,19.8%), dorsal nasal(23 cases, 18.3%), tip nasi(22 cases, 17.5%) and paranasal(18 cases,14.3%). Malignant external nasal skin tumors were alar nasi(18 cases,28.5%), dorsal nasal(15 cases,24.6%) and tip nasi(11 cases,18.0%). Epidermal cellderived basal cell carcinoma was the most common malignant tumor(44 cases,72.1%), followed by squamous cell carcinoma(11 cases,18.0%). Conclusion: External nasal skin malignancies have the characteristics of the elderly at the peak age of onset, skin basal cell carcinoma is the most common, for the incidence of basal cell carcinoma constitutes the largest, so that early detection, early diagnosis, early treatment.

Evaluation of the regenerative capacity of the tissues of the external auditory canal and tympanic membrane in patients with chronic otitis media

Relevance: It is noted that the condition of the skin, the external auditory canal bone, the eardrum residues, that is, the tissues, from which the graft must first receive nutrition, largely determine the myringoplasty result. Purpose: to assess the regenerative ability of the external auditory canal and tympanic membrane tissues in patients with chronic otitis media. Materials and Methods: The migration ability of the external auditory canal and tympanic membrane tissues study was carried out in 98 patients with acute tympanic membrane perforation using a tissue staining test. In patients with chronic otitis media the staining test was performed before the operation. The external auditory canal skin in the bone part and the tympanic membrane residues were taken in patients of all groups in myringoplasty for immunohistochemistry. The quantitative assessment of the biomolecular markers expression was performed by the digital image analyzing. It was obtained by a Leica DMLS microscope with software (Germany) and a JVC digital camera (the magnification of 200 times and a minimum number of view fields 5 in each microslide) using «positive pixel count» and morphometry software Aperio Image Scope. Results: It was noted that in cases where the perforation was not closed, the migration ability of the tissues was impaired. A correlation was established between the regenerative ability of the epithelium by determining tissue biomarkers and migration ability. A high EGF level indicates a good regenerative ability and a positive test with staining. A low EGF level is noted in a negative test with staining. The state of the migratory ability of the external auditory canal epithelium and the tympanic membrane epithelium may indirectly indicate the regenerative ability of tissues and affect the tympanoplasty result. The staining test can serve as a prognostic criterion for the myringoplasty result, because it evaluates the regenerative ability state of the external auditory canal epithelium and eardrum epithelium.