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Kutbi AH, Malas M, Al-Talhi AA, Noori F, Amoodi HA. The Effect of Using Ofloxacin Ear Drops in Traumatic Tympanic Membrane Healing: A Systematic Review and Meta-Analysis. EAR, NOSE & THROAT JOURNAL 2024:1455613241264479. [PMID: 38907707 DOI: 10.1177/01455613241264479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2024] Open
Abstract
Objectives: To evaluate the effectiveness of ofloxacin ear drops versus no intervention in the repair of traumatic tympanic membrane (TM) perforations from randomized controlled trials (RCTs). Data Sources: Medline/PubMed, CENTRAL, Clinical Trials.Gov, and Google Scholar. Study Selection: Inclusion criteria: (1) English language; (2) RCT studies; (3) reported the outcomes on the application of ofloxacin and outcomes of spontaneous healing. Exclusion criteria: (1) studies without a control group; (2) patient with severe otologic disease such as chronic suppurative otitis media or ossicular disruption or patients with craniocerebral injury; (3) studies with no pretreatment values or single-arm clinical studies. Data Extraction: Country, year of publication, number of participants in each arm, patient characteristics such as age, sex, intervention details, laterality, cause of TM perforation, position of perforation, follow-up time, hearing gain, rate of TM closure, and closure time. Results: A total of 6 RCTs studies were analyzed. A total of 502 participants were included; the relative risk for closure rate of ofloxacin treatment was 1.18 [95% confidence interval (CI), 1.08 to 1.28, P < .001] and the mean difference (MD) for healing time was -18.4 (95% CI, -19.96 to -16.82, P < .001), suggesting ofloxacin has a significant effect on closure of TM perforations. However, no clinically significant effect in hearing (SMD: 0.21, 95% CI, 0.02 to 0.40, P = .03) was seen in ofloxacin group. Also, patients in the ofloxacin group were associated with a 13% reduction in the risk of infections compared to their observation-assigned counterparts, but this estimate was not statistically significant. Conclusion: Ofloxacin use in patients with traumatic TM perforation is effective in reducing healing time and increasing rate of TM perforation closure. No evidence of increased risk of hearing loss or infection rates are encountered when ofloxacin is prescribed to patients with traumatic TM perforation.
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Affiliation(s)
- Abdullah H Kutbi
- Otolaryngology-Head and Neck Surgery, Surgery Department, King Abdulaziz Medical City, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Moayyad Malas
- Department of Otolaryngology, East Jeddah Hospital, Ministry of Health, Jeddah, Saudi Arabia
| | - Atheer Ali Al-Talhi
- Otolaryngology-Head and Neck Surgery, Dr. Soliman Fakeeh Hospital, Jeddah, Saudi Arabia
| | - Faisal Noori
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Hosam A Amoodi
- Department of Medicine, College of Medicine, University of Jeddah, Jeddah, Saudi Arabia
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Khursheed Z, Alam M, Chandra K. Role of Topical Estrogen in Outcomes of Myringoplasty: Does it Really Affect the Results of Graft Success and Hearing Thresholds? Indian J Otolaryngol Head Neck Surg 2024; 76:2458-2463. [PMID: 38883536 PMCID: PMC11169194 DOI: 10.1007/s12070-024-04531-z] [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: 11/28/2023] [Accepted: 01/18/2024] [Indexed: 06/18/2024] Open
Abstract
The tympanic membrane forms a barrier between the external auditory canal and the middle ear. In the inactive mucosal type of chronic otitis media, there is a perforation in the tympanic membrane which is surgically managed by Myringoplasty. Estrogen as a growth factor has been shown to have a mitogenic effect on keratinocytes thus hastening the rate of epithelialization following injury. This property of estrogen is being studied in this study for its role in the outcomes of myringoplasty. This study was carried out from January 2021 to December 2022 in the Department of Otorhinolaryngology, of a tertiary teaching hospital in North