Direct application of basic fibroblast growth factor improves tympanic membrane perforation healing

Area of Science:

• Otolaryngology
• Regenerative Medicine
• Biomaterials Science

Background:

• Tympanic membrane (TM) perforations are common ear conditions.
• Effective healing strategies for TM perforations are crucial for restoring hearing.
• Basic fibroblast growth factor (b-FGF) shows potential in tissue regeneration.

Purpose of the Study:

• To investigate the efficacy of topical basic fibroblast growth factor (b-FGF) in promoting TM perforation healing.
• To evaluate the impact of scaffolding materials, specifically Gelfoam, on b-FGF-enhanced TM repair.

Main Methods:

• Guinea pigs with 1-mm or 2-mm TM perforations were treated with topical b-FGF or placebo.
• Treatment was applied directly to the perforation or via a Gelfoam pledget.
• Healing response and scar formation were assessed over time.

Main Results:

• Topical b-FGF significantly accelerated TM perforation healing when applied directly, without scaffolds.
• b-FGF induced a hyperplastic, linear subepidermal connective tissue reaction.
• Gelfoam scaffolds, with or without b-FGF, resulted in voluminous scar tissue protruding into the middle ear, involving ossicles, and showed no improvement over time.

Conclusions:

• Topical b-FGF can enhance TM perforation healing in the absence of scaffolding.
• Gelfoam is not recommended as a scaffold for TM repair due to adverse scarring effects.
• Further research into optimal scaffolding or scaffold-free approaches for TM regeneration is warranted.