Tympanic Membrane Perforation Research Articles

Correlation of Air-Bone Gap on Pure Tone Audiometry with the Size of Perforation Assessed on Oto-Endoscopy.

To determine the correlation between the air-bone gap on pure tone audiometry with size of perforation oto-endoscopically. Study Design: A descriptive study. Place and Duration of the Study: Department of ENT - Head and Neck Surgery, Dow University of Health Sciences (DUHS), from February 2020 to August 2021. Methodology: A total of 43 patients with dry central pars tensa tympanic membrane perforation were diagnosed through oto-endoscopy during the study. The mean air-bone gap was calculated by assessing each air-bone gap through pure tone audiometry at different frequencies i.e., 250 Hz, 500 Hz, 1,000 Hz, 2,000 Hz, and 4,000 Hz. Air-bone gap was found to be the average value of these frequencies. The photograph of the tympanic membrane was taken oto-endoscopically, and the ratio between size of the perforation to the entire area of the tympanic membrane was measured. During the course of the study, a total of 43 patients agreed to provide consent for this study. Out of the 43 patients, 16 (37.2%) were males and 27 (62.8%) were females. The age range was from 18 to 50 years with average age of 38.302 ± 5.74 years. The mean perforation size was 28.255 ± 9.16% while the mean air-bone gap was 28.000 ± 3.89 dB. It was concluded that the Pearson's correlation coefficient is directly correlated to perforation size and air-bone gap (r = 0.898, p <0.001). Further, hearing loss decreases with decreased middle ear volume and mastoid pneumatisation. Moreover, no change was seen in the mean air-bone gap according to the location of perforation. The hearing loss due to perforation of the tympanic membrane was correlated to the size of the perforation. Further, hearing loss decreases with reduced middle ear volume and mastoid pneumatisation. Size of perforation, Hearing loss, Air-bone gap, Oto-endoscopy, Conductive deafness, Mastoid pneumatisation.

Manufacturing Radially Aligned PCL Nanofibers Reinforced With Sulfated Levan and Evaluation of its Biological Activity for Healing Tympanic Membrane Perforations.

The main objective of this study is to construct radially aligned PCL nanofibers reinforced with levan polymer and investigate their in vitro biological activities thoroughly. First Halomonas levan (HL) polysaccharide is hydrolyzed (hHL) and subjected to sulfation to attain Sulfated hydrolyzed Halomonas levan (ShHL)-based material indicating heparin mimetic properties. Then, optimization studies are carried out to produce coaxially generated radially aligned Poly(caprolactone) (PCL) -ShHL nanofibers via electrospinning. The obtained nanofibers are characterized with Fourier Transform Infrared Spectroscopy (FTIR)and Field Emission Scanning Electron Microscopy with Energy Dispersive X-Ray (FESEM-EDX) analysis, and mechanical, contact angle measurement, biodegradability, and swelling tests as well. Afterward, cytotoxicity of artificial tympanic membranes is analyzed by MTT (3-(4,5-Dimethylthiazol-2-yl) -2,5 Diphenyltetrazolium Bromide) test, and their impacts on cell proliferation, cellular adhesion, wound healing processes are explored. Furthermore, an additional FESEM imaging is performed to manifest the interactions between fibroblasts and nanofibers. According to analytical measurements it is detected that PCL-ShHL nanofibers i) are smaller in fiber diameter, ii) are more biodegradable, iii) are more hydrophilic, and iv) demonstrated superior mechanical properties compared to PCL nanofibers. Moreover, it is also deciphered that PCL-ShHL nanofibers strongly elevated cellular adhesion, proliferation, and in vitro wound healing features compared to PCL nanofibers. According to obtained results it is assumed that newly synthetized levan and PCL mediated nanofibers are very encouraging for healing tympanic membrane perforations.

An elastic piezoelectric nanomembrane with double noise reduction for high-quality bandpass acoustics

Polymer piezoelectrics with high electromechanical energy conversion (HEEC) are very promising for flexible acoustoelectric devices. However, reducing thickness and improving ordered polarization and ferroelectricity while maintaining high mechanical strength pose enormous fabrication challenges for polymer piezoelectric membranes—additionally, noise management in the acoustoelectric conversion remains an open issue. Here, we present a hydro-levitation superspreading approach for fabricating polymer nanomembranes with ordered crystalline phases and sub-nanostructures on the water surface. The elastic piezoelectric nanomembrane (EPN) is only 335 nanometers thick and consists of a conductance-stable piezoelectric layer sandwiched between two elastic damping layers. Such an all-in-one EPN can reduce background noise with low autocorrelation in the environment, suppress spurious noise caused by poor circuit contact, and achieve bandpass filtering of acoustic signals at human voice frequencies. This nanomembrane holds promise in repairing the auditory system of patients with tympanic membrane perforation and in a wide range of other acoustoelectric conversion fields.