India. Patients were assessed by history, examination, otoscopy, Audiometry, and oto-endoscopy. A total of 88 patients were taken out of which 44 patients underwent myringoplasty in which topical estrogen (estradiol valerate solution) was used, and the remaining 44 patients were taken as controls. Patients were then assessed post-operatively based on Audiometry results and graft uptake status. In the estrogen group successful Graft uptake was in seen 40 (90.9%) patients and failed in 4 (9.1%), while in the control group, it was successful in 37 (84.1%) patients and failed in 7 (15.9%), statistically there was no significant difference between two groups in terms of graft uptake (p value = 0.334). Post-operatively, in the estrogen group, the mean change in Air Conduction (AC) was 15.5 dB, the change in the air-bone gap (ABG) was 11.5 dB and for Bone Conduction (BC) it was 3.2 dB. However, in the control group mean post-operative changes in Air Conduction, Air-Bone Gap, and Bone Conduction were 12 dB, 10.7 dB, and 0.8 dB respectively. Statistically, there was a significant difference in postoperative changes in AC (p value = 0.011) and BC (p value = 0.009) between the two groups. There was no significant difference in post-operative changes in Air-Bone Gap (p value = 0.571). Topical Estrogen (Estradiol valerate) solution is cost-effective, with enriched growth factors that accelerate tympanic membrane perforation closure following myringoplasty and resulted in significant improvement in hearing thresholds both for Air Conduction and Bone Conduction.
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Affiliation(s)
- Zarqa Khursheed
- Department of Otorhinolaryngology-Head and Neck Surgery, J.N. Medical College, A.M.U., Aligarh, U.P. India
| | - Mehtab Alam
- Department of Otorhinolaryngology-Head and Neck Surgery, J.N. Medical College, A.M.U., Aligarh, U.P. India
| | - Kamlesh Chandra
- Department of Otorhinolaryngology-Head and Neck Surgery, J.N. Medical College, A.M.U., Aligarh, U.P. India
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Lou Z, Lou Z, Chen Z. Effect of Packing Versus No Packing in Transperforation Myringoplasty for Chronic Tympanic Membrane Perforations. Otolaryngol Head Neck Surg 2023; 169:1170-1178. [PMID: 37222172 DOI: 10.1002/ohn.381] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 04/03/2023] [Accepted: 05/01/2023] [Indexed: 05/25/2023]
Abstract
OBJECTIVE To compare the operation times, graft survival and success rates, audiometric outcomes, and complications of patients who underwent transperforation myringoplasty with and without packing but without perforation rimming. STUDY DESIGN A prospective, randomized controlled trial. SETTING A university-affiliated teaching hospital. METHODS We conducted a randomized controlled trial that enrolled patients who underwent underlay myringoplasty. No patient underwent perforation rimming. Patients underwent myringoplasty with or without graft lateral packing. The operation times, graft survival and success rates, audiometric outcomes, and complications were compared between the 2 groups. RESULTS Sixty patients with unilateral perforations were included. The mean neovascularization score at postoperative week 2 was significantly higher in the no-packing group than in the packing group (p < .01) but did not differ significantly at postoperative weeks 3 and 4, or postoperative month 3. Neither the graft healing rate (p = .313) nor the perforation closure rate (p = .640) significantly differed between the 2 groups. The mean air-bone gap improved by 8.91 ± 5.45 dB in the packing group and 8.17 ± 1.19 dB in the no-packing group (p = .758). CONCLUSION The long-term graft success and hearing improvements in transperforation myringoplasty with no rimming of the perforation and no-graft lateral packing were comparable to those in the graft lateral packing group with no rimming of the perforation, with a low incidence of complications. These results may change the traditional practice of packing the external auditory canal and rimming the perforation in underlay myringoplasty, even for all myringoplasty surgery.
