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Updated: May 16, 2025

Endoscopic Cholesteatoma Surgery
Published on: January 19, 2022
Evidence Showing Three Layers of Reconstructed Tympanic Membrane After Second Regenerative Treatment
Hiroshi Hidaka1, Tomofumi Sakagami, Yuri Noda2
1Department of Otolaryngology-Head and Neck Surgery, Kansai Medical University.
Objective:
To describe the case of a patient who twice underwent recently developed regenerative treatment for tympanic membrane perforation (RT-TMP), achieving successful regeneration of the TM consisting of three layers (epidermis, lamina propria, and mucosa) on pathological analyses of the regenerated part.
Study Design:
Clinical capsule report.
Patient:
A 48-year-old woman with right chronic otitis media, showing a large TMP covering 80% of the total TM.
Interventions:
After the initial RT-TMP, the patient had a residual posterior TMP affecting 25% of the TM. At the second procedure, a portion of the previously regenerated TM was harvested for pathological analysis.
Results:
Pathological analysis of the surgical specimen showed that the regenerated TM tissue coandnsisted of three parts: outer epidermal, intermediate, and mucosal layers.
Conclusion:
By applying a recently developed RT-TMP, this report describes the first human study confirming the regeneration of the TM consisting of three layers (epidermis, lamina propria, and mucosa) on pathological analyses of the regenerated part at the second RT-TMP. This is a major step toward the goal of TM regeneration that recapitulates the structural properties of the native TM.

