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Yuan Z, Teh BM, Liu X, Liu Z, Huang J, Hu Y, Guo C, Shen Y. Fabrication and Evaluation of Hyaluronidase-Responsive Scaffolds by Electrospinning with Antibacterial Properties for Tympanic Membrane Repair. ACS Biomater Sci Eng 2024; 10:4400-4410. [PMID: 38917429 DOI: 10.1021/acsbiomaterials.4c00060] [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] [Indexed: 06/27/2024]
Abstract
Tympanic membrane perforation (TMP) is prevalent in clinical settings. Patients with TMPs often suffer from infections caused by Staphylococcus aureus and Pseudomonas aeruginosa, leading to middle ear and external ear canal infections, which hinder eardrum healing. The objective of this study is to fabricate an enzyme-responsive antibacterial electrospun scaffold using poly(lactic-co-glycolic acid) and hyaluronic acid for the treatment of infected TMPs. The properties of the scaffold were characterized, including morphology, wettability, mechanical properties, degradation properties, antimicrobial properties, and biocompatibility. The results indicated that the fabricated scaffold had a core-shell structure and exhibited excellent mechanical properties, hydrophobicity, degradability, and cytocompatibility. Furthermore, in vitro bacterial tests and ex vivo investigations on eardrum infections suggested that this scaffold possesses hyaluronidase-responsive antibacterial properties. It may rapidly release antibiotics when exposed to the enzyme released by S. aureus and P. aeruginosa. These findings suggest that the scaffold has great potential for repairing TMPs with infections.
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Affiliation(s)
- Zhechen Yuan
- Department of Otolaryngology Head and Neck Surgery, Ningbo No.2 Hospital, Ningbo 315010, China
- Health Science Center, Ningbo University, Ningbo 315211, Zhejiang, China
| | - Bing Mei Teh
- Department of Otolaryngology Head and Neck Surgery, Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton 3800, Victoria, Australia
| | - Xiaoling Liu
- Department of Mechanical, Materials and Manufacturing Engineering, The University of Nottingham Ningbo China, Ningbo 315100, China
| | - Ziqian Liu
- Department of Mechanical, Materials and Manufacturing Engineering, The University of Nottingham Ningbo China, Ningbo 315100, China
| | - Juntao Huang
- Department of Otolaryngology Head and Neck Surgery, Ningbo Medical Center Lihuili Hospital, The Affiliated Lihuili Hospital of Ningbo University, Ningbo 315040, China
| | - Yi Hu
- Department of Otolaryngology Head and Neck Surgery, Ningbo Medical Center Lihuili Hospital, The Affiliated Lihuili Hospital of Ningbo University, Ningbo 315040, China
| | - Chengchen Guo
- School of Engineering, Westlake University, Hangzhou 310030, China
| | - Yi Shen
- Department of Otolaryngology Head and Neck Surgery, Ningbo Medical Center Lihuili Hospital, The Affiliated Lihuili Hospital of Ningbo University, Ningbo 315040, China
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Kaboodkhani R, Mehrabani D, Moghaddam A, Salahshoori I, Khonakdar HA. Tissue engineering in otology: a review of achievements. JOURNAL OF BIOMATERIALS SCIENCE. POLYMER EDITION 2024; 35:1105-1153. [PMID: 38386362 DOI: 10.1080/09205063.2024.2318822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/09/2024] [Indexed: 02/23/2024]
Abstract
Tissue engineering application in otology spans a distance from the pinna to auditory nerve covered with specialized tissues and functions such as sense of hearing and aesthetics. It holds the potential to address the barriers of lack of donor tissue, poor tissue match, and transplant rejection through provision of new and healthy tissues similar to the host and possesses the capacity to renew, to regenerate, and to repair in-vivo and was shown to be a bypasses for any need to immunosuppression. This review aims to investigate the application of tissue engineering in otology and to evaluate the achievements and challenges in external, middle and inner ear sections. Since gaining the recent knowledge and training on use of different scaffolds is essential for otology specialists and who look for the recovery of ear function and aesthetics of patients, it is shown in this review how utilizing tissue engineering and cell transplantation, regenerative medicine can provide advancements in hearing and ear aesthetics to fit different patients' needs.
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Affiliation(s)
- Reza Kaboodkhani
- Otorhinolaryngology Research Center, Department of Otorhinolaryngology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Davood Mehrabani
- Burn and Wound Healing Research Center, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
- Stem Cell Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | | | | | - Hossein Ali Khonakdar
- Iran Polymer and Petrochemical Institute (IPPI), Tehran, Iran
- Max Bergmann Center of Biomaterials and Institute of Materials Science, Technische Universität Dresden, Dresden, Germany
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Silk/Rayon Webs and Nonwoven Fabrics: Fabrication, Structural Characteristics, and Properties. Int J Mol Sci 2022; 23:ijms23147511. [PMID: 35886857 PMCID: PMC9321737 DOI: 10.3390/ijms23147511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/05/2022] [Accepted: 07/05/2022] [Indexed: 02/04/2023] Open
Abstract
Silk is a naturally occurring material and has been widely used in biomedical and cosmetic applications owing to its unique properties, including blood compatibility, excellent cytocompatibility, and a low inflammatory response in the body. A natural silk nonwoven fabric with good mechanical properties was recently developed using the binding property of sericin. In this study, silk/rayon composite nonwoven fabrics were developed to increase productivity and decrease production costs, and the effect of the silk/rayon composition on the structure and properties of the fabric was examined. The crystalline structure of silk and rayon was maintained in the fabric. As the silk content increased, the porosity and moisture regain of the silk/rayon web and nonwoven fabric decreased. As the silk content increased, the maximum stress of the web and nonwoven fabric increased, and the elongation decreased. Furthermore, the silk/rayon web exhibited the highest values of maximum stress and elongation at ~200 °C. Regardless of the silk/rayon composition, all silk/rayon nonwoven fabrics showed good cytocompatibility. Thus, the silk/rayon fabric is a promising material for cosmetic and biomedical applications owing to its diverse properties and high cell viability.
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Zhang Z, Li JB, Li X, Zhu CY, Ren L, Huang XJ, Wu J, Ji J, Xu ZK. Janus membranes with asymmetric cellular adhesion behaviors for regenerating eardrum perforation. J Mater Chem B 2022; 10:2719-2727. [PMID: 35138320 DOI: 10.1039/d1tb02418c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The tympanic membrane plays an important role in the human hearing system, which is easily perforated under unfavorable conditions, leading to loss of hearing and otitis media. Many autologous materials and artificial materials have been used to repair a perforated tympanic membrane, but these materials sometimes can cause severe hearing loss because of their adhesion to the ossicle during the healing process and the postoperative process. Herein, we report Janus membranes with asymmetric cellular adhesion behaviors for regenerating the eardrum. These Janus membranes are constructed by co-depositing a tannic acid (TA)/3-aminopropyltriethoxysilane (APTES) coating on one surface of the polypropylene microfiltration membrane. Cellular experiments indicate that the Janus membranes have good biocompatibility and asymmetric cellular adhesion properties. The repair of the tympanic membrane perforation experiment and laser Doppler vibrometer (LDV) measurements prove that the hydrophilic surface of Janus membranes repairs perforated eardrums, and meanwhile the hydrophobic surface can avoid adhering to the inner ear tissue for reducing hearing loss. The Janus membranes have good prospects in the treatment of tympanic membrane perforation.
