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Hara S, Liu X, Shah FA, Saeki H, Orita H, Sakyo A, Anzai T, Takata Y, Kamiya K, Matsumoto F, Gabrielson K. Assessing the Efficacy of Tragal Pumping in a Novel Tympanostomy Tube-Rat Model. OTO Open 2024; 8:e160. [PMID: 38974179 PMCID: PMC11227604 DOI: 10.1002/oto2.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/29/2024] [Accepted: 06/08/2024] [Indexed: 07/09/2024] Open
Abstract
Objective Tragal pumping (TP) is a practice of pushing on the tragus to raise pressure within the external auditory canal and is a commonly recommended adjunctive maneuver believed to facilitate the introduction of ototopical medications into the middle ear cavity via a tympanostomy tube. To investigate the efficacy of TP in the penetration of eardrops into the middle ear cavity via tympanostomy tube, we established the novel tympanostomy tube-rat model. We investigated the histology of the middle ear to determine the efficacy in moving fluid into the middle ear. Study Design Prospective controlled animal study. Setting Animal laboratory in a university hospital. Methods Ten rats were recruited, and a tympanostomy tube insertion and green dye eardrops into outer ears were performed on bilateral ears. TP was performed only on 1 ear and was not applied on the other ear in each rat. Green dye in a middle ear cavity in hematoxylin and eosin-stained temporal bone sections was evaluated by blinded experts in microscopic anatomy (staining grade) and by using Image J software (staining level). The results of these 2 methods were statistically validated. Results The staining grade (P < .001) and the staining level (P < .001) were significantly higher in the ears which we applied TP than in the control ears. The results of 2 methods were significantly and positively correlated (r = .898, P < .001). Conclusion Our results showed that the TP accelerate the penetration of eardrops into the middle ear cavity in the tympanostomy tube-rat model.
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Affiliation(s)
- Satoshi Hara
- Department of Molecular and Comparative PathobiologyJohns Hopkins University School of MedicineBaltimoreMarylandUSA
- Department of OtorhinolaryngologyJuntendo University Faculty of MedicineTokyoJapan
- International Collaborative Research AdministrationJuntendo UniversityTokyoJapan
| | - Xinyu Liu
- Department of Molecular and Comparative PathobiologyJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Firasat Ali Shah
- Department of Molecular and Comparative PathobiologyJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Harumi Saeki
- Department of Human PathologyJuntendo University Faculty of MedicineTokyoJapan
| | - Hajime Orita
- International Collaborative Research AdministrationJuntendo UniversityTokyoJapan
- Department of Gastroenterology and Minimally Invasive SurgeryJuntendo University Faculty of MedicineTokyoJapan
| | - Airi Sakyo
- Department of OtorhinolaryngologyJuntendo University Faculty of MedicineTokyoJapan
- Department of Otorhinolaryngology, Graduate School of MedicineJuntendo UniversityTokyoJapan
| | - Takashi Anzai
- Department of OtorhinolaryngologyJuntendo University Faculty of MedicineTokyoJapan
| | - Yusuke Takata
- Department of OtorhinolaryngologyJuntendo University Faculty of MedicineTokyoJapan
| | - Kazusaku Kamiya
- Department of OtorhinolaryngologyJuntendo University Faculty of MedicineTokyoJapan
| | - Fumihiko Matsumoto
- Department of OtorhinolaryngologyJuntendo University Faculty of MedicineTokyoJapan
| | - Kathleen Gabrielson
- Department of Molecular and Comparative PathobiologyJohns Hopkins University School of MedicineBaltimoreMarylandUSA
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Bularda D, Șerban R, Butnaru C, Mareș M, Burtan LC, Rădulescu L, Mârțu C. Searching for a Better Animal Model for Chronic Tympanic Membrane Perforation. J Pers Med 2024; 14:513. [PMID: 38793095 PMCID: PMC11121853 DOI: 10.3390/jpm14050513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 05/01/2024] [Accepted: 05/06/2024] [Indexed: 05/26/2024] Open
Abstract
Chronic tympanic membrane perforation represents a prevalent otological condition, necessitating a reliable animal model for the validation and safety assessment of surgical techniques and materials employed in myringoplasty. This prospective study involved the establishment of chronic tympanic membrane perforation animal models in 16 chinchillas. A thermic myringotomy was conducted on the right ear (study group), followed by cold instrument myringotomy, coupled with the topical application of mitomycin C and dexamethasone solution on the left ear (control group). Results revealed that tympanic membrane perforations in the study group persisted for a minimum of 4 weeks in 93.7% of cases and extended to 12 weeks in 62.5% of the cases. In contrast, all tympanic membrane perforations in the control group were present at 4 weeks, with only 37.5% persisting after 12 weeks, although statistical tests did not find significant differences between the two groups (chi-square: p-value = 0.157, Kruskal-Wallis: p-value = 0.093, Mann-Whitney: p-value = 0.121). The thermic myringotomy employed to induce chronic tympanic membrane perforation in animals demonstrated efficiency and sustainability. This model, characterized by stability and reproducibility, holds promise for future experimental applications in the field.