Conventional one-handed compared to two-handed endoscopic ear surgery using an endoscope holder: a single center study.

One-handedness is a challenge in conventional endoscopic ear surgery (EES). We present results on the first-ever application of the passive endoscope holder 'Endofix exo' (Co. AKTORmed GmbH, Neutraubling, Germany) in EES, which enables two-handed surgery. This two-sided study compares cut-suture time, operating time, postoperative complications, graft take rates, hearing results and quality of life in patients who underwent first stage tympanoplasty due to tympanic membrane perforation with intact ossicular chain conditions. 25 patients received classic EES (EES-, mean age: 28 ± 21 years) and 15 received EES with the passive holder (EES+, mean age: 48 ± 21 years). Mean operating times (EES-: 96 ± 38 (SD) min; EES+: 107 ± 33min), cut-suture times (EES-: 68 ± 30min; EES+: 73 ± 31min), complications, graft take rates and hearing results (preoperative air bone gap (ABG) (PTA4): 15 dB ± SD 8 dB (EES-); 16 dB ± SD 8 dB (EES+); postoperative ABG (PTA4): 11.25dB ± SD 11.3dB (EES-); 14 dB ± SD 10 dB (EES+)) did not differ significantly (p > 0.05) between the two groups. Postoperative hearing results and quality of life tended to improve in both groups (p > 0.05). The passive endoscope holder has been successfully applied during the course of the study. However, modifications of the endoscope holder and further studies are recommended focusing on positioning of grafts and prostheses to obtain conclusive results regarding the superiority of two-handed EES over one-handed conventional EES.

The disease burden of untreated chronic otitis media in Indigenous children from remote communities does not improve over time. A longitudinal study.

In Australia, middle ear disease disproportionately affects Indigenous children, leading to poor hearing outcomes. This study aimed to determine the natural history of untreated chronic otitis media in Indigenous children in remote South Australia. Baseline and 3 year follow-up data was collected from Indigenous children aged 5-18 years living on the Anangu Pitjantjatjara Yankunytjatjara Lands. 4-frequency pure-tone audiometry was used to determine hearing levels. Middle ear pathology was determined by video-otoscopy with tympanometry and classified at baseline as group 1 (normal), group 2 (abnormal with intact tympanic membrane), or group 3 (perforated tympanic membrane). A total of 253 children were included in this study. Children in group 1 (20.6 ± 1.5 dBHL; Mean ± SD) had significantly better hearing outcomes at 3 year follow-up than children with abnormal ears (groups 2 and 3) (23.8 ± 7.0 dBHL), P < 0.001. The difference was greatest for group 1 versus 3 (27.6 ± 8.4 dBHL), P < 0.001, followed by 1 versus 2 (22.4 ± 5.8 dBHL), P = 0.009, and between 2 (22.4 ± 5.8 dBHL) and 3 (27.6 ± 8.4 dBHL), P < 0.001. Hearing in Indigenous children with untreated middle ear pathology remains poor at follow-up compared to those without pathology. Intervention is therefore critical to prevent persisting poor hearing outcomes.

Aspergillus otitis externa: A retrospective study of predisposing factors, treatment, and complications.

To study the predisposing factors, treatment, and complications of Aspergillus otitis externa. A retrospective analysis of patients diagnosed with Aspergillus otitis externa at the Department of Otorhinolaryngology, Helsinki University Hospital, between January 2010 and December 2018 was performed. Of the 269 Aspergillus otitis externa (OE) patients, 96 developed otitis media (OM) and 7 developed mastoiditis. Antibiotic and steroid treatment and otological history were risk factors for Aspergillus OE. Systemic diseases and immunocompromising states were more common in mastoiditis patients. Repetitive ear cleaning and topical drugs are primary treatments, but systemic drugs and surgery were needed in resistant and invasive cases. Forty-five novel tympanic membrane (TM) perforations were reported. A strong association between Aspergillus species and final infection types was found; A. niger was the dominant species in OM and in novel TM perforations, whereas A. flavus and A. fumigatus caused mastoiditis. Some of the TM perforations persisted despite treatment. Permanent hearing impairment was associated with OM and mastoiditis. As Aspergillus OE has the potential to cause acute and chronic complications, fungal OE should be suspected early on if the infection persists after conventional treatment. The identification of Aspergillus species could aid in spotting patients at risk for more severe disease and complications. Intensive local treatment is sufficient in most cases of OE and OM but effective topical antifungals are limited. Patients with Aspergillus OM and mastoiditis should be followed up for hearing impairment and permanent TM perforations after the infection resolves. Level 4 (The Oxford 2011 Levels of Evidence).