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Affiliation(s)
- Zhengcai Lou
- Department of Otorhinolaryngology, Wenzhou Medical University Affiliated Yiwu Hospital, Yiwu, Zhejiang, China
| | - Zihan Lou
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Otolaryngology-Head and Neck Surgery, Center of Sleep Medicine, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Otology Lab, Otolaryngological Institute of Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Lab Sleep Disordered Breathing, Shanghai, China
| | - Zhengnong Chen
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Otolaryngology-Head and Neck Surgery, Center of Sleep Medicine, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Otology Lab, Otolaryngological Institute of Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Lab Sleep Disordered Breathing, Shanghai, China
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Ding Y, Wei R, Li D, Li Y, Tian Z, Xie Q, Liu Y. Comparative study of fibroblast growth factor 2 and ofloxacin ear drops for repairing large traumatic perforations: A randomized controlled study. Am J Otolaryngol 2023; 44:103954. [PMID: 37348245 DOI: 10.1016/j.amjoto.2023.103954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 06/05/2023] [Accepted: 06/05/2023] [Indexed: 06/24/2023]
Abstract
OBJECTIVE The objective of this study was to compare the healing outcome of fibroblast growth factor 2 (FGF2), ofloxacin ear drops (OFLX) and spontaneous healing for repairing large traumatic tympanic membrane (TM) perforations. MATERIAL AND METHODS A total of 75 traumatic large perforations with >1/4 of TM were randomly divided into FGF2 (n = 25), OFLX (n = 25), and spontaneous healing (n = 25) groups. The closure rates, closure times, and hearing gains were compared at 3 months. RESULTS At 2 weeks after treatment, the closure rate was 95.8 % in the FGF2 group, 96.0 % in the ofloxacin ear drops group, and 14.3 % in the spontaneous healing group (P < 0.01), respectively. At 3 months after treatment, the closure rate was 100 % in the FGF2 group, 100 % in the OFLX group, and 85.7 % in the spontaneous healing group, no among-group differences were significant (P > 0.05). The mean closure time was 9.69 ± 2.46 days in the FGF2 group, 9.45 ± 2.32 days in the OFLX group, and 30.94 ± 8.95 days in the spontaneous healing group (P < 0.01). The mean ABG was 10.37 ± 2.51 dB for the FGF2 group, 11.01 ± 1.31 dB for the OFLX group, and 10.86 ± 1.94 dB for the spontaneous healing group, no significant difference was found among three groups (P > 0.05). CONCLUSIONS This study suggested that both FGF2 and OFLX significantly shortened the mean closure time and improved the closure rate compared with spontaneous healing for repairing large traumatic perforations, while the healing outcome wasn't significantly different among FGF2 and OFLX groups.
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Affiliation(s)
- Yongqing Ding
- Dept Otolaryngol Head & Neck Surg. Hebei North Univ, Affiliated Hosp 1, 12 Changqing Rd, Zhangjiakou City 075000, Hebei, China
| | - Ruili Wei
- Dept Otolaryngol Head & Neck Surg. Hebei North Univ, Affiliated Hosp 1, 12 Changqing Rd, Zhangjiakou City 075000, Hebei, China
| | - Dong Li
- Dept Otolaryngol Head & Neck Surg. Hebei North Univ, Affiliated Hosp 1, 12 Changqing Rd, Zhangjiakou City 075000, Hebei, China
| | - Yanping Li
- Dept Otolaryngol Head & Neck Surg. Hebei North Univ, Affiliated Hosp 1, 12 Changqing Rd, Zhangjiakou City 075000, Hebei, China
| | - Zedong Tian
- Dept Otolaryngol Head & Neck Surg. Hebei North Univ, Affiliated Hosp 1, 12 Changqing Rd, Zhangjiakou City 075000, Hebei, China
| | - Qi Xie
- Dept Otolaryngol Head & Neck Surg. Hebei North Univ, Affiliated Hosp 1, 12 Changqing Rd, Zhangjiakou City 075000, Hebei, China
| | - Yachao Liu
- Dept Otolaryngol Head & Neck Surg. Hebei North Univ, Affiliated Hosp 1, 12 Changqing Rd, Zhangjiakou City 075000, Hebei, China.