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Affiliation(s)
- Dragoș Bularda
- Department of Otorhinolaryngology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania (C.B.)
| | - Roxana Șerban
- Department of Biochemistry, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Corina Butnaru
- Department of Otorhinolaryngology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania (C.B.)
| | - Mihai Mareș
- Laboratory of Antimicrobial Chemotherapy, Iasi University of Life Sciences “Ion Ionescu de la Brad” (IULS), 700490 Iași, Romania;
| | - Liviu Catalin Burtan
- Clinical Department, Iasi University of Life Sciences “Ion Ionescu de la Brad” (IULS), 700490 Iași, Romania
| | - Luminița Rădulescu
- Department of Otorhinolaryngology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania (C.B.)
| | - Cristian Mârțu
- Department of Otorhinolaryngology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania (C.B.)
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Pasdelou MP, Byelyayeva L, Malmström S, Pucheu S, Peytavy M, Laullier H, Hodges DB, Tzafriri AR, Naert G. Ototoxicity: a high risk to auditory function that needs to be monitored in drug development. Front Mol Neurosci 2024; 17:1379743. [PMID: 38756707 PMCID: PMC11096496 DOI: 10.3389/fnmol.2024.1379743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 04/15/2024] [Indexed: 05/18/2024] Open
Abstract
Hearing loss constitutes a major global health concern impacting approximately 1.5 billion people worldwide. Its incidence is undergoing a substantial surge with some projecting that by 2050, a quarter of the global population will experience varying degrees of hearing deficiency. Environmental factors such as aging, exposure to loud noise, and the intake of ototoxic medications are implicated in the onset of acquired hearing loss. Ototoxicity resulting in inner ear damage is a leading cause of acquired hearing loss worldwide. This could be minimized or avoided by early testing of hearing functions in the preclinical phase of drug development. While the assessment of ototoxicity is well defined for drug candidates in the hearing field - required for drugs that are administered by the otic route and expected to reach the middle or inner ear during clinical use - ototoxicity testing is not required for all other therapeutic areas. Unfortunately, this has resulted in more than 200 ototoxic marketed medications. The aim of this publication is to raise awareness of drug-induced ototoxicity and to formulate some recommendations based on available guidelines and own experience. Ototoxicity testing programs should be adapted to the type of therapy, its indication (targeting the ear or part of other medications classes being potentially ototoxic), and the number of assets to test. For multiple molecules and/or multiple doses, screening options are available: in vitro (otic cell assays), ex vivo (cochlear explant), and in vivo (in zebrafish). In assessing the ototoxicity of a candidate drug, it is good practice to compare its ototoxicity to that of a well-known control drug of a similar class. Screening assays provide a streamlined and rapid method to know whether a drug is generally safe for inner ear structures. Mammalian animal models provide a more detailed characterization of drug ototoxicity, with a possibility to localize and quantify the damage using functional, behavioral, and morphological read-outs. Complementary histological measures are routinely conducted notably to quantify hair cells loss with cochleogram. Ototoxicity studies can be performed in rodents (mice, rats), guinea pigs and large species. However, in undertaking, or at the very least attempting, all preclinical investigations within the same species, is crucial. This encompasses starting with pharmacokinetics and pharmacology efficacy studies and extending through to toxicity studies. In life read-outs include Auditory Brainstem Response (ABR) and Distortion Product OtoAcoustic Emissions (DPOAE) measurements that assess the activity and integrity of sensory cells and the auditory nerve, reflecting sensorineural hearing loss. Accurate, reproducible, and high throughput ABR measures are fundamental to the quality and success of these preclinical trials. As in humans, in vivo otoscopic evaluations are routinely carried out to observe the tympanic membrane and auditory canal. This is often done to detect signs of inflammation. The cochlea is a tonotopic structure. Hair cell responsiveness is position and frequency dependent, with hair cells located close to the cochlea apex transducing low frequencies and those at the base transducing high frequencies. The cochleogram aims to quantify hair cells all along the cochlea and consequently determine hair cell loss related to specific frequencies. This measure is then correlated with the ABR & DPOAE results. Ototoxicity assessments evaluate the impact of drug candidates on the auditory and vestibular systems, de-risk hearing loss and balance disorders, define a safe dose, and optimize therapeutic benefits. These types of studies can be initiated during early development of a therapeutic solution, with ABR and otoscopic evaluations. Depending on the mechanism of action of the compound, studies can include DPOAE and cochleogram. Later in the development, a GLP (Good Laboratory Practice) ototoxicity study may be required based on otic related route of administration, target, or known potential otic toxicity.
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Lyu Y, Liu Y, He H, Wang H. Application of Silk-Fibroin-Based Hydrogels in Tissue Engineering. Gels 2023; 9:gels9050431. [PMID: 37233022 DOI: 10.3390/gels9050431] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/12/2023] [Accepted: 05/17/2023] [Indexed: 05/27/2023] Open
Abstract
Silk fibroin (SF) is an excellent protein-based biomaterial produced by the degumming and purification of silk from cocoons of the Bombyx mori through alkali or enzymatic treatments. SF exhibits excellent biological properties, such as mechanical properties, biocompatibility, biodegradability, bioabsorbability, low immunogenicity, and tunability, making it a versatile material widely applied in biological fields, particularly in tissue engineering. In tissue engineering, SF is often fabricated into hydrogel form, with the advantages of added materials. SF hydrogels have mostly been studied for their use in tissue regeneration by enhancing cell activity at the tissue defect site or counteracting tissue-damage-related factors. This review focuses on SF hydrogels, firstly summarizing the fabrication and properties of SF and SF hydrogels and then detailing the regenerative effects of SF hydrogels as scaffolds in cartilage, bone, skin, cornea, teeth, and eardrum in recent years.