Tympanic Membrane Regeneration Therapy for Pediatric Tympanic Membrane Perforation.

To evaluate tympanic membrane regeneration therapy (TMRT) for pediatric tympanic membrane perforations (TMPs). Intervention study. Research institute hospital. In this study, 20 patients with chronic TMP (M/F: 13/7, 13/8 ears, age 0-15 years) treated with TMRT were evaluated. As comparison, 20 pediatric patients with chronic TMP who underwent myringoplasty/tympanoplasty were included. For the TM repair procedure, the edge of the TMP was disrupted mechanically, and gelatin sponge immersed in basic fibroblast growth factor was placed inside and outside the tympanic cavity and covered with fibrin glue. The TMP was examined 4 ± 1 weeks later. The protocol was repeated up to four times until closure was complete. Closure of the TMP and hearing improvement were evaluated at 16 weeks after the final regenerative procedure. Adverse events were monitored. The mean follow-up period was 427.1 days. The TM regenerated in all cases, but pinhole reperforation occurred in two cases, and the final closure rate was 90.5% (19 of 21). Hearing improved to 24.9 ± 7.6 dB on average before surgery and to 13.8 ± 5.4 dB after surgery. The AB gap improved from 12.9 ± 8.0 to 5.2 ± 3.5 dB.The myringoplasty/tympanoplasty group had significantly lower AB gap improvement compared with the TMRT group. There were no adverse events. TMRT can be expected to regenerate near-normal TMs with a high closure ratio, resulting in better-hearing improvement compared with the myringoplasty/tympanoplasty group, and is an effective treatment for children with long life expectancy.

Exploring the burden of paediatric acute otitis media with discharge in the UK: a qualitative study

BackgroundAcute otitis media with discharge (AOMd) results from a tympanic membrane perforation secondary to a middle ear infection. Currently, the impact of AOMd on children and young people (CYP) and...

A comparison of surgical outcomes of endoscopic versus microscopic myringoplasty

BackgroundThere is a gradual transition from open to minimal access surgeries in Otorhinolaryngology. Myringoplasty can be done with either microscope or endoscope. Use of both the techniques has been reported in literature. However, there is no clear consensus over which is better than the other. The current study was done with the aim of comparing the hearing outcomes post myringoplasty by endoscopic versus microscopic technique. MethodsHundred patients of chronic otitis media mucosal inactive were recruited and divided into two groups, A and B. The patients in group A underwent endoscopic myringoplasty while those in group B underwent conventional microscopic myringoplasty. All patients underwent pure tone audiometry (PTA) and oto-endoscopy prior to and six months post-surgery. The study outcomes in the form of air-bone (AB) gap on PTA, successful closure of tympanic membrane perforation, pain scores, duration of hospital stay and occurrence of complications were compared. ResultsThe post-operative AB gap on PTA and pain score was lesser in the endoscopic technique as compared to microscopic technique. The reduction in AB gap post-surgery, duration of hospital stay, proportion of patients with closure of AB gap to ≤10 dB, successful closure of tympanic membrane perforation, and taste alteration were similar in both groups. ConclusionEndoscopic technique for myringoplasty can be recommended in view of similar or slightly better surgical and functional outcomes, wider field of view and better visualisation of middle ear by the endoscopes.

Outcomes of Microscopic vs. Endoscopic Tympanoplasty at a Tertiary Healthcare Institution in Western Maharashtra.