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Zong H, Lou Z. Healing large Traumatic Tympanic Membrane Perforations Using Vaseline Gauze and Gelfoam Patching Alone. EAR, NOSE & THROAT JOURNAL 2023:1455613221150571. [PMID: 36625009 DOI: 10.1177/01455613221150571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the effect of vaseline gauze (VG) patching on the treatment of large traumatic perforation of tympanic membrane (TM). MATERIAL AND METHODS 90 patients with traumatic perforation larger than 25% of the TM were randomly allocated into the control group of observation only, VG group, and Gelfoam patch alone group. The closure rate and closure time among the 3 groups were compared at 3 months. RESULTS In total, 82 large traumatic perforations were analyzed in this study. The closure rates in the control, VG, and gelfoam patch groups were 84.6%, 100.0%, and 89.3%, respectively (P = 0.637). Post-hoc multiple comparisons showed that the difference between the control and VG groups was significant (P = 0.047), but the difference wasn't significant between gelfoam alone and control groups (P = 0.699) or VG groups (P = 0.236). The mean closure times were 5.41 ± 1.47, 2.14 ± 0.93, and 3.00 ± 0.62 weeks for the control, VG, and gelfoam patch groups, respectively (P < 0.001). Post-hoc multiple comparisons showed that the difference was significant between the control and VG groups (P < 0.001) or gelfoam alone group (P < 0.001) or VG and gelfoam groups (P < 0.05). CONCLUSIONS VG improved the closure rate and shortened the closure time compared with observation only, which could be an effective patch material for repairing traumatic lager perforations in the outpatient setting, which is readily available and convenient.
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Affiliation(s)
- Huiqin Zong
- Department of Otorhinolaryngology, Wenzhou medical university affiliated Yiwu Hospital, Yiwu city, China
| | - Zhengcai Lou
- Department of Otorhinolaryngology, Wenzhou medical university affiliated Yiwu Hospital, Yiwu city, China
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Li Y, Ding Y, Li D, Xin Y, Wei R, Liu Y. With and without exogenous biological scaffolds for repairing traumatic perforations of tympanic membrane: Randomized clinical trials. Am J Otolaryngol 2023; 44:103650. [DOI: 10.1016/j.amjoto.2022.103650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/06/2022] [Accepted: 09/29/2022] [Indexed: 11/05/2022]
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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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FGF2 and EGF for the Regeneration of Tympanic Membrane: A Systematic Review. Stem Cells Int 2021; 2021:2366291. [PMID: 34306094 PMCID: PMC8263243 DOI: 10.1155/2021/2366291] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 06/16/2021] [Indexed: 11/17/2022] Open
Abstract
Objective A systematic review was conducted to compare the effectiveness and safety of fibroblast growth factor-2 (FGF2) and epidermal growth factor (EGF) for regeneration of the tympanic membrane (TM). Methods The PubMed database was searched for relevant studies. Experimental and clinical studies reporting acute and chronic TM perforations in relation to two healing outcomes (success rate and closure time) and complications were selected. Results A total of 47 studies were included. Five experimental studies showed closure rates of 55%-100% with FGF2 compared with 10%-62.5% in controls for acute perforations. Five experimental studies showed closure rates of 30.3%-100% with EGF and 3.6%-41% in controls for chronic perforations. Two experimental studies showed closure rates of 31.6% or 85.7% with FGF2 and 15.8% or 100% with EGF. Nine clinical studies of acute large perforations showed closure rates of 91.4%-100% with FGF2 or EGF. Two clinical studies showed similar closure rates between groups treated with FGF2 and EGF. Seven clinical studies showed closure rates of 88.9%-100% within 3 months and 58%-66% within 12 months using FGF2 in repair of chronic perforations, but only one study showed a significantly higher closure rate in the saline group compared with the FGF2 group (71.4% vs. 57.5%, respectively, P = 0.547). In addition, three experimental studies showed no ototoxicity associated with FGF2 or EGF. No middle ear cholesteatoma or epithelial pearls were reported, except in one experimental study and one clinical study, respectively. Conclusions FGF2 and EGF showed good effects and reliable safety for the regeneration of TM. In addition, EGF was better for the regeneration of acute perforations, while FGF2 combined with biological scaffolds was superior to EGF for chronic perforations, but was associated with high rates of reperforation over time. Further studies are required to determine whether EGF or FGF2 is better for TM regeneration.
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Vojtová L, Pavliňáková V, Muchová J, Kacvinská K, Brtníková J, Knoz M, Lipový B, Faldyna M, Göpfert E, Holoubek J, Pavlovský Z, Vícenová M, Blahnová VH, Hearnden V, Filová E. Healing and Angiogenic Properties of Collagen/Chitosan Scaffolds Enriched with Hyperstable FGF2-STAB ® Protein: In Vitro, Ex Ovo and In Vivo Comprehensive Evaluation. Biomedicines 2021; 9:590. [PMID: 34067330 PMCID: PMC8224647 DOI: 10.3390/biomedicines9060590] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/13/2021] [Accepted: 05/19/2021] [Indexed: 12/15/2022] Open
Abstract
Wound healing is a process regulated by a complex interaction of multiple growth factors including fibroblast growth factor 2 (FGF2). Although FGF2 appears in several tissue engineered studies, its applications are limited due to its low stability both in vitro and in vivo. Here, this shortcoming is overcome by a unique nine-point mutant of the low molecular weight isoform FGF2 retaining full biological activity even after twenty days at 37 °C. Crosslinked freeze-dried 3D porous collagen/chitosan scaffolds enriched with this hyper stable recombinant human protein named FGF2-STAB® were tested for in vitro biocompatibility and cytotoxicity using murine 3T3-A31 fibroblasts, for angiogenic potential using an ex ovo chick chorioallantoic membrane assay and for wound healing in vivo with 3-month old white New Zealand rabbits. Metabolic activity assays indicated the positive effect of FGF2-STAB® already at very low concentrations (0.01 µg/mL). The angiogenic properties examined ex ovo showed enhanced vascularization of the tested scaffolds. Histological evaluation and gene expression analysis by RT-qPCR proved newly formed granulation tissue at the place of a previous skin defect without significant inflammation infiltration in vivo. This work highlights the safety and biocompatibility of newly developed crosslinked collagen/chitosan scaffolds involving FGF2-STAB® protein. Moreover, these sponges could be used as scaffolds for growing cells for dermis replacement, where neovascularization is a crucial parameter for successful skin regeneration.
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Affiliation(s)
- Lucy Vojtová
- CEITEC–Central European Institute of Technology, Brno University of Technology, 612 00 Brno, Czech Republic; (L.V.); (J.M.); (K.K.); (J.B.); (B.L.)
| | - Veronika Pavliňáková
- CEITEC–Central European Institute of Technology, Brno University of Technology, 612 00 Brno, Czech Republic; (L.V.); (J.M.); (K.K.); (J.B.); (B.L.)
| | - Johana Muchová
- CEITEC–Central European Institute of Technology, Brno University of Technology, 612 00 Brno, Czech Republic; (L.V.); (J.M.); (K.K.); (J.B.); (B.L.)
| | - Katarína Kacvinská
- CEITEC–Central European Institute of Technology, Brno University of Technology, 612 00 Brno, Czech Republic; (L.V.); (J.M.); (K.K.); (J.B.); (B.L.)
| | - Jana Brtníková
- CEITEC–Central European Institute of Technology, Brno University of Technology, 612 00 Brno, Czech Republic; (L.V.); (J.M.); (K.K.); (J.B.); (B.L.)
| | - Martin Knoz
- Faculty of Medicine, Department of Burns and Plastic Surgery, Institution Shared with the University Hospital Brno, 625 00 Brno, Czech Republic; (M.K.); (J.H.)