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Affiliation(s)
- Zhili Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, The first affiliated hospital of Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Jin-Bo Li
- Department of Chemistry, Zhejiang University, Hangzhou 310027, China.
| | - Xu Li
- MOE Key Laboratory of Macromolecular Synthesis and Functionalization, and Key Laboratory of Adsorption and Separation Materials & Technologies of Zhejiang Province, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou 310027, China.
| | - Cheng-Ye Zhu
- MOE Key Laboratory of Macromolecular Synthesis and Functionalization, and Key Laboratory of Adsorption and Separation Materials & Technologies of Zhejiang Province, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou 310027, China.
| | - Liujie Ren
- Department of FPRS, Eye & ENT Hospital of Fudan University, Shanghai 200031, China.
| | - Xiao-Jun Huang
- MOE Key Laboratory of Macromolecular Synthesis and Functionalization, and Key Laboratory of Adsorption and Separation Materials & Technologies of Zhejiang Province, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou 310027, China.
| | - Jian Wu
- Department of Chemistry, Zhejiang University, Hangzhou 310027, China.
| | - Jian Ji
- MOE Key Laboratory of Macromolecular Synthesis and Functionalization, and Key Laboratory of Adsorption and Separation Materials & Technologies of Zhejiang Province, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou 310027, China.
| | - Zhi-Kang Xu
- MOE Key Laboratory of Macromolecular Synthesis and Functionalization, and Key Laboratory of Adsorption and Separation Materials & Technologies of Zhejiang Province, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou 310027, China.
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Huang J, Teh BM, Xu Z, Yuan Z, Zhou C, Shi Y, Shen Y. The possible mechanism of Hippophae fructus oil applied in tympanic membrane repair identified based on network pharmacology and molecular docking. J Clin Lab Anal 2022; 36:e24157. [PMID: 34859918 PMCID: PMC8761429 DOI: 10.1002/jcla.24157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 11/19/2021] [Accepted: 11/20/2021] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE This study aimed to explore the mechanisms of Hippophae fructus oil (HFO) in the treatment of tympanic membrane (TM) perforation through network pharmacology-based identification. METHODS The compounds and related targets of HFO were extracted from the TCMSP database, and disease information was obtained from the OMIM, GeneCards, PharmGkb, TTD, and DrugBank databases. A Venn diagram was generated to show the common targets of HFO and TM, and GO and KEGG analyses were performed to explore the potential biological processes and signaling pathways. The PPI network and core gene subnetwork were constructed using the STRING database and Cytoscape software. A molecular docking analysis was also conducted to simulate the combination of compounds and gene proteins. RESULTS A total of 33 compounds and their related targets were obtained from the TCMSP database. After screening the 393 TM-related targets, 21 compounds and 22 gene proteins were selected to establish the network diagram. GO and KEGG enrichment analyses revealed that HFO may promote TM healing by influencing cellular oxidative stress and related signaling pathways. A critical subnetwork was obtained by analyzing the PPI network with nine core genes: CASP3, MMP2, IL1B, TP53, EGFR, CXCL8, ESR1, PTGS2, and IL6. In addition, a molecular docking analysis revealed that quercetin strongly binds the core proteins. CONCLUSION According to the analysis, HFO can be utilized to repair perforations by influencing cellular oxidative stress. Quercetin is one of the active compounds that potentially plays an important role in TM regeneration by influencing 17 gene proteins.
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Affiliation(s)
- Juntao Huang
- Department of Otolaryngology Head and Neck SurgeryNingbo Medical Center (Ningbo Lihuili Hospital)The Affiliated Lihuili Hospital of Ningbo UniversityNingboChina
- School of MedicineNingbo UniversityNingboChina
| | - Bing Mei Teh
- Department of Ear Nose and Throat, Head and Neck SurgeryEastern HealthBox HillVictoriaAustralia
- Department of Otolaryngology, Head and Neck SurgeryMonash HealthClaytonVictoriaAustralia
- Faculty of Medicine, Nursing and Health SciencesMonash UniversityClaytonVictoriaAustralia
| | - Ziqian Xu
- Department of DermatologyShanghai General HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Zhechen Yuan
- Department of Otolaryngology Head and Neck SurgeryNingbo Medical Center (Ningbo Lihuili Hospital)The Affiliated Lihuili Hospital of Ningbo UniversityNingboChina
- School of MedicineNingbo UniversityNingboChina
| | - Chongchang Zhou
- Department of Otolaryngology Head and Neck SurgeryNingbo Medical Center (Ningbo Lihuili Hospital)The Affiliated Lihuili Hospital of Ningbo UniversityNingboChina
- School of MedicineNingbo UniversityNingboChina
| | - Yunbin Shi
- Department of Otolaryngology Head and Neck SurgeryNingbo Medical Center (Ningbo Lihuili Hospital)The Affiliated Lihuili Hospital of Ningbo UniversityNingboChina
- School of MedicineNingbo UniversityNingboChina
| | - Yi Shen
- Department of Otolaryngology Head and Neck SurgeryNingbo Medical Center (Ningbo Lihuili Hospital)The Affiliated Lihuili Hospital of Ningbo UniversityNingboChina
- School of MedicineNingbo UniversityNingboChina
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Huang J, Teh BM, Zhou C, Shi Y, Shen Y. Tympanic membrane regeneration using platelet-rich fibrin: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol 2021; 279:557-565. [PMID: 34086080 DOI: 10.1007/s00405-021-06915-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 05/26/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Platelet-rich fibrin (PRF) results in satisfactory wound healing. This analysis focuses on assessing the effectiveness of PRF in the treatment of tympanic membrane (TM) perforations. MATERIALS AND METHODS The literature was searched using PubMed, Embase, Cochrane Library and Web of Science databases from inception to February 28th, 2021. The following healing and hearing outcomes were measured: closure rate, pre-and postoperative auditory results, and incidence of postoperative infections. Data were pooled and expressed as the odds ratio (OR). RESULTS Ten studies were eligible for qualitative review, and seven of them were included for the final quantitative comparison. The OR for the closure rate of acute perforations was 4.30 (95% CI 1.35-13.70, I2 = 0%), and the OR in the chronic subgroup was 5.42 (95% CI 2.57-11.43, I2 = 0%). The total OR value for the completed closure rate was 5.10 (95% CI 2.72-9.54, I2 = 0%), indicating that the utilization of PRF can enhance the closure of both acute and chronic perforations. The qualitative review did not find improved hearing results with the use of PRF. In addition to promoting closure, PRF can reduce the incidence of infections (OR = 0.14). The sensitivity analysis did not change the final results, and there was no publication bias in this analysis. CONCLUSION PRF can increase the closure rate of acute perforations, enhance the survival rate of autografts in TM surgeries and reduce the incidence of infections. However, the literature indicates that PRF does not influence the hearing outcomes. This study shows that PRF is an effective agent for TM regeneration.