Introduction Chronic suppurative otitis media (CSOM) involves tympanic membrane perforation and is traditionally treated with microscopic tympanoplasty. Recent advancements in endoscopic techniques offer enhanced visibility and outcomes. This retrospective study compares endoscopic and microscopic tympanoplasty outcomes in CSOM patients between 2023 and 2024. Aim This study aims to evaluate outcomes of endoscopic vs. microscopic tympanoplasty in patients suffering from CSOM who are presenting at our tertiary care center. Methodology A retrospective study of 100 patients of CSOM undergoing tympanoplasty. Sixty patients underwent microscopic tympanoplasty and 40 endoscopic tympanoplasty. Postoperative successful uptake of graft and resultant hearing were compared between the two groups. Results Ninety-seven out of 100 patients had a successful graft uptake at three months. Fifty-eight patients in the microscopic tympanoplasty group (96.67%) and 39 in the endoscopic group (97.5%) had healed the tympanic membrane at three months of follow-up (p = 0.864). At postoperative three months, no statistically significant difference was found in the improvements in air conduction levels of the two groups (p = 0.995). No significant difference in the air-bone gap between the two groups (p = 0.095). The average air-bone gap at three months postoperative was 7.95 ± 4.20 decibel (dB) in the microscopic tympanoplasty group and 7.80 ± 4.10 dB in the endoscopic tympanoplasty group (p = 0.680). The incidence of postoperative wound area pain, numbness, and ear discharge was significantly higher in patients undergoing microscopic tympanoplasty (p < 0.05). Conclusion The two methods did not significantly differ in terms of the outcome of the hearing test or the rate of graft uptake. However, a better result was noted in endoscopic tympanoplasty compared to the microscopic tympanoplasty group. Postoperative complications encountered were less in the endoscopic tympanoplasty group.

Myringoplasty: A comparison of inlay and underlay techniques

PurposeMyringoplasty aims to improve hearing and prevent otorrhea, making graft uptake rates and hearing crucial considerations. This study analyzed the factors associated with unsuccessful graft uptake and hearing improvement to guide the selection of optimal surgical approaches for myringoplasty. MethodsWe retrospectively reviewed 56 ears with chronic otitis media. All patients were followed up for >6 months after tympanic membrane closure surgery. We compared the underlay method using the transcanal approach with the inlay method using the retroauricular approach for myringoplasty in patients with chronic otitis media. The underlay and inlay methods were used for 23 and 33 ears, respectively. The primary outcomes were graft uptake rate and hearing improvement. Additionally, factors such as the location of tympanic membrane perforation, patient age, and the degree of mastoid development were evaluated. ResultsThe perforation rate was high when the transcanal underlay method was employed to repair perforations in the anterior inferior quadrant. Both the underlay and inlay methods significantly improved hearing. However, the success rate of the inlay method was lower. Within the cases performed using the inlay method, outcomes tended to be poorer in older age groups. There were no significant differences in surgical success rates related to mastoid development. ConclusionThe inlay method using the retroauricular approach is a favorable option for repairing perforations involving the anterior inferior quadrant. However, older patients presented lower rates of hearing improvement when the inlay method was used.

Endoscopic Push-Through Technique Myringoplasty in Tympanic Membrane Perforations; An Institutional Experience in Kathmandu, Nepal

Background Push-through technique cartilage perichondrium composite graft myringoplasty involves placing the graft beneath the freshened perforation by endoscopic approach without elevating tympanomeatal flap. The aim of this study is to assess the graft uptake and hearing after push-through myringoplasty at our institution. MethodsThis prospective study was conducted in Otorhinolarynology Department of Nepal Medical College Teaching Hospital from November 2022 to October 2023 after obtaining ethical clearance from Research and Ethical Sub Committee (RESC). All patients aged 20 years and above with inactive type of chronic otitis media mucosal disease with conductive hearing loss underwent myringoplasty by push-through technique using cartilage perichondrium composite graft. Pure tone audiograms of the patients were done before and after surgery. Graft uptake and hearing results were evaluated at 12 weeks using SPSS. Paired t test was used to assess hearing improvement.ResultsThe success rate among the participants who underwent endoscopic push through myringoplasty regarding graft uptake was 84.8% (78 of 92). The mean preoperative bone conduction threshold was 13.6±4.1 dB as compared to 13.1±4.0 dB postoperatively. Similarly, the mean preoperative air conduction threshold was 45.2±7.3 dB, with the postoperative value being 30.9±7.6 dB. The mean preoperative air-bone gap was 30.6±7.5 dB, while the air-bone gap postoperatively was 17.8±6.7 dB. Paired t-test comparing the means of the preoperative to postoperative air-bone gap showed a significant difference post-surgery with a p value of less than 0.001. Conclusions Push through technique myringoplasty can be used to repair perforations with good results in terms of graft uptake and improved hearing.

