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A pilot study investigating basic fibroblast growth factor for the repair of chronic tympanic membrane perforations
Aanand N Acharya1, Harvey Coates2, Dayse Tavora-Vièira1
1Fremantle Hospital & Health Service, Department of Otolaryngology, Alma Street, Fremantle, 6160, Western Australia, Australia.
Insights
Basic Fibroblast Growth Factor (bFGF) shows promise for closing pediatric tympanic membrane perforations (TMPs). This minimally invasive technique achieved high closure rates and improved hearing with no adverse events.
Area of Science:
- Otolaryngology
- Regenerative Medicine
- Pediatric Surgery
Background:
- Tympanic membrane perforations (TMPs) are common in children.
- Conventional surgical repair (myringoplasty) can be invasive.
- Exploring novel, minimally invasive therapeutic options is crucial.
Purpose of the Study:
- To evaluate the efficacy of basic Fibroblast Growth Factor (bFGF) in closing pediatric TMPs.
- To assess the safety and impact on hearing of the bFGF technique.
Main Methods:
- Prospective pilot cohort study.
- Modified bFGF application technique.
- Serial otoscopy and audiometry for outcome assessment.
Main Results:
- Successful TMP closure in 58% on first attempt, 83% overall.
- Hearing improvement in 80% of successfully treated cases.
- No complications or adverse outcomes reported.
Conclusions:
- Topical bFGF is a promising, minimally invasive alternative to myringoplasty for pediatric TMPs.
- Offers comparable success rates with potentially reduced morbidity and cost.
- Not suitable for patients with active ear infection or inflammation.
Objective:
A pilot study to investigate the utility of basic Fibroblast Growth Factor (bFGF) in tympanic membrane perforation (TMP) closure in a small cohort of pediatric patients.
Methods:
Prospective cohort study. Suitability for inclusion in the study was confirmed by the application of defined inclusion and exclusion criteria, and informed parental consent obtained. The technique used was a modification of the bFGF-technique by Kanemaru et al. Response to treatment was monitored with serial otoscopy and audiometric outcomes were determined. Statistical analysis of the outcomes was carried out.
Results:
TMPs were successfully closed in 7/12 children at the first attempt (58%) and in 10/12 children overall (83%). Hearing improvement was observed in 8/10 successfully treated cases (80%). There were no complications or adverse outcomes.
Conclusions:
The topical bFGF regeneration technique offers a promising, minimally invasive alternative to conventional myringoplasty in pediatric patients with comparable success and reduced morbidity and cost, especially considering the option of performing repeat applications. Patients with an active infection or inflammation are not suitable for the bFGF-mediated technique.