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Affiliation(s)
- Yihan Lyu
- Department of Pharmacology, School of Medicine, Southeast University, Nanjing 210009, China
| | - Yusheng Liu
- Department of Pharmacology, School of Medicine, Southeast University, Nanjing 210009, China
| | - Houzhe He
- Department of Pharmacology, School of Medicine, Southeast University, Nanjing 210009, China
| | - Hongmei Wang
- Department of Pharmacology, School of Medicine, Southeast University, Nanjing 210009, China
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Hu H, Chen J, Li S, Xu T, Li Y. 3D printing technology and applied materials in eardrum regeneration. JOURNAL OF BIOMATERIALS SCIENCE, POLYMER EDITION 2022; 34:950-985. [PMID: 36373498 DOI: 10.1080/09205063.2022.2147350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Tympanic membrane perforation is a common condition in clinical otolaryngology. Although some eardrum patients can self-heal, a long period of non-healing perforation leads to persistent otitis media, conductive deafness, and poor quality of life. Tympanic membrane repair with autologous materials requires a second incision, and the sampling site may get infected. It is challenging to repair tympanic membranes while maintaining high functionality, safety, affordability, and aesthetics. 3D bioprinting can be used to fabricate tissue patches with materials, factors, and cells in a design manner. This paper reviews 3D printing technology that is being used widely in recent years to construct eardrum stents and the utilized applied materials for tympanic membrane repair. The paper begins with an introduction of the physiological structure of the tympanic membrane, briefly reviews the current clinical method thereafter, highlights the recent 3D printing-related strategies in tympanic membrane repair, describes the materials and cells that might play an important role in 3D printing, and finally provides a perspective of this field.
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Affiliation(s)
- Haolei Hu
- Department of Otolaryngology, the 988th Hospital of the Joint Support Force of the Chinese People’s Liberation Army, Zhengzhou City 450042, Henan Province, China
| | - Jianwei Chen
- Bio-intelligent Manufacturing and Living Matter Bioprinting Center, Research Institute of Tsinghua University in Shenzhen, Tsinghua University, Shenzhen, 518057, People’s Republic of China
| | - Shuo Li
- Xinxiang Medical College, Xinxiang,453003, Henan Province, China
| | - Tao Xu
- Bio-intelligent Manufacturing and Living Matter Bioprinting Center, Research Institute of Tsinghua University in Shenzhen, Tsinghua University, Shenzhen, 518057, People’s Republic of China
| | - Yi Li
- Department of Otolaryngology, the 988th Hospital of the Joint Support Force of the Chinese People’s Liberation Army, Zhengzhou City 450042, Henan Province, China
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Strüder D, Lachmann C, van Bonn SM, Grambow E, Schraven SP, Mlynski R, Vollmar B. The Dorsal Skinfold Chamber as a New Tympanic Membrane Wound Healing Model: Intravital Insights into the Pathophysiology of Epithelialized Wounds. Eur Surg Res 2021; 63:1-15. [PMID: 34856545 PMCID: PMC9808650 DOI: 10.1159/000519774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 09/05/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND Tympanic membrane perforations (TMPs) are a common complication of trauma and infection. Persisting perforations result from the unique location of the tympanic membrane. The wound is surrounded by air of the middle ear and the external auditory canal. The inadequate wound bed, growth factor, and blood supply lead to circular epithelialization of the perforation's edge and premature interruption of defect closure. Orthotopic animal models use mechanical or chemical tympanic membrane laceration to identify bioactive wound dressings and overcome premature epithelialization. However, all orthotopic models essentially lack repetitive visualization of the biomaterial-wound interface. Therefore, recent progress in 3D printing of customized wound dressings has not yet been transferred to the unique wound setup of the TMP. Here, we present a novel application for the mice dorsal skinfold chamber (DSC) with an epithelialized full-thickness defect as TMP model. METHODS A circular 2-mm defect was cut into the extended dorsal skinfold using a biopsy punch. The skinfold was either perforated through both skin layers without prior preparation or perforated on 1 side, following resection of the opposing skin layer. In both groups, the wound was sealed with a coverslip or left unclosed (n = 4). All animals were examined for epithelialization of the edge (histology), size of the perforation (planimetry), neovascularization (repetitive intravital fluorescence microscopy), and inflammation (immunohistology). RESULTS The edge of the perforation was overgrown by the cornified squamous epithelium in all pre-parations. Reduction in the perforation's size was enhanced by application of a coverslip. Microsurgical preparation before biopsy punch perforation and sealing with a coverslip enabled repetitive high-quality intravital fluorescence microscopy. However, spontaneous reduction of the perforation occurred frequently. Therefore, the direct biopsy punch perforation without microsurgical preparation was favorable: spontaneous reduction did not occur throughout 21 days. Moreover, the visualization of the neovascularization was sufficient in intravital microscopy. CONCLUSIONS The DSC full-thickness defect is a valuable supplement to orthotopic TMP models. Repetitive intravital microscopy of the epithelialized edge enables investigation of the underlying pathophysiology during the transition from the inflammation to the proliferation phase of wound healing. Using established analysis procedures, the present model provides an effective platform for the screening of bioactive materials and transferring progress in tissue engineering to the special conditions of tympanic membrane wound healing.
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Affiliation(s)
- Daniel Strüder
- Department of Otorhinolaryngology, Head and Neck Surgery “Otto Körner”, Rostock University Medical Center, Rostock, Germany,Institute for Experimental Surgery, Rostock University Medical Center, Rostock, Germany,*Daniel Strüder,
| | - Christoph Lachmann
- Department of Otorhinolaryngology, Head and Neck Surgery “Otto Körner”, Rostock University Medical Center, Rostock, Germany
| | - Sara Maria van Bonn
- Department of Otorhinolaryngology, Head and Neck Surgery “Otto Körner”, Rostock University Medical Center, Rostock, Germany
| | - Eberhard Grambow
- Institute for Experimental Surgery, Rostock University Medical Center, Rostock, Germany,Department of General, Visceral, Vascular and Transplantation Surgery, Rostock University Medical Center, Rostock, Germany
| | - Sebastian P. Schraven
- Department of Otorhinolaryngology, Head and Neck Surgery “Otto Körner”, Rostock University Medical Center, Rostock, Germany
| | - Robert Mlynski
- Department of Otorhinolaryngology, Head and Neck Surgery “Otto Körner”, Rostock University Medical Center, Rostock, Germany
| | - Brigitte Vollmar
- Institute for Experimental Surgery, Rostock University Medical Center, Rostock, Germany
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Mokoyan Z, Svistushkin V, Zolotova A, Svistushkin M. Chronic tympanic membrane perforation: Histopathological evidence of the experimental model. Int J Pediatr Otorhinolaryngol 2021; 151:110964. [PMID: 34749050 DOI: 10.1016/j.ijporl.2021.110964] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 10/05/2021] [Accepted: 10/25/2021] [Indexed: 01/28/2023]
Abstract
OBJECTIVES This study aims to compare the effectiveness of three different models of chronic tympanic membrane perforations. MATERIALS The experimental study included 18 male chinchillas, divided into 3 equal groups. Group 1 perforations were performed with infolding technique myringotomy. Laser myringotomy was performed for perforation creation in Group 2. Group 3 perforations were performed with infolding myringotomy combined with ventilation tube insertion. At the end of the follow-up period, which lasts 8 weeks, all tympanic membranes with patent perforations were examined histologically. RESULTS Although, the mean perforation patency in Group 2 was significantly higher than in Group 1 (5 vs. 2.4 weeks, p < 0.01), both of them failed in creation of chronic perforation according to time parameters. Group 3 demonstrated the longest mean perforation patency among investigated models (8 weeks). In Group 3, histological examination of perforations, which were considered to be chronic, revealed, that stratified squamous epithelium continued from the lateral surface around the perforation edge to join with the medial mucosal layer of TM. CONCLUSION Our findings demonstrated that the combination of infolding technique and ventilation tube insertion seems to be a potential candidate for an effective animal model of tympanic membrane perforation. Further large-scale studies are required to verify our promising results.
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Affiliation(s)
- Zhanna Mokoyan
- Department of Ear, Nose and Throat Diseases, I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
| | - Valery Svistushkin
- Head of the Department of Ear, Nose and Throat Diseases, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University (Sechenov University) of the Russian Federation Ministry of Health. Russia, Moscow, Trubetskaya Street, 8, 119048, Russia.
| | - Anna Zolotova
- Department of Ear, Nose and Throat Diseases, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University (Sechenov University) of the Russian Federation Ministry of Health. Russia, Moscow, Trubetskaya Street, 8, 119048, Russia.
| | - Mikhail Svistushkin
- Department of Ear, Nose and Throat Diseases, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University (Sechenov University) of the Russian Federation Ministry of Health. Russia, Moscow, Trubetskaya Street, 8, 119048, Russia.
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Jang CH, Kim W, Moon C, Kim G. Bioprinted collagen-based cell-laden scaffold with growth factors for tympanic membrane regeneration in chronic perforation model. IEEE Trans Nanobioscience 2021; 21:370-379. [PMID: 34086575 DOI: 10.1109/tnb.2021.3085599] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
With the recent development of bioprinting technology, various attempts have been made to replace bioprinting technologies and regenerative medicine are more directed towards transplantation/reconstructive surgeries only with the implantation of scaffolds. The purpose of this study is to determine whether the growth factors, human umbilical cord serum (hUCS) and bFGF (basic fibroblast growth factor), have a synergistic effect on eardrum regeneration, when used with a cell-printed scaffold in a chronic tympanic membrane perforation (TMP) model. In this study, in vitro cellular activities for bioprinted cell-laden collagen scaffolds using human adipose stem cells (hASCs) and supplemented with 10 μg/mL hUCS and 10 ng/mL bFGF were performed. The mixture of the growth factors in the cell-laden structures effectively affects various in vitro cellular responses including the proliferation of hASCs and the migration of keratinocytes due to the synergistic effect of the growth factors and hASCs. For the in vivo evaluation, a rat TMP model was used, and the TMP regeneration was assessed by otoscopic examination, hearing threshold measurement, and histologic examination. Although the cell-laden structure containing hUCS was more enhancing effect compared to the structure with bFGF, more synergistic effect in the structure using hUCS/bFGF was observed. Based on the results, we believe that the cell-laden structure incorporating hUCS and bFGF can induce significant regeneration of chronic tympanic membrane perforation.
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Sun W, Gregory DA, Tomeh MA, Zhao X. Silk Fibroin as a Functional Biomaterial for Tissue Engineering. Int J Mol Sci 2021; 22:ijms22031499. [PMID: 33540895 PMCID: PMC7867316 DOI: 10.3390/ijms22031499] [Citation(s) in RCA: 155] [Impact Index Per Article: 51.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 01/27/2021] [Accepted: 01/27/2021] [Indexed: 12/22/2022] Open
Abstract
Tissue engineering (TE) is the approach to combine cells with scaffold materials and appropriate growth factors to regenerate or replace damaged or degenerated tissue or organs. The scaffold material as a template for tissue formation plays the most important role in TE. Among scaffold materials, silk fibroin (SF), a natural protein with outstanding mechanical properties, biodegradability, biocompatibility, and bioresorbability has attracted significant attention for TE applications. SF is commonly dissolved into an aqueous solution and can be easily reconstructed into different material formats, including films, mats, hydrogels, and sponges via various fabrication techniques. These include spin coating, electrospinning, freeze drying, physical, and chemical crosslinking techniques. Furthermore, to facilitate fabrication of more complex SF-based scaffolds with high precision techniques including micro-patterning and bio-printing have recently been explored. This review introduces the physicochemical and mechanical properties of SF and looks into a range of SF-based scaffolds that have been recently developed. The typical TE applications of SF-based scaffolds including bone, cartilage, ligament, tendon, skin, wound healing, and tympanic membrane, will be highlighted and discussed, followed by future prospects and challenges needing to be addressed.
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Affiliation(s)
- Weizhen Sun
- Department of Chemical and Biological Engineering, University of Sheffield, Sheffield S1 3JD, UK; (W.S.); (D.A.G.); (M.A.T.)
| | - David Alexander Gregory
- Department of Chemical and Biological Engineering, University of Sheffield, Sheffield S1 3JD, UK; (W.S.); (D.A.G.); (M.A.T.)
- Department of Material Science and Engineering, University of Sheffield, Sheffield S3 7HQ, UK
| | - Mhd Anas Tomeh
- Department of Chemical and Biological Engineering, University of Sheffield, Sheffield S1 3JD, UK; (W.S.); (D.A.G.); (M.A.T.)
| | - Xiubo Zhao
- Department of Chemical and Biological Engineering, University of Sheffield, Sheffield S1 3JD, UK; (W.S.); (D.A.G.); (M.A.T.)
- School of Pharmacy, Changzhou University, Changzhou 213164, China
- Correspondence: ; Tel.: +44(0)-114-222-8256
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Yao X, Teh BM, Li H, Hu Y, Huang J, Lv C, Bu S, Zheng M, Shen Y. Acellular Collagen Scaffold With Basic Fibroblast Growth Factor for Repair of Traumatic Tympanic Membrane Perforation in a Rat Model. Otolaryngol Head Neck Surg 2021; 164:381-390. [PMID: 32662734 DOI: 10.1177/0194599820938345] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 06/10/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To evaluate the efficacy of acellular collagen scaffold (ACS) in combination with basic fibroblast growth factor (bFGF) for the repair of traumatic tympanic membrane (TM) perforation in a rat model. STUDY DESIGN A prospective controlled animal study in a rat model of traumatic TM perforation. SETTING Tertiary medical center. SUBJECTS AND METHODS Sprague-Dawley rats (N = 84) with unilateral traumatic perforation of the right TMs were randomized to receive ACS, bFGF, ACS in combination with bFGF (ACS/bFGF), or nothing (spontaneous healing without any interventions as a control group). The healing outcomes were evaluated by otoscopy, optical coherence tomography, histology, and transmission electron microscopy at 1, 2, and 4 weeks postoperatively. The hearing outcomes were assessed with auditory brainstem response testing. RESULTS ACS/bFGF resulted in higher perforation closure rates at an earlier stage than spontaneous healing, ACS, and bFGF. Based on histology, optical coherence tomography, and transmission electron microscopy, a trilaminar structure and uniform thickness with mature, densely packed collagen fibers were seen in the ACS/bFGF group. Auditory brainstem response evaluation also showed that ACS/bFGF treatment promoted faster functional hearing recovery as compared with the control group. CONCLUSIONS ACS is an effective TM scaffold and a carrier for bFGF. ACS/bFGF improves the TM closure rate, results in better-reconstructed TMs, and improves hearing. ACS/bFGF serves as a potential substitute for TM perforations in clinical settings.
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Affiliation(s)
- Xu Yao
- Department of Otolaryngology-Head and Neck Surgery, Ningbo Medical Center (Ningbo Lihuili Hospital), The Affiliated Lihuili Hospital of Ningbo University, Ningbo, China
- School of Medicine, Ningbo University, Ningbo, China
| | - Bing Mei Teh
- Department of Ear, Nose, and Throat-Head and Neck Surgery, Eastern Health, Box Hill, Australia
- Department of Otolaryngology-Head and Neck Surgery, Monash Health; Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia
| | - Huan Li
- Department of Otolaryngology-Head and Neck Surgery, Ningbo Medical Center (Ningbo Lihuili Hospital), The Affiliated Lihuili Hospital of Ningbo University, Ningbo, China
- School of Medicine, Ningbo University, Ningbo, China
| | - Yi Hu
- Department of Otolaryngology-Head and Neck Surgery, Ningbo Medical Center (Ningbo Lihuili Hospital), The Affiliated Lihuili Hospital of Ningbo University, Ningbo, China
- School of Medicine, Ningbo University, Ningbo, China
| | - Juntao Huang
- Department of Otolaryngology-Head and Neck Surgery, Ningbo Medical Center (Ningbo Lihuili Hospital), The Affiliated Lihuili Hospital of Ningbo University, Ningbo, China
- School of Medicine, Ningbo University, Ningbo, China
| | - Cuiting Lv
- Department of Otolaryngology-Head and Neck Surgery, Ningbo Medical Center (Ningbo Lihuili Hospital), The Affiliated Lihuili Hospital of Ningbo University, Ningbo, China
- School of Medicine, Ningbo University, Ningbo, China
| | - Shizhong Bu
- School of Medicine, Ningbo University, Ningbo, China
| | - Minghao Zheng
- Medical School, Faculty of Health and Medical Sciences, The University of Western Australia, Nedlands, Australia
| | - Yi Shen
- Department of Otolaryngology-Head and Neck Surgery, Ningbo Medical Center (Ningbo Lihuili Hospital), The Affiliated Lihuili Hospital of Ningbo University, Ningbo, China
- School of Medicine, Ningbo University, Ningbo, China
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Langston M, Grobman A, Goncalves S, Angeli SI. Animal Model of Chronic Tympanic Membrane Perforation. Anat Rec (Hoboken) 2019; 303:619-625. [PMID: 31260172 DOI: 10.1002/ar.24220] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 01/02/2019] [Accepted: 02/28/2019] [Indexed: 01/16/2023]
Abstract
Chronic tympanic membrane perforations (TMP) can be a source of significant morbidity from hearing loss, recurrent middle ear infections, changes in lifestyle, and risk of cholesteatoma formation. Laboratory experiments of TMP have been fraught by the rapid and high rate of spontaneous healing observed in animal models. There is controversy on the minimal time that perforations in animal models must have in order to be considered chronic TMP and thus have clinical relevance, with authors suggesting time periods of perforation patency of 8-12 weeks. In this article, we sought to create a clinically significant experimental model that could yield a high rate of perforation patency for at least 8 weeks. Animals undergoing acute TMP were exposed to three different experimental situations to delay the healing of the perforation: fractionated radiation, topical lipopolysaccharide application, and a combined dexamethasone and mitomycin C (DXM/MC) solution. In our study, the use of DXM/MC reliably produced TMP lasting at least 8 weeks in 86.48% of the cases without the need to reopen the perforation, infolding the edges of the membrane, or using physical barriers to prevent TMP closure. Histologically, the resulting perforated tympanum showed hyaline changes of the remnant tympanum and hyperkeratosis of the squamous epithelia of the external auditory canal. We believe that this model is reproducible and has potential use in experiments of delayed healing of TMP. Anat Rec, 303:619-625, 2020. © 2019 American Association for Anatomy.
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Affiliation(s)
- Michael Langston
- Department of Otolaryngology, Head and Neck Surgery, University of Miami Miller School of Medicine, University of Miami Ear Institute, Miami, Florida
| | - Ariel Grobman
- Department of Otolaryngology, Head and Neck Surgery, University of Miami Miller School of Medicine, University of Miami Ear Institute, Miami, Florida
| | - Stefania Goncalves
- Department of Otolaryngology, Head and Neck Surgery, University of Miami Miller School of Medicine, University of Miami Ear Institute, Miami, Florida
| | - Simon I Angeli
- Department of Otolaryngology, Head and Neck Surgery, University of Miami Miller School of Medicine, University of Miami Ear Institute, Miami, Florida
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Lou ZC. Letter to the editor regarding: Rat model of chronic tympanic membrane perforation: Ventilation tube with mitomycin C and dexamethasone. Int J Pediatr Otorhinolaryngol 2017; 100:254-255. [PMID: 28693894 DOI: 10.1016/j.ijporl.2017.06.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Accepted: 06/30/2017] [Indexed: 11/17/2022]
Affiliation(s)
- Zheng-Cai Lou
- Department of Otorhinolaryngology, The Affiliated YiWu Hospital of Wenzhou Medical University, 699 Jiangdong Road, 322000, Yiwu City, Zhejiang Provice, China.
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Schart-Morén N, Mannström P, Rask-Andersen H, von Unge M. Effects of mechanical trauma to the human tympanic membrane: an experimental study using transmission electron microscopy. Acta Otolaryngol 2017; 137:928-934. [PMID: 28471720 DOI: 10.1080/00016489.2017.1321139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
HYPOTHESIS To examine the cellular events following induced superficial lesions of the human tympanic membrane (TM). Such information could lead to enhanced appreciation of repair mechanisms and novel strategies to restore TM perforations. BACKGROUND Persistent perforation of the TM in chronic otitis media is a major global health problem and frequently necessitates surgical intervention. Most TM perforations heal spontaneously and swiftly, but sometimes healing fails. The underlying mechanisms and the reason for incomplete repair are often elusive, although some mechanisms have been proposed. METHODS Here, five healthy adult human TMs were sampled during vestibular schwannoma surgery. Three days before harvesting, three TMs were superficially lesioned, including the epithelial and sub-epithelial layers, using a needle and two TMs served as controls. Light and transmission electron microscopy were performed. RESULTS Surrounding lesion showed distinct ultrastructural changes. This included a keratinocyte frontier with electron-dense cells with abundant ribosomes and nuclei metamorphosis. Beneath, were activated fibroblasts and invaded/transformed free cells and signs of increased transcellular activity of adjacent blood vessels. CONCLUSIONS The study describes dynamic morphological events of a human lesioned TM. The human model may be used for further investigations and understanding of TM healing mechanisms.
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Affiliation(s)
- Nadine Schart-Morén
- Departments of Otolaryngology, Head and Neck Surgery, Uppsala University Hospital, University Uppsala, Uppsala, Sweden
| | - Paula Mannström
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Helge Rask-Andersen
- Departments of Otolaryngology, Head and Neck Surgery, Uppsala University Hospital, University Uppsala, Uppsala, Sweden
| | - Magnus von Unge
- Department of ENT, Akershus University Hospital, University of Oslo, Oslo, Norway
- Centre for Clinical Research, Region Vastmanland-Uppsala University, Hospital of Vastmanland, Västerås, Sweden
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Wang AY, Liew LJ, Shen Y, Wang JT, von Unge M, Dilley RJ. In response to the letter to the editor regarding: Rat model of chronic tympanic membrane perforation: Ventilation tube with mitomycin C and dexamethasone. Int J Pediatr Otorhinolaryngol 2017; 100:256-257. [PMID: 28720306 DOI: 10.1016/j.ijporl.2017.06.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 06/30/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Allen Y Wang
- Ear Sciences Centre, School of Surgery, The University of Western Australia, Perth, Western Australia, Australia; Ear Science Institute Australia, Perth, Western Australia, Australia; Department of Otolaryngology, Head and Neck, Skull Base Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
| | - Lawrence J Liew
- Ear Sciences Centre, School of Surgery, The University of Western Australia, Perth, Western Australia, Australia; Ear Science Institute Australia, Perth, Western Australia, Australia
| | - Yi Shen
- Ear Sciences Centre, School of Surgery, The University of Western Australia, Perth, Western Australia, Australia; Ear Science Institute Australia, Perth, Western Australia, Australia; Department of Otolaryngology, Head and Neck Surgery, Ningbo Lihuili Hospital (Ningbo Medical Centre), Ningbo, Zhejiang, China
| | - Jeffrey T Wang
- Ear Sciences Centre, School of Surgery, The University of Western Australia, Perth, Western Australia, Australia
| | - Magnus von Unge
- Akershus University Hospital and University of Oslo, Norway; Center for Clinical Research Västerås, University of Uppsala, Sweden
| | - Rodney J Dilley
- Ear Sciences Centre, School of Surgery, The University of Western Australia, Perth, Western Australia, Australia; Ear Science Institute Australia, Perth, Western Australia, Australia
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Wang AY, Liew LJ, Shen Y, Wang JT, von Unge M, Atlas MD, Dilley RJ. Rat model of chronic tympanic membrane perforation: A longitudinal histological evaluation of underlying mechanisms. Int J Pediatr Otorhinolaryngol 2017; 93:88-96. [PMID: 28109506 DOI: 10.1016/j.ijporl.2016.12.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 12/15/2016] [Accepted: 12/18/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate histologically the progressive development and underlying mechanisms of chronic tympanic membrane perforation (TMP) in a rat model using a two-weeks ventilation tube (VT) treatment combined with topical application of mitomycin C/dexamethasone (VT-M/D), compared with normal tympanic membrane and acute TMPs. METHODS Fifty male Sprague-Dawley rats were divided into three experimental groups: a normal control group (n = 5), an acute TMP group (n = 5) (i.e. 3 days post-myringotomy) and a VT-M/D group (n = 40). The TMs were regularly assessed by otoscopy. The normal control animals were sacrificed on day 0 and the acute TMP group was sacrificed 3 days post-myringotomy for histological and immunohistochemical evaluations. The VT-M/D group was sacrificed at various time points - 14 and 17 days, 3, 4, 6, 8 and 10 weeks. RESULTS On longitudinal histological examination, compared with normal TM and acute TMP, the perforation edges at the later time points illustrated thickened stratified squamous epithelium rimming around the edges, significant increase in keratin and collagen deposition, increased macrophage infiltration as well as reduced cellular proliferation. Three phases of TMP healing process were identified - the acute healing phase (3-17 days), the transition phase (3-4 weeks) and the chronic phase (6-10 weeks). CONCLUSION Based on the histological results of this study, the progressive development of chronic TMPs appeared to be associated with increased epidermal thickening, collagen and keratin deposition, macrophage infiltration and reduced cellular proliferation. After the 3-4 weeks of transition phase, the TMPs seemed to have transformed into a non-healing chronic TMP between 6 and 10 weeks.
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Affiliation(s)
- Allen Y Wang
- Ear Sciences Centre, School of Surgery, The University of Western Australia, Perth, Western Australia, Australia; Ear Science Institute Australia, Perth, Western Australia, Australia; Department of Otolaryngology, Head and Neck, Skull Base Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
| | - Lawrence J Liew
- Ear Sciences Centre, School of Surgery, The University of Western Australia, Perth, Western Australia, Australia; Ear Science Institute Australia, Perth, Western Australia, Australia
| | - Yi Shen
- Ear Sciences Centre, School of Surgery, The University of Western Australia, Perth, Western Australia, Australia; Ear Science Institute Australia, Perth, Western Australia, Australia; Department of Otolaryngology, Head and Neck Surgery, Ningbo Lihuili Hospital (Ningbo Medical Centre), Ningbo, Zhejiang, China
| | - Jeffrey T Wang
- Ear Sciences Centre, School of Surgery, The University of Western Australia, Perth, Western Australia, Australia
| | - Magnus von Unge
- Akershus University Hospital and University of Oslo, Norway; Center for Clinical Research Västerås, University of Uppsala, Sweden
| | - Marcus D Atlas
- Ear Sciences Centre, School of Surgery, The University of Western Australia, Perth, Western Australia, Australia; Ear Science Institute Australia, Perth, Western Australia, Australia; Department of Otolaryngology, Head and Neck, Skull Base Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Rodney J Dilley
- Ear Sciences Centre, School of Surgery, The University of Western Australia, Perth, Western Australia, Australia; Ear Science Institute Australia, Perth, Western Australia, Australia
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Liu J, Agrawal SK, Ladak HM, Wan W. Fiber Arrangement in the Rat Tympanic Membrane. Anat Rec (Hoboken) 2016; 299:1531-1539. [PMID: 27532441 DOI: 10.1002/ar.23461] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 06/15/2016] [Accepted: 06/20/2016] [Indexed: 11/07/2022]
Abstract
The fiber arrangement in the pars tensa of the rat tympanic membrane (TM) was observed using a high resolution scanning electron microscope. The entire pars tensa is composed of fibrils with diameter of approximately 25 nm. These fibrils can be grouped into radial, circular, parabolic, and oblique fibers as reported in other mammals. The radial fibrils interweave into a planar form rather than into discrete cylindrical fibers. Before attaching to the manubrium and tympanic ring, the radial fibrils bend and cross neighboring fibrils to form a random fibril network, and change their direction from perpendicular to somewhat parallel to the manubrium and tympanic ring. The circular fibrils form cylindrical fibers near the peripheral part of the TM while closer to the manubrium, they form planar bundles. The observed fiber morphology and arrangement may provide helpful information in improving numerical models for the TM's acoustical response and designing a fibrous graft for the repair of TM perforations. Anat Rec, 299:1531-1539, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Jian Liu
- Department of Chemical and Biochemical Engineering, Western University, London, Ontario, Canada
| | - Sumit K Agrawal
- Department of Medical Biophysics, Western University, London, Ontario, Canada
- Department of Electrical and Computer Engineering, Western University, London, Ontario, Canada
- Department of Otolaryngology - Head and Neck Surgery, London Health Sciences Centre, London, Ontario, Canada
| | - Hanif M Ladak
- Department of Medical Biophysics, Western University, London, Ontario, Canada.
- Department of Electrical and Computer Engineering, Western University, London, Ontario, Canada.
- Department of Otolaryngology - Head and Neck Surgery, London Health Sciences Centre, London, Ontario, Canada.
- Biomedical Engineering Graduate Program, Western University, London, Ontario, Canada.
| | - Wankei Wan
- Department of Chemical and Biochemical Engineering, Western University, London, Ontario, Canada.
- Biomedical Engineering Graduate Program, Western University, London, Ontario, Canada.
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Shen Y, Teh BM, Dilley RJ. In response to Tympanic membrane repair using silk fibroin and acellular collagen scaffolds. Laryngoscope 2016; 126:E422. [DOI: 10.1002/lary.25935] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 01/29/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Yi Shen
- Department of Otolaryngology; Head and Neck Surgery, Ningbo Lihuili Hospital (Ningbo Medical Centre), School of Medicine,Ningbo University; Ningbo China
- Ear Sciences Centre; School of Surgery, University of Western Australia, Ear Science Institute Australia; Perth Australia
| | - Bing Mei Teh
- Ear Sciences Centre; School of Surgery, University of Western Australia, Ear Science Institute Australia; Perth Australia
| | - Rodney J. Dilley
- Ear Sciences Centre; School of Surgery, University of Western Australia, Ear Science Institute Australia; Perth Australia
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18
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Santa Maria PL, Kim S, Varsak YK, Yang YP. In Response to the Letter to the Editor Regarding: Heparin Binding-Epidermal Growth Factor-Like Growth Factor for the Regeneration of Chronic Tympanic Membrane Perforations in Mice. Tissue Eng Part A 2016; 22:570-1. [PMID: 26908042 DOI: 10.1089/ten.tea.2016.0059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Peter Luke Santa Maria
- 1 Department of Otolaryngology, Head and Neck Surgery, Stanford University , Stanford, California
| | - Sungwoo Kim
- 2 Department of Orthopedic Surgery, Stanford University , Stanford, California
| | - Yasin Kursad Varsak
- 1 Department of Otolaryngology, Head and Neck Surgery, Stanford University , Stanford, California
| | - Yunzhi Peter Yang
- 2 Department of Orthopedic Surgery, Stanford University , Stanford, California.,3 Materials Science and Engineering, Stanford University , Stanford, California
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