Developing Approaches to Optimise Reparative Histogenesis of the Tympanic Membrane Tissues: History, the State-of-Art and Perspectives of Reparative Otosurgery

The paper describes the issues to optimize reparative histogenesis of the tympanic membrane tissues (history, state-of-the art and perspectives) based on data from national and foreign scientific literature. One of the causes of hearing loss is the violated integrity of the tympanic membrane, resulting from its injury or the developing inflammatory processes in the middle ear. It has been established that small perforations of the tympanic membrane can spontaneously close in the reparative stage of acute purulent otitis media or when the exacerbation of chronic purulent otitis media subsides. Restoration of large perforations of the tympanic cavity requires surgical intervention. Since 17th century, plastic surgery options for the tympanic membrane perforations with various biological and non-biological materials have been developing. However, until the beginning of the XX century, the approaches used did not lead to complete histio- and organotypic restoration of the tympanic membrane, but only ensured closure of the defect. At the present stage, otosurgeons use various plastic materials to restore the integrity of the eardrum: autografts; allografts; implants made of non-biological material. Nylon mesh, cotton-adhesive discs, and knotless knitted fabric made of polyamide fiber are applied as implants. Biological transplants applied include the skin of the inner surface of the shoulder and the occipital-temporal region, the wall of the vein, the fascia of the temporal muscle, the dura mater, the perichondrium, nanostructured bioplastic material created on the basis of hyaluronic acid hydrocolloid and a peptide complex, etc. The use of these modern options in most cases leads to organotypic and, in some cases, histiotypic restoration of the eardrum structure, ensuring complete epithelialization of its outer and inner surfaces. However, there are a number of unresolved issues regarding the diverse materials application for plastic surgery, as well as the timing of reconstructive surgeries on the middle ear.

Endoscopic Tympanoplasty in Chronic Otitis Media with Inactive Mucosal Disease

&amp;lt;i&amp;gt;Background:&amp;lt;/i&amp;gt; Chronic otitis media (COM) is a condition usually seen in patients attending the ENT department. Chronic inactive mucosal disease (CIMD) is characterized by tympanic membrane (TM) perforation with hearing loss. Endoscopic tympanoplasty (ET) is a surgical method to repair TM perforation with minimal invasion. &amp;lt;i&amp;gt;Objective:&amp;lt;/i&amp;gt; The present analysis was done to find out the outcome of ET surgeries in CIMD. &amp;lt;i&amp;gt;Methods:&amp;lt;/i&amp;gt; Retrospective data analysis was done in 30 patients underwent ET with endoscopic under-lay technique at Al-Ameen medical college, Vijapur, India. &amp;lt;i&amp;gt;Results:&amp;lt;/i&amp;gt; Average age of patients was 34.17±9.52 years. Majority (40%) patients were from 18-30 years of age group. There were 12 (40%) males and 18 (60%) females. Right-side and left-side CIMD was equally distributed in 30 patients. Sixteen (53.3%) and 14 (46.7%) patients were having right and left TM perforation, respectively. TM perforation size was small, medium and large in 43.3%, 30% and 26.7% of patients, respectively. Twenty-eight (93.3%) patients had temporalis fascia and 2 (6.7%) patients had tragal cartilage as graft material. Two (6.7%) patients had graft rejection without improvement in hearing. No patient had complication or any miscellaneous issues. Eighteen (60.0%), 11 (36.7%) and 1 (3.3%) pre-operative patient with pure-tone average (PTA) had mild, moderate, and severe conductive hearing loss (CHL), respectively. All patients with PTA were improved after surgery. &amp;lt;i&amp;gt;Conclusion: &amp;lt;/i&amp;gt;ET is an effective, minimally invasive, and less painful surgical technique for repair of central TM perforations in CIMD.

Comparison of porcine small intestinal submucosa and autologous graft material for repairing tympanic membrane perforation: a systematic review and meta-analysis.