- Clinic of Plastic and Esthetic Surgery, St Anne’s University Hospital, 602 00 Brno, Czech Republic
| | - Břetislav Lipový
- CEITEC–Central European Institute of Technology, Brno University of Technology, 612 00 Brno, Czech Republic; (L.V.); (J.M.); (K.K.); (J.B.); (B.L.)
- Faculty of Medicine, Department of Burns and Plastic Surgery, Institution Shared with the University Hospital Brno, 625 00 Brno, Czech Republic; (M.K.); (J.H.)
| | - Martin Faldyna
- Veterinary Research Institute, 621 00 Brno, Czech Republic; (M.F.); (E.G.); (M.V.)
| | - Eduard Göpfert
- Veterinary Research Institute, 621 00 Brno, Czech Republic; (M.F.); (E.G.); (M.V.)
| | - Jakub Holoubek
- Faculty of Medicine, Department of Burns and Plastic Surgery, Institution Shared with the University Hospital Brno, 625 00 Brno, Czech Republic; (M.K.); (J.H.)
| | - Zdeněk Pavlovský
- Faculty of Medicine, Institute of Pathology, University Hospital Brno, Masaryk University, 625 00 Brno, Czech Republic;
| | - Monika Vícenová
- Veterinary Research Institute, 621 00 Brno, Czech Republic; (M.F.); (E.G.); (M.V.)
| | - Veronika Hefka Blahnová
- Institute of Experimental Medicine of the Czech Academy of Science, 142 20 Prague, Czech Republic; (V.H.B.); (E.F.)
| | - Vanessa Hearnden
- Department of Materials Science and Engineering, Kroto Research Institute, North Campus, University of Sheffield, Broad Lane, Sheffield S3 7HQ, UK;
| | - Eva Filová
- Institute of Experimental Medicine of the Czech Academy of Science, 142 20 Prague, Czech Republic; (V.H.B.); (E.F.)
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Lou Z. Comparison of biodegradable synthetic polyurethane foam versus Gelfoam packing in cartilage graft myringoplasty procedures. Auris Nasus Larynx 2020; 47:976-981. [DOI: 10.1016/j.anl.2020.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/24/2020] [Accepted: 06/08/2020] [Indexed: 12/28/2022]
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Lou Z, Li X. A comparative study of endoscopic cartilage myringoplasty used to treat wet and dry ears with mucosal-type chronic otitis media. J Laryngol Otol 2020; 134:1-6. [PMID: 32753085 DOI: 10.1017/s0022215120001486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The outcomes of dry and wet ears were compared following endoscopic cartilage myringoplasty performed to treat chronic tympanic membrane perforations in patients with mucosal chronic otitis media. METHODS Patients with chronic perforations, and with mucosal chronic otitis media with or without discharge, were recruited; all underwent endoscopic cartilage myringoplasty. The graft success rate and hearing gain were evaluated at six months post-operatively. RESULTS The graft success rates were 85.9 per cent (67 out of 78) in dry ears and 86.2 per cent (25 out of 29) in wet ears; the difference was not significant (p = 0.583). Among the 29 wet ears, the graft success rates were 100 per cent in 11 ears with mucoid discharge and 77.8 per cent in the 18 patients with mucopurulent otorrhoea. CONCLUSION The wet or dry status of ears in patients with chronic perforations with mucosal chronic otitis media did not affect graft success rate or hearing gain after endoscopic cartilage myringoplasty. However, ears with mucopurulent discharge were associated with increased failure rates and graft collapse, whereas ears with mucoid discharge were associated with higher graft success rates.
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Affiliation(s)
- Z Lou
- Department of Otorhinolaryngology, Yiwu Central Hospital, China
| | - X Li
- Department of Otolaryngology, Jining No. 1 People's Hospital, China
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Gelfoam, bactroban ointment and ofloxacin drops facilitate the eardrum healing. Am J Otolaryngol 2020; 41:102405. [PMID: 31987599 DOI: 10.1016/j.amjoto.2020.102405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Accepted: 01/20/2020] [Indexed: 11/22/2022]
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Epidermal growth factor on the healing of human subacute tympanic membrane perforation. Am J Otolaryngol 2020; 41:102399. [PMID: 31948693 DOI: 10.1016/j.amjoto.2020.102399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 01/09/2020] [Indexed: 11/22/2022]
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Tachibana T, Kariya S, Orita Y, Makino T, Haruna T, Matsuyama Y, Komatsubara Y, Naoi Y, Nakada M, Noda Y, Sato Y, Nishizaki K. Spontaneous closure of traumatic tympanic membrane perforation following long-term observation. Acta Otolaryngol 2019; 139:487-491. [PMID: 30957610 DOI: 10.1080/00016489.2019.1592225] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Traumatic tympanic membrane perforation (TTMP) is usually managed conservatively because most close spontaneously within a few months. Nevertheless, spontaneous closure of TTMP during long-term observation has not been well described in the literature. OBJECTIVES The present study investigated factors associated with spontaneous closure of TTMP, and the characteristics of cases exhibiting spontaneous closure following long-term observation. MATERIALS AND METHODS The medical records of 40 patients with TTMP who visited the authors' hospital were retrospectively reviewed. RESULTS Spontaneous closure was observed in 27 (67.5%) patients. The healing period was <2 weeks in 6 cases, <4 weeks in 9, <3 months in 5, <6 months in 3, and ≥6 months in 4. All four cases in which spontaneous closure took ≥6 months exhibited a sign of spontaneous closure at 6 months following injury. Perforation in contact with the malleus was associated with a lower frequency of spontaneous closure. CONCLUSIONS AND SIGNIFICANCE In TTMP, surgery should be considered in patients who exhibit perforation in contact with the malleus. However, it has also been suggested that long-term observation may be a viable treatment option when a sign of spontaneous closure is observed within 6 months following injury.
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Affiliation(s)
- Tomoyasu Tachibana
- Department of Otolaryngology, Japanese Red Cross Society Himeji Hospital, Himeji City, Hyogo, Japan
| | - Shin Kariya
- Departments of Otolaryngology Head and Neck Surgery, Okayama University Graduate School of Medicine, Okayama City, Okayama, Japan
| | - Yorihisa Orita
- Department of Otolaryngology Head and Neck Surgery, Kumamoto University Graduate School of Medicine, Kumamoto City, Kumamoto, Japan
| | - Takuma Makino
- Department of Otolaryngology, Japanese Red Cross Society Himeji Hospital, Himeji City, Hyogo, Japan
| | - Takenori Haruna
- Department of Otolaryngology, Japanese Red Cross Society Himeji Hospital, Himeji City, Hyogo, Japan
| | - Yuko Matsuyama
- Department of Otolaryngology, Japanese Red Cross Society Himeji Hospital, Himeji City, Hyogo, Japan
| | - Yasutoshi Komatsubara
- Department of Otolaryngology, Japanese Red Cross Society Himeji Hospital, Himeji City, Hyogo, Japan
| | - Yuto Naoi
- Department of Otolaryngology, Japanese Red Cross Society Himeji Hospital, Himeji City, Hyogo, Japan
| | | | - Yohei Noda
- Departments of Otolaryngology Head and Neck Surgery, Okayama University Graduate School of Medicine, Okayama City, Okayama, Japan
| | - Yasuharu Sato
- Department of Pathology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama City, Okayama, Japan
| | - Kazunori Nishizaki
- Departments of Otolaryngology Head and Neck Surgery, Okayama University Graduate School of Medicine, Okayama City, Okayama, Japan
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The two-hit hypothesis and paraganglioma of the head and neck. The Journal of Laryngology & Otology 2017; 131:563. [DOI: 10.1017/s0022215117001207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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