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Affiliation(s)
- Juntao Huang
- Department of Otolaryngology Head and Neck Surgery, Ningbo Medical Center (Ningbo Lihuili Hospital), The Affiliated Lihuili Hospital of Ningbo University, Ningbo, 315040, Zhejiang, China.,School of Medicine, Ningbo University, Ningbo, Zhejiang, China
| | - Bing Mei Teh
- Department of Ear Nose and Throat, Head and Neck Surgery, Eastern Health, Box Hill, VIC, Australia.,Department of Otolaryngology, Head and Neck Surgery, Monash Health, Clayton, VIC, Australia.,Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia
| | - Chongchang Zhou
- Department of Otolaryngology Head and Neck Surgery, Ningbo Medical Center (Ningbo Lihuili Hospital), The Affiliated Lihuili Hospital of Ningbo University, Ningbo, 315040, Zhejiang, China.,School of Medicine, Ningbo University, Ningbo, Zhejiang, China
| | - Yunbin Shi
- Department of Otolaryngology Head and Neck Surgery, Ningbo Medical Center (Ningbo Lihuili Hospital), The Affiliated Lihuili Hospital of Ningbo University, Ningbo, 315040, Zhejiang, China.,School of Medicine, Ningbo University, Ningbo, Zhejiang, China
| | - Yi Shen
- Department of Otolaryngology Head and Neck Surgery, Ningbo Medical Center (Ningbo Lihuili Hospital), The Affiliated Lihuili Hospital of Ningbo University, Ningbo, 315040, Zhejiang, China. .,School of Medicine, Ningbo University, Ningbo, Zhejiang, China.
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Huang J, Teh BM, Shen Y. Butterfly Cartilage Tympanoplasty as an Alternative to Conventional Surgery for Tympanic Membrane Perforations: A Systematic Review and Meta-Analysis. EAR, NOSE & THROAT JOURNAL 2021:1455613211015439. [PMID: 34056940 DOI: 10.1177/01455613211015439] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE To compare the effectiveness of butterfly cartilage tympanoplasty (BCT) with that of conventional surgical approaches in the treatment of tympanic membrane perforations. METHODS A systematic search was performed by screening the PubMed, Embase, and Cochrane Library databases up to October 31, 2020. Two coauthors independently identified studies in accordance with the selection criteria. Data were pooled and analyzed via Review Manager version 5.3 and Stata version 12.0 software. The postoperative outcomes were measured and expressed as odds ratios (ORs) and standardized mean differences (SMDs). Additionally, heterogeneity was assessed through the I2 statistic. RESULTS A total of 15 articles were eligible for final inclusion. The OR values for the graft uptake rate, compared to conventional tympanoplasty, were 1.12 (95%CI: 0.56-2.22, I2 = 52%, P = .75) and 1.22 (95%CI: 0.58-2.59, I2 = 0%, P = .60), and the OR compared to fat plug myringoplasty was 3.02 (95%CI: 1.04-8.77, I2 = 0%, P = .04). The qualitative analysis of the hearing results reflected significant postoperative auditory gains with no significant differences between the BCT and control groups, indicating satisfactory and similar postoperative hearing improvement. Moreover, the operation time was shortened (SMD = -2.19, 95%CI: -2.79 to -1.59, I2 = 82%, P < .05), and the postoperative pain was less with the BCT approach. CONCLUSION Butterfly cartilage tympanoplasty has satisfactory efficacy in terms of anatomical and functional results in small to medium perforations. It reduces operation time and postoperative pain. However, the effectiveness on large perforation requires further assessment by well-designed studies.
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Affiliation(s)
- Juntao Huang
- Department of Otolaryngology Head and Neck Surgery, Ningbo Medical Center, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, Zhejiang, China.,School of Medicine, Ningbo University, Ningbo, Zhejiang, China
| | - Bing Mei Teh
- Department of Ear Nose and Throat, Head and Neck Surgery, Eastern Health, Box Hill, Victoria, Australia.,Department of Otolaryngology, Head and Neck Surgery, Monash Health, Clayton, Victoria, Australia.,Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Yi Shen
- Department of Otolaryngology Head and Neck Surgery, Ningbo Medical Center, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, Zhejiang, China.,School of Medicine, Ningbo University, Ningbo, Zhejiang, China
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The Effectiveness of bFGF in the Treatment of Tympanic Membrane Perforations: A Systematic Review and Meta-Analysis. Otol Neurotol 2021; 41:782-790. [PMID: 32097362 PMCID: PMC7302323 DOI: 10.1097/mao.0000000000002628] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Objective: To investigate the effectiveness of basic fibroblast growth factor (bFGF) versus placebo or no intervention in the treatment of tympanic membrane (TM) perforations from randomized controlled trials (RCTs), prospective and retrospective studies. Data Sources: PubMed, EMBASE, and Cochrane databases were screened from their inceptions to June 2019. Study Selection: Inclusion criteria: 1) English language; 2) observational (retrospective or prospective) or treatment (RCT) studies; 3) reported the outcomes on the application of bFGF in adult or pediatric population. Exclusion criteria: 1) studies without a control group; 2) animal studies, in vitro studies, review studies, and case reports. Data Extraction: Number of patients, cause of TM perforation, perforation size, treatment, mean age, follow-up time, sex, closure rate, healing time, mean air-bone gap improvement. Data Synthesis: A total of 14 studies were included, including seven RCTs and seven non-RCTs with a total of 1,072 participants. The odds ratio for closure rate of bFGF treatment was 7.33 (95% confidence interval [CI], 4.65 to 11.53; p < 0.01; I2 = 44%) and the standardized mean difference (SMD) for healing time was –5.89 (95% CI: –7.85 to –3.93, p < 0.01, I2 = 98%), suggesting bFGF application has a significant effect on closure of TM perforations. However, no significant change in hearing (SMD: 0.08, 95% CI: –0.11 to 0.27, p = 0.39, I2 = 0%) was seen as a result of bFGF treatment. Conclusions: Our meta-analysis has revealed that the application of bFGF can significantly enhance the closure rate as well as shorten the healing time for TM perforations. In terms of hearing, there is as yet no evidence that bFGF has a significant effect. Given its ease, availability, and safety, bFGF can be used effectively for TM repair.
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Shen Y, Mei Teh B. Response to "Is Biological Scaffold Need for Repair of Traumatic Tympanic Membrane Perforation?". Otolaryngol Head Neck Surg 2021; 164:452. [PMID: 33527875 DOI: 10.1177/0194599820962492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Hussain Z, Pei R. Necessities, opportunities, and challenges for tympanic membrane perforation scaffolding-based bioengineering. Biomed Mater 2021; 16. [PMID: 33260166 DOI: 10.1088/1748-605x/abcf5d] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 12/01/2020] [Indexed: 02/08/2023]
Abstract
Tympanic membrane (TM) perforation is a global clinical dilemma. It occurs as a consequence of object penetration, blast trauma, barotrauma, and middle ear diseases. TM perforation may lead to otitis media, retraction pockets, cholesteatoma, and conductive deafness. Molecular therapies may not be suitable to treat perforation because there is no underlying tissue matrix to support epithelium bridging. Chronic perforations are usually reconstructed with autologous grafts via surgical myringoplasty. Surgical treatment is uncomfortable for the patients. The grafting materials are not perfect because they produce an opaque membrane, fail in up to 20% of cases, and are suboptimal to restore acoustic function. Millions of patients from developing parts of the world have not got access to surgical grafting due to operational complexities, lack of surgical resources, and high cost. These shortcomings emphasize bioengineering to improve placement options, healing rate, hearing outcomes, and minimize surgical procedures. This review highlights cellular, structural, pathophysiological, and perforation specific determinants that affect healing, acoustic and surgical outcomes; and integrates necessities relevant to bioengineered scaffolds. This study further summarizes scaffolding components, progress in scaffolding strategies and design, and engenders limitations and challenges for optimal bioengineering of chronic perforation.
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Affiliation(s)
- Zahid Hussain
- School of Nano-Tech and Nano-Bionics, University of Science and Technology of China (USTC), Hefei 230026, People's Republic of China
- CAS Key Laboratory for Nano-Bio Interface, Division of Nanobiomedicine, Suzhou Institute of Nano-Tech and Nano-Bionics (SINANO), Chinese Academy of Sciences, Suzhou 215123, People's Republic of China
| | - Renjun Pei
- School of Nano-Tech and Nano-Bionics, University of Science and Technology of China (USTC), Hefei 230026, People's Republic of China
- CAS Key Laboratory for Nano-Bio Interface, Division of Nanobiomedicine, Suzhou Institute of Nano-Tech and Nano-Bionics (SINANO), Chinese Academy of Sciences, Suzhou 215123, People's Republic of China
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Aleemardani M, Bagher Z, Farhadi M, Chahsetareh H, Najafi R, Eftekhari B, Seifalian A. Can Tissue Engineering Bring Hope to the Development of Human Tympanic Membrane? TISSUE ENGINEERING PART B-REVIEWS 2021; 27:572-589. [PMID: 33164696 DOI: 10.1089/ten.teb.2020.0176] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The tympanic membrane (TM), more commonly known as the eardrum, consists of a thin layer of tissue in the human ear that receives sound vibrations from outside of the body and transmits them to the auditory ossicles. The TM perforations (TMPs) are a common ontological condition, which in some cases can result in permanent hearing loss. Despite the spontaneous healing capacity of the TM to regenerate in the majority of cases of acute perforation, chronic perforations require surgical interventions. However, the disadvantages of the surgical procedure include infection, anesthetic risks, and high failure of graft patency. The tissue engineering strategy, which includes the applications of a three-dimensional (3D) scaffold, cells, and biomolecules or a combination of them for the closure of chronic perforation, has been considered as an emerging treatment. Using this approach, emerging products are currently under development to regenerate the TM structure and its properties. This research aimed to highlight the problems with the current methods of TMP treatment, and critically evaluate the tissue engineering approaches, which may overcome these drawbacks. The focus of this review is on recent literature to critically discuss the emerging advanced materials used as a 3D scaffold in the development of a TM with cellular engineering, biomolecules, cells, and the fabrications of the TM and its pathway to the clinical application. In this review, we discuss the properties of TM and the advantages and disadvantages of the current clinical products for repair and replacement of the TM. Furthermore, we provide an overview of the in vitro and preclinical studies of emerging products over the past 5 years. The results of recent preclinical studies suggest that the tissue engineering field holds significant promise.
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Affiliation(s)
- Mina Aleemardani
- Biomedical Engineering Department, Amirkabir University of Technology, Tehran, Iran
| | - Zohreh Bagher
- ENT and Head & Neck Research Centre and Department, The Five Senses Institute, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Farhadi
- ENT and Head & Neck Research Centre and Department, The Five Senses Institute, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Hadi Chahsetareh
- Department of Life Science Engineering, Faculty of New Science and Technologies, University of Tehran, Tehran, Iran
| | - Roghayeh Najafi
- Department of Life Science Engineering, Faculty of New Science and Technologies, University of Tehran, Tehran, Iran
| | - Behnaz Eftekhari
- Biomedical Engineering Department, Amirkabir University of Technology, Tehran, Iran
| | - Alexander Seifalian
- Nanotechnology and Regenerative Medicine Commercialisation Centre (NanoRegMed Ltd.), London BioScience Innovation Centre, London, United Kingdom
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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: 150] [Impact Index Per Article: 50.0] [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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13
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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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14
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Huang J, Shi Y, Wu L, Lv C, Hu Y, Shen Y. Comparative efficacy of platelet-rich plasma applied in myringoplasty: A systematic review and meta-analysis. PLoS One 2021; 16:e0245968. [PMID: 33493204 PMCID: PMC7833258 DOI: 10.1371/journal.pone.0245968] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 01/11/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Tympanic membrane (TM) perforation is quite common in the clinical setting. Chronic TM perforations require surgical treatments such as myringoplasty. Currently, platelet-rich plasma (PRP) is a novel, effective substance that is increasingly utilized for TM perforation repair. This study aims to evaluate the effectiveness of PRP in the application of TM perforation repair. METHODS A systematic search was conducted to screen the Medline, Embase, Cochrane, Scopus and Web of Science databases up to July 2020. Studies were identified in accordance with the selection criteria by two coauthors independently. Data regarding the healing and hearing outcomes were pooled and analyzed via Review Manager version 5.3 and STATA version 12.0 software. Odds ratio (OR) was utilized to compare the closure rate. Furthermore, the results of hearing improvements and incidence of complications were also compared to evaluate the effectiveness of PRP. RESULTS A total of eight studies with 455 participants were eligible according to the selection criteria. Compared to conventional surgery, the OR of closure was 2.70 (95% CI: 1.27 to 5.76, P = 0.01, I2 = 0%) in randomized controlled trial (RCT) subgroup and 6.18 (95% CI: 2.22 to 17.25, P = 0.0005, I2 = 0) in non-RCT subgroup. The overall OR of closure was 3.69 (95% CI: 2.02 to 6.74, P<0.0001, I2 = 0%), suggesting a significant effect on the healing of TM perforation. Between preoperative and postoperative hearing results, there is no statistical difference between the PRP and the control groups. Additionally, the use of PRP resulted in a lower incidence of complication than the use of conventional approaches. CONCLUSION The application of PRP during the TM surgeries can enhance the closure rate, provide similar hearing improvements and decrease the incidence of postoperative complications. Given these advantages, PRP can be considered an effective treatment for TM regeneration.
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Affiliation(s)
- Juntao Huang
- Department of Otolaryngology Head and Neck Surgery, Ningbo Medical Center of Lihuili Hospital, The Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
- School of Medicine, Ningbo University, Ningbo, Zhejiang, China
| | - Yunbin Shi
- Department of Otolaryngology Head and Neck Surgery, Ningbo Medical Center of Lihuili Hospital, The Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Linrong Wu
- Department of Otolaryngology Head and Neck Surgery, Ningbo Medical Center of Lihuili Hospital, The Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
- School of Medicine, Ningbo University, Ningbo, Zhejiang, China
| | - Cuiting Lv
- Department of Otolaryngology Head and Neck Surgery, Ningbo Medical Center of Lihuili Hospital, The Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
- School of Medicine, Ningbo University, Ningbo, Zhejiang, China
| | - Yi Hu
- Department of Otolaryngology Head and Neck Surgery, Ningbo Medical Center of Lihuili Hospital, The Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
- School of Medicine, Ningbo University, Ningbo, Zhejiang, China
| | - Yi Shen
- Department of Otolaryngology Head and Neck Surgery, Ningbo Medical Center of Lihuili Hospital, The Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
- School of Medicine, Ningbo University, Ningbo, Zhejiang, China
- * E-mail:
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15
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Chen J, Han S, Huang M, Li J, Zhou M, He J. Green crosslinked nanofibers membrane based on CS/PVA combined with polybasic organic acid for tympanic membrane repair. INT J POLYM MATER PO 2020. [DOI: 10.1080/00914037.2020.1825084] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Jia Chen
- The Department of Otolaryngology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Shuying Han
- College of Materials Science and Engineering, Zhejiang University of Technology, Hangzhou, China
| | - Mengjia Huang
- College of Materials Science and Engineering, Zhejiang University of Technology, Hangzhou, China
| | - Jie Li
- Research and Development Department, Hangzhou Singclean Medical Products Co., Ltd., Hangzhou, China
| | - Mi Zhou
- College of Materials Science and Engineering, Zhejiang University of Technology, Hangzhou, China
| | - Jianguo He
- The Department of Otolaryngology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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16
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Sabariego M, Tabrizi NS, Marshall GJ, McLagan AN, Jawad S, Hales JB. In the temporal organization of episodic memory, the hippocampus supports the experience of elapsed time. Hippocampus 2020; 31:46-55. [PMID: 32956520 DOI: 10.1002/hipo.23261] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 07/29/2020] [Accepted: 08/30/2020] [Indexed: 12/13/2022]
Abstract
Space and time are both essential features of episodic memory, for which the hippocampus is critical (Howard & Eichenbaum, 2015). Spatial tasks have been used effectively to study the behavioral relevance of place cells. However, the behavioral paradigms utilized for the study of time cells have not used time duration as a variable that animals need to be aware of to solve the task. Therefore, the behavioral relevance of this cell firing is unclear. In order to directly study the role of the hippocampus in processing elapsed time, we created a novel time duration discrimination task. Rats learned to make a decision to turn left or right depending on the preceding tone duration (10 s, left turn; 20 s, right turn). Once the rats reached criterion performance of 90% correct on two out of three consecutive days, they received either an excitotoxic hippocampal lesion or a sham-lesion surgery. After recovery, rats were tested to determine hippocampal involvement in discriminating time duration. Rats with hippocampal lesions performed at chance level on their first testing day postlesion, and they were impaired relative to the sham-lesioned rats. Although the hippocampal-lesioned rats began discriminating at above chance level, their performance never returned to criterion even with 50 days of postoperative testing. Furthermore, while sham rats showed no difference in the number of errors they made on 10- versus 20-s delay trials, hippocampal lesion rats similarly improved their performance under the 10-s delay condition, but not under the 20-s delay condition. Results indicate that hippocampal lesions resulted in a selective impairment in discriminating elapsed time only during the longer delay trials. The implications of these results are discussed in relation to the limits of working-memory capacity and to the role of sustained hippocampal time cell activity in memory performance depending on the perceived relevance of the delay period.
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Affiliation(s)
- Marta Sabariego
- Program in Neuroscience and Behavior, Mount Holyoke College, South Hadley, Massachusetts, USA
| | - Nina S Tabrizi
- Department of Psychological Sciences, University of San Diego, San Diego, California, USA
| | - Greer J Marshall
- Department of Psychological Sciences, University of San Diego, San Diego, California, USA
| | - Ali N McLagan
- Department of Psychological Sciences, University of San Diego, San Diego, California, USA
| | - Safa Jawad
- Program in Neuroscience and Behavior, Mount Holyoke College, South Hadley, Massachusetts, USA
| | - Jena B Hales
- Department of Psychological Sciences, University of San Diego, San Diego, California, USA
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Abstract
PURPOSE OF REVIEW One of the most common diseases of the tympanic membrane is a perforation, and tympanoplasty is one of the more common procedures in otolaryngology. Tympanic membrane regeneration and bioengineering aim to improve the success rate of the procedure, increase the availability of different scaffolds and provide innovative tools that will simplify the surgical technique and make it accessible for surgeons with varying expertise level. This review aims to raise awareness of current tissue engineering developments in tympanic membrane regeneration and how they may augment current clinical practices. We focus here on achievements in tympanic membrane cell cultures and on innovations in development of new scaffolds and growth factors that enhance regeneration of patient's native tympanic membranes. RECENT FINDINGS In recent years, great achievements were reached in the field of tympanic membrane regeneration in the three hallmarks of bioengineering: cells, scaffolds and bioactive molecules. New techniques for modeling normal tympanic membrane proliferation were developed, as well as for isolation and expansion of normal tympanic membrane keratinocytes from miniature samples of scarred tissue. Ongoing clinical trials aim to seal the perforation by applying different scaffolds infiltrated by growth factors on the tympanic membrane. SUMMARY Research efforts in tympanic membrane regeneration continue to seek the ideal single tissue-engineered substitute. Recent advances in tympanic membrane bioengineering include new types of scaffolds that may augment and provide a safe and effective alternative to the current gold-standard autograft. New bioactive molecules may simplify the surgical procedure and reduce surgical time by augmenting the native tympanic membrane regeneration. Several groups of bioengineering scientists and neurotologists are continuing to move forward and develop new strategies, seeking to create a fully functional tissue-engineered tympanic membrane.
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18
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Application of mesenchymal stem cell for tympanic membrane regeneration by tissue engineering approach. Int J Pediatr Otorhinolaryngol 2020; 133:109969. [PMID: 32126416 DOI: 10.1016/j.ijporl.2020.109969] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 02/22/2020] [Accepted: 02/22/2020] [Indexed: 12/13/2022]
Abstract
Regeneration is a biological process of cell renewal that takes place in damaged tissues or organs. It is naturally stimulated by the release of different growth factors, cytokines, surface molecules, and stem cells at the wounded sites. The tympanic membrane (TM) is an essential component of the hearing process in the auditory system, which can amplify and transmit sound vibrations through a chain of mobile ossicles. Middle ear infection, external sound pressure, insertion of sharp objects into the ear, and severe trauma are the main causes of TM perforations (TMPs), which could result in deficient hearing function. So far, otolaryngologists have employed surgical procedures (myringoplasty or tympanoplasty) to close the perforated eardrum. Because of limitations such as side effects, discomfort, and high cost to patients, there is a need for better alternatives to surgical procedures. Tissue engineering is a promising tool that can overcome the operational risk and restore, maintain, and improve the function of the TM using a range of biocompatible scaffolds, commercially available growth factors, and stem cells. Currently, multipotent mesenchymal stem cells (MSCs) are a good therapeutic option for the treatment of TMPs because of their self-renewing, and autocrine and paracrine activities. As there are fewer risks of isolation in the use of MSCs for the treatment of TMPs, they are more advantageous for tissue regeneration. The delivery of either MSCs alone or a combination of MSCs with biomaterials and growth factors (GFs) at the ruptured TM sites may enhance the activation of epithelial stem cell markers and increase the migration and proliferation of keratinocytes resulting in faster closure of TMPs. This review focuses on the current strategies used to treat TMPs and the importance of MSCs in TM regeneration. Particularly, we have discussed the synergistic effect of MSCs and scaffolds or GFs or scaffolds/GFs in TM regeneration. Finally, with the advancement of tissue engineering technologies such as 3D and 4D bioprinting, MSCs can be used to design patient-specific scaffolds, which may contain physical and chemical guidance cues to improve the extent and rate of targeted tissue regeneration.
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Abstract
Airway and other head and neck disorders affect hundreds of thousands of patients each year and most require surgical intervention. Among these, congenital deformity that affects newborns is particularly serious and can be life-threatening. In these cases, reconstructive surgery is resolutive but bears significant limitations, including the donor site morbidity and limited available tissue. In this context, tissue engineering represents a promising alternative approach for the surgical treatment of otolaryngologic disorders. In particular, 3D printing coupled with advanced imaging technologies offers the unique opportunity to reproduce the complex anatomy of native ear, nose, and throat, with its import in terms of functionality as well as aesthetics and the associated patient well-being. In this review, we provide a general overview of the main ear, nose and throat disorders and focus on the most recent scientific literature on 3D printing and bioprinting for their treatment.
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Affiliation(s)
- Roberto Di Gesù
- Fondazione Ri.MED, Palermo, Italy.,Department of Pediatrics, Division of Pulmonary Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Abhinav P Acharya
- Department of Chemical Engineering, Arizona State University, Tempe, AZ, USA
| | - Ian Jacobs
- Department of Surgery, Division of Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Riccardo Gottardi
- Fondazione Ri.MED, Palermo, Italy.,Department of Pediatrics, Division of Pulmonary Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
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20
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Kiseleva A, Kiselev G, Kessler V, Seisenbaeva G, Gets D, Rumyantseva V, Lyalina T, Fakhardo A, Krivoshapkin P, Krivoshapkina E. Optically Active Hybrid Materials Based on Natural Spider Silk. ACS APPLIED MATERIALS & INTERFACES 2019; 11:22962-22972. [PMID: 31252494 DOI: 10.1021/acsami.9b05131] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Spider silk is a natural material possessing unique properties such as biocompatibility, regenerative and antimicrobial activity, and biodegradability. It is broadly considered an attractive matrix for tissue regeneration applications. Optical monitoring and potential control over tissue regrowth are attractive tools for monitoring of this process. In this work, we show upconversion modification of natural spider silk fibers with inorganic nanoparticles. To achieve upconversion, metal oxide nanoparticles were doped with low concentrations of rare-earth elements, producing potentially biocompatible luminescent nanomaterials. The suggested approach to spider silk modification is efficient and easy to perform, opening up sensing and imaging possibilities of biomaterials in a noninvasive and real-time manner in bio-integration approaches.
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Affiliation(s)
| | - Grigorii Kiselev
- ITMO University , Lomonosova Street 9 , Saint Petersburg 191002 , Russia
| | - Vadim Kessler
- Department of Molecular Sciences, Biocenter , SLU , P.O. Box 7015, SE-75007 Uppsala , Sweden
| | - Gulaim Seisenbaeva
- Department of Molecular Sciences, Biocenter , SLU , P.O. Box 7015, SE-75007 Uppsala , Sweden
| | - Dmitry Gets
- ITMO University , Lomonosova Street 9 , Saint Petersburg 191002 , Russia
| | | | - Tatiana Lyalina
- ITMO University , Lomonosova Street 9 , Saint Petersburg 191002 , Russia
| | - Anna Fakhardo
- ITMO University , Lomonosova Street 9 , Saint Petersburg 191002 , Russia
| | - Pavel Krivoshapkin
- ITMO University , Lomonosova Street 9 , Saint Petersburg 191002 , Russia
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21
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Li L, Zhang W, Huang M, Li J, Chen J, Zhou M, He J. Preparation of gelatin/genipin nanofibrous membrane for tympanic member repair. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2018; 29:2154-2167. [PMID: 30295148 DOI: 10.1080/09205063.2018.1528519] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Longfei Li
- College of Materials Science and Engineering, Zhejiang University of Technology, Hangzhou, China
| | - Weizheng Zhang
- College of Materials Science and Engineering, Zhejiang University of Technology, Hangzhou, China
| | - Mengjia Huang
- College of Materials Science and Engineering, Zhejiang University of Technology, Hangzhou, China
| | - Jie Li
- College of Materials Science and Engineering, Zhejiang University of Technology, Hangzhou, China
| | - Jia Chen
- Department of Otorhinolaryngology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Mi Zhou
- College of Materials Science and Engineering, Zhejiang University of Technology, Hangzhou, China
| | - Jianguo He
- Department of Otorhinolaryngology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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22
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Huang P, Zhang S, Gong X, Wang X, Lou ZH. Endoscopic observation of different repair patterns in human traumatic tympanic membrane perforations. Braz J Otorhinolaryngol 2018; 84:545-552. [PMID: 28823697 PMCID: PMC9452262 DOI: 10.1016/j.bjorl.2017.06.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Revised: 06/07/2017] [Accepted: 06/30/2017] [Indexed: 01/01/2023] Open
Abstract
Introduction In the last decade, there has been an increasing use of biomaterial patches in the regeneration of traumatic tympanic membrane perforations. The major advantages of biomaterial patches are to provisionally restore the physiological function of the middle ear, thereby immediately improving ear symptoms, and act as a scaffold for epithelium migration. However, whether there are additional biological effects on eardrum regeneration is unclear for biological material patching in the clinic. Objective This study evaluated the healing response for different repair patterns in human traumatic tympanic membrane perforations by endoscopic observation. Methods In total, 114 patients with traumatic tympanic membrane perforations were allocated sequentially to two groups: the spontaneous healing group (n = 57) and Gelfoam patch-treated group (n = 57). The closure rate, closure time, and rate of otorrhea were compared between the groups at 3 months. Results Ultimately, 107 patients were analyzed in the two groups (52 patients in the spontaneous healing group vs. 55 patients in the Gelfoam patch-treated group). The overall closure rate at the end of the 3 month follow-up period was 90.4% in the spontaneous healing group and 94.5% in the Gelfoam patch-treated group; the difference was not statistically significant (p > 0.05). However, the total average closure time was significantly different between the two groups (26.8 ± 9.1 days in the spontaneous healing group vs. 14.7 ± 9.1 days in the Gelfoam patch-treated group, p < 0.01). In addition, the closure rate was not significantly different between the spontaneous healing group and Gelfoam patch-treated group regardless of the perforation size. The closure time in the Gelfoam patch-treated group was significantly shorter than that in the spontaneous healing group regardless of the perforation size (small perforations: 7.1 ± 1.6 days vs. 12.6 ± 3.9, medium-sized perforations: 13.3 ± 2.2 days vs. 21.8 ± 4.2 days, and large perforations: 21.2 ± 4.7 days vs. 38.4 ± 5.7 days; p < 0.01). Conclusion In the regeneration of traumatic tympanic membrane perforations, Gelfoam patching not only plays a scaffolding role for epithelial migration, it also promotes edema and hyperplasia of granulation tissue at the edges of the perforation and accelerates eardrum healing.