To perform a systematic review and meta-analysis exploring the effectiveness of porcine small intestinal submucosa(pSIS) compared with autologous grafts for tympanic membrane perforation repair. A prospective meta-analysis protocol was registered on PROSPERO (International Prospective Register of Systematic Reviews) on June 5th, 2024, under protocol CRD42024551979. PubMed, Embase/Ovid and Cochrane Central databases were searched from inception to 28/05/2024 for studies comparing the use of pSIS versus autologous grafts (perichondrium, cartilage, temporalis fascia or cartilage-perichondrium) for tympanic membrane perforation repair. The outcomes evaluated were persistent perforation after surgery, operative time and hearing outcome. Statistical analyses were performed using the online Review Manager (Cochrane Collaboration). A subgroup analyses were carried out for the paediatric population. We included 1,407 patients (1447 ears) from seven records; six retrospective cohort studies and one randomised controlled trial (RCT). pSIS graft was used in 563 ear surgeries (38.1%). Four studies included children with a mean age ranging from 7.3 to 11.7 years and the other 3 studies included adults with a mean age ranging from 30.8 to 48.4 years. Follow-up ranged from 2 to 132 months. There was no statistically significant difference in the failure rate (persistent perforation) between pSIS graft and autologous graft (RR 0.95; 95% CI 0.67-1.33; p = 0.76). However, reduced operative time was associated with using pSIS grafts (MD -16.12min; 95% CI -22.94-9.31; p = < 0.00001). Tympanic membrane perforation repair with pSIS grafts had a similar failure rate and hearing outcome compared to autologous grafts and demonstrated an association with reduced operative time.

Comprehensive management of chronic ear disease: Consecutive patient analysis at a tertiary children's hospital

ObjectiveTo characterize medical complexity and advanced interventions necessary to treat pediatric patients with chronic ear disease. MethodsA retrospective case review of children who received surgery for chronic otitis media, cholesteatoma, or tympanic membrane perforation at a tertiary children's hospital from 2020 to 2024 was performed. The frequency and type of medical complexities as well as distribution and success of advanced otologic interventions were recorded. ResultsOperations were performed on 80 ears. Forty-five percent were in medically complex patients. Twenty-five percent had a syndrome, 13 % had American Society for Anesthesiologists Severity Class 3 or more, and 38 % attended multi-disciplinary programs. Advanced audiology testing protocols were utilized in 53 % of patients, and multiple children received complex sleep and airway operations. Advanced surgical techniques were required in 58 %. Post-operatively, an intact tympanic membrane was achieved in 95 % of operated ears (p < 0.01). Residual and recurrent cholesteatoma were each present in 5 % of cases, with mean follow-up of 11.6 months. Otorrhea reduced from 64 % of patients pre-operatively to 2 % post-operatively (p < 0.01), including cessation in all individuals who reported social/bullying issues related to ear drainage/odor. Unrestricted water exposure was achieved in 99 % of individuals (p < 0.01). Patients showed a mean improvement after surgery of 7.6 dB, as measured by the change in air-bone gap (p < 0.05). Conclusions: Comprehensive treatment of otologic conditions included care that was holistic of all medical needs, integrated with other services, developmentally appropriate, encompassing of non-otologic procedures, technically advanced, effective, and functionally-focused. Surgical teams should endeavor together to provide this combination of services.

Latent stem cell-stimulating radially aligned electrospun nanofibrous patches for chronic tympanic membrane perforation therapy

Chronic tympanic membrane (TM) perforation is a tubotympanic disease caused by either traumatic injury or inflammation. A recent study demonstrated significant progress in promoting the regeneration of chronic TM perforations through the application of nanofibers with radially aligned nanostructures and controlled release of growth factors. However, radially aligned nanostructures with stem cell-stimulating factors have never been used. In this study, insulin-like growth factor binding factor 2 (IGFBP2)-incorporated radially aligned nanofibrous patches (IRA-NFPs) were developed and applied to regenerate chronic TM perforations. The IRA-NFPs were prepared by electrospinning 8 wt% polycaprolactone in trifluoroethanol and acetic acid (9:1). Random nanofibers (RFs) and aligned nanofibers (AFs) were successfully fabricated using a flat plate and a custom-designed circular collector, respectively. The presence of IGFBP2 was confirmed via Fourier transform infrared spectroscopy and the release of IGFBP2 was sustained for up to 20 days. In vitro studies revealed enhanced cellular proliferation and migration on AFs compared to RFs, and the incorporation of IGFBP2 further promoted these effects. Quantitative real-time PCR revealed mRNA downregulation, correlating with accelerated migration and increased cell confluency. In vivo studies showed IGFBP2-loaded RF and AF patches increased regeneration success rates by 1.59-fold and 2.23-fold, respectively, while also reducing healing time by 2.5-fold compared to the control. Furthermore, IGFBP2-incorporated AFs demonstrated superior efficacy in healing larger perforations with enhanced histological similarity to native TMs. This study, combining stem cell stimulating factors and aligned nanostructures, proposes a novel approach potentially replacing conventional surgical methods for chronic TM perforation regeneration. Statement of significanceChronic otitis media (COM) affects approximately 200 million people worldwide due to inflammation, inadequate blood supply, and lack of growth factors. Current surgical treatments have limitations like high costs and anesthetic risks. Recent research explored the use of nanofibers with radially aligned nanostructures and controlled release of growth factors to treat chronic tympanic membrane (TM) perforations. In this study, insulin-like growth factor binding protein 2 (IGFBP2)-incorporated radially aligned nanofibrous patches (IRA-NFPs) were developed and applied to regenerate chronic TM perforations. We assessed their properties and efficacy through in vitro and in vivo studies. IRA-NFPs showed promising healing capabilities with chronic TM perforation models. This innovative approach has the potential to improve COM management, reduce surgery costs, and enhance patient safety.

Observation Versus Gel-Foam Grafting of Acute Traumatic Tympanic Membrane Perforation: Which Is Better?

Observation Versus Gel-Foam Grafting of Acute Traumatic Tympanic Membrane Perforation: Which Is Better?

A Simple Egg Membrane Patch Bridging Method for Repairing Tympanic Membrane Perforation

Objective: To analyze the clinical effect of a simple egg membrane patch bridging method in repairing tympanic membrane perforation. Methods: A total of 93 tympanic membrane perforation patients admitted to the hospital between September 2022 and October 2023 were selected and divided into two groups according to the random number table method. The control group implemented the conventional treatment (n = 46 cases), and the patch group adopted the simple egg membrane patch bridging method (n = 47 cases). The healing rate of the tympanic membrane, the air-bone gap, the air conduction hearing threshold, the dry ear rate, and the incidence of complications in both groups were compared before and after treatment. Results: The healing rate of the tympanic membrane in the patch group was significantly higher than that of the control group (95.75% vs. 76.09%), with P &lt; 0.05; there was no difference in the air-bone gap and air conduction hearing threshold levels between the two groups before treatment (P &gt; 0.05), and the hearing indexes of the patch group were significantly lower than those of the control group 3 months after treatment (P &lt; 0.05); the dry ear rate in the patch group was significantly higher than that of the control group after treatment (85.11% vs. 67.39%), and the total incidence of complications was also significantly lower than that of the control group (6.38% vs. 21.74%), with P &lt; 0.05. Conclusion: The simple egg membrane patch bridging method is effective in repairing tympanic membrane perforation, which can effectively improve patients’ hearing levels and reduce the occurrence of post-treatment complications. Thus, it is worth popularizing and applying in the clinic.

WIDEBAND ABSORBANCE PATTERNS IN ADULTS WITH CENTRAL AND MARGINAL TYMPANIC MEMBRANE PERFORATION

IntroductionThis study aimed to investigate the impact of central and marginal tympanic membrane perforations (TMP) on wideband absorbance (WBA) and compare it with normal ears.Material and methodsThree groups of individuals, aged 18 to 50 years: Group I with central TMP (&lt;i&gt;n&lt;/i&gt; = 65), Group II with marginal TMP (&lt;i&gt;n&lt;/i&gt; = 13), and Group III with normal middle ears (&lt;i&gt;n&lt;/i&gt; = 20) were considered. WBA measurements were performed at peak and ambient pressure conditions across frequencies.ResultsSignificant differences in WBA were observed between the groups with central and marginal TMP and the normal ear group across all frequencies. Central TMP exhibited decreased absorbance at low frequencies and increased absorbance at high frequencies, peaking at 5000 Hz. Marginal TMP showed peaks at 600, 4000, and 6000 Hz with decreased absorbance at 2000 Hz. Central TMP exhibited lower absorbance than marginal TMP at lower frequencies, while marginal TMP showed decreased absorbance at mid and high frequencies.ConclusionsThese findings highlight the role of WBA in differentiating normal ears from those with TMP. Understanding TM vibration patterns and frequency-dependent variations in absorbance enhances diagnostic accuracy and clinical management.