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23
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Huang M, Li J, Chen J, Zhou M, He J. Preparation of CS/PVA Nanofibrous Membrane with Tunable Mechanical Properties for Tympanic Member Repair. Macromol Res 2018. [DOI: 10.1007/s13233-018-6127-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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24
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Fan L, Li JL, Cai Z, Wang X. Creating Biomimetic Anisotropic Architectures with Co-Aligned Nanofibers and Macrochannels by Manipulating Ice Crystallization. ACS NANO 2018; 12:5780-5790. [PMID: 29846058 DOI: 10.1021/acsnano.8b01648] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The continuous evolution of tissue engineering scaffolds has been driven by the desire to recapitulate structural features and functions of the natural extracellular matrix (ECM). However, it is still an extreme challenge to create a three-dimensional (3D) scaffold with both aligned nanofibers and aligned interconnected macrochannels to mimic the ECM of anisotropic tissues. Here, we develop a facile strategy to create such a scaffold composed of oriented nanofibers and interconnected macrochannels in the same direction, with various natural polymers typically used for tissue regeneration. The orientation of nanofibers and interconnected macrochannels can be easily tuned by manipulating ice crystallization. The scaffold demonstrates both structural and functional features similar to the natural ECM of anisotropic tissues. Taking silk fibroin as an example, the scaffold with radially oriented nanofibers and interconnected macrochannels is more efficient for capturing cells and promoting the growth of both nonadherent embryonic dorsal root ganglion neurons (DRGs) and adherent human umbilical vein endothelial cells (HUVECs) compared to the widely used scaffold types. Interestingly, DRGs and neurites on the SF scaffold demonstrate a 3D growth mode similar to that of natural nerve tissues. Furthermore, the coaligned nanofibers and macrochannels of the scaffold can direct HUVECs to assemble into blood vessel-like structures and their collagen deposition in their arrangement direction. The strategy could inspire the design and development of multifunctional 3D scaffolds with desirable structural features for engineering different tissues.
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Affiliation(s)
- Linpeng Fan
- Institute for Frontier Materials , Deakin University , Geelong , Victoria 3216 , Australia
| | - Jing-Liang Li
- Institute for Frontier Materials , Deakin University , Geelong , Victoria 3216 , Australia
| | - Zengxiao Cai
- Institute for Frontier Materials , Deakin University , Geelong , Victoria 3216 , Australia
| | - Xungai Wang
- Institute for Frontier Materials , Deakin University , Geelong , Victoria 3216 , Australia
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25
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Kuo CY, Wilson E, Fuson A, Gandhi N, Monfaredi R, Jenkins A, Romero M, Santoro M, Fisher JP, Cleary K, Reilly B. Repair of Tympanic Membrane Perforations with Customized Bioprinted Ear Grafts Using Chinchilla Models. Tissue Eng Part A 2018; 24:527-535. [PMID: 28726587 PMCID: PMC5833256 DOI: 10.1089/ten.tea.2017.0246] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 06/23/2017] [Indexed: 01/21/2023] Open
Abstract
The goal of this work is to develop an innovative method that combines bioprinting and endoscopic imaging to repair tympanic membrane perforations (TMPs). TMPs are a serious health issue because they can lead to both conductive hearing loss and repeated otitis media. TMPs occur in 3-5% of cases after ear tube placement, as well as in cases of acute otitis media (the second most common infection in pediatrics), chronic otitis media with or without cholesteatoma, or as a result of barotrauma to the ear. About 55,000 tympanoplasties, the surgery performed to reconstruct TMPs, are performed every year, and the commonly used cartilage grafting technique has a success rate between 43% and 100%. This wide variability in successful tympanoplasty indicates that the current approach relies heavily on the skill of the surgeon to carve the shield graft into the shape of the TMP, which can be extremely difficult because of the perforation's irregular shape. To this end, we hypothesized that patient specific acellular grafts can be bioprinted to repair TMPs. In vitro data demonstrated that our approach resulted in excellent wound healing responses (e.g., cell invasion and proliferations) using our bioprinted gelatin methacrylate constructs. Based on these results, we then bioprinted customized acellular grafts to treat TMP based on endoscopic imaging of the perforation and demonstrated improved TMP healing in a chinchilla study. These ear graft techniques could transform clinical practice by eliminating the need for hand-carved grafts. To our knowledge, this is the first proof of concept of using bioprinting and endoscopic imaging to fabricate customized grafts to treat tissue perforations. This technology could be transferred to other medical pathologies and be used to rapidly scan internal organs such as intestines for microperforations, brain covering (Dura mater) for determination of sites of potential cerebrospinal fluid leaks, and vascular systems to determine arterial wall damage before aneurysm rupture in strokes.
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Affiliation(s)
- Che-Ying Kuo
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, Washington, District of Columbia
| | - Emmanuel Wilson
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, Washington, District of Columbia
| | - Andrew Fuson
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, Washington, District of Columbia
| | - Nidhi Gandhi
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, Washington, District of Columbia
| | - Reza Monfaredi
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, Washington, District of Columbia
| | - Audrey Jenkins
- MedStar Health Research Institute, Washington, District of Columbia
| | | | - Marco Santoro
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland
| | - John P. Fisher
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, Washington, District of Columbia
| | - Kevin Cleary
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, Washington, District of Columbia
| | - Brian Reilly
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, Washington, District of Columbia
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Gao L, Orth P, Cucchiarini M, Madry H. Effects of solid acellular type-I/III collagen biomaterials on in vitro and in vivo chondrogenesis of mesenchymal stem cells. Expert Rev Med Devices 2018; 14:717-732. [PMID: 28817971 DOI: 10.1080/17434440.2017.1368386] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Type-I/III collagen membranes are advocated for clinical use in articular cartilage repair as being able of inducing chondrogenesis, a technique termed autologous matrix-induced chondrogenesis (AMIC). Area covered: The current in vitro and translational in vivo evidence for chondrogenic effects of solid acellular type-I/III collagen biomaterials. Expert commentary: In vitro, mesenchymal stem cells (MSCs) adhere to the fibers of the type-I/III collagen membrane. No in vitro study provides evidence that a type-I/III collagen matrix alone may induce chondrogenesis. Few in vitro studies compare the effects of type-I and type-II collagen scaffolds on chondrogenesis. Recent investigations suggest better chondrogenesis with type-II collagen scaffolds. A systematic review of the translational in vivo data identified one long-term study showing that covering of cartilage defects treated by microfracture with a type-I/III collagen membrane significantly enhanced the repair tissue volume compared with microfracture alone. Other in vivo evidence is lacking to suggest either improved histological structure or biomechanical function of the repair tissue. Taken together, there is a paucity of in vitro and preclinical in vivo evidence supporting the concept that solid acellular type-I/III collagen scaffolds may be superior to classical approaches to induce in vitro or in vivo chondrogenesis of MSCs.
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Affiliation(s)
- Liang Gao
- a Lehrstuhl für Experimentelle Orthopädie und Arthroseforschung , Saarland University , Homburg/Saar , Germany
| | - Patrick Orth
- a Lehrstuhl für Experimentelle Orthopädie und Arthroseforschung , Saarland University , Homburg/Saar , Germany
| | - Magali Cucchiarini
- a Lehrstuhl für Experimentelle Orthopädie und Arthroseforschung , Saarland University , Homburg/Saar , Germany
| | - Henning Madry
- a Lehrstuhl für Experimentelle Orthopädie und Arthroseforschung , Saarland University , Homburg/Saar , Germany
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27
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Aksoy MA, Açıkalın MF, Gürbüz MK, Özüdoğru EN, Canaz F, Kaya E, Pınarbaşlı MÖ, İncesulu A, Çaklı H, Cingi C. Efficacy of Platelet-Rich Plasma on Fat Grafts in the Repair of Tympanic Membrane Perforations: An Experimental Study. J Int Adv Otol 2017; 14:58-62. [PMID: 29283097 DOI: 10.5152/iao.2017.3845] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE We investigated the use of autologous platelet-rich plasma (PRP) to improve the success rate of fat graft myringoplasty in perforated tympanic membranes of rats. MATERIALS AND METHODS A total of 20 healthy Wistar albino female rats were divided into two groups. In Group 1, the left tympanic membranes were perforated and grafted with a fat graft that was harvested from the inguinal region. In Group 2, the left tympanic membranes were perforated, and a fat graft was also harvested from the inguinal region. Then, the fat was soaked in 0.5 mL PRP and grafted at the perforation. After the procedure, the rats were examined, and the graft situation was assessed at 3, 5, 7, 10, and 14 days. All of the rats were sacrificed 21 days after perforation, and a histopathological examination was made. RESULTS We compared fat graft histopathological and otomicroscopic findings between the groups. While we did not observe graft rejections in Group 2, we saw 1 case of graft rejection in Group 1. In the histopathological examination, PRP prevents fat graft resorption by the terms of the adipocyte area, granulation tissue area, and vacuolization area. CONCLUSION This study demonstrated the efficacy of fat grafts prepared with PRP on rat tympanic membranes. The fat graft with PRP did not statistically improve the success rate compared to the graft without PRP. Histopatologic findings of the study showed that PRP prevents fat graft resorption. Further studies are needed to further examine the advantages of the graft with PRP.
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Affiliation(s)
- Mehmet Akif Aksoy
- Department of Ear Nose and Throat, Gölköy State Hospital, Ordu, Turkey
| | - Mustafa Fuat Açıkalın
- Department of Pathology, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Melek Kezban Gürbüz
- Department of Ear Nose and Throat, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Erkan Niyazi Özüdoğru
- Department of Ear Nose and Throat, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Funda Canaz
- Department of Pathology, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Ercan Kaya
- Department of Ear Nose and Throat, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Mehmet Özgür Pınarbaşlı
- Department of Ear Nose and Throat, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Armağan İncesulu
- Department of Ear Nose and Throat, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Hamdi Çaklı
- Department of Ear Nose and Throat, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Cemal Cingi
- Department of Ear Nose and Throat, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
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Allardyce BJ, Rajkhowa R, Dilley RJ, Redmond SL, Atlas MD, Wang X. Glycerol-plasticised silk membranes made using formic acid are ductile, transparent and degradation-resistant. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2017; 80:165-173. [DOI: 10.1016/j.msec.2017.05.112] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 05/11/2017] [Accepted: 05/16/2017] [Indexed: 11/28/2022]
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29
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Kim SH, Lee HJ, Yoo JC, Park HJ, Jeong JY, Seo YB, Sultan MT, Kim SH, Lee OJ, Park CH. Novel transparent collagen film patch derived from duck's feet for tympanic membrane perforation. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2017; 29:997-1010. [PMID: 28862068 DOI: 10.1080/09205063.2017.1374031] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
To increase healing rate of tympanic membrane (TM) perforations, patching procedure has been commonly conducted. Biocompatible, biodegradable patching materials which is not limited across cultures is needed. The authors evaluated the effectiveness of novel transparent duck's feet collagen film (DCF) patch in acute traumatic TM perforation. This procedure was compared with spontaneous healing and paper patching. Cell proliferation features were observed in paper and DCF patches. Forty-eight TMs of 24 rats were used for animal experiment, perforations were made on each TMs, and divided into three groups according to treatment modality. Sixteen were spontaneously healed, 16 were paper patched and 16 were DCF patched. The gross and histological healing results were analyzed. Both paper and DCF patch showed no cytotoxicity, but cell proliferations were more active in DCF than paper in early stage. In animal study, the healing of TM perforations were completed within 14 days in all three groups, but found to be faster in DCF patch group than paper patch or spontaneous healing group. The DCF patches were transparent and size of DCF patches were gradually decreased, so there were no need to remove the DCF patches to check the wound status or after the completion of healing. According to this result, authors concluded that DCF patch is transparent, biocompatible and biodegradable material, and can induce fast healing in acute traumatic TM perforations.
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Affiliation(s)
- Soo Hyeon Kim
- a School of Medicine , Nano-Bio Regenerative Medical Institute, Hallym University , Chuncheon , Republic of Korea
| | - Ho Jun Lee
- a School of Medicine , Nano-Bio Regenerative Medical Institute, Hallym University , Chuncheon , Republic of Korea.,b Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine , Chuncheon Sacred Heart Hospital, Hallym University , Chuncheon , Republic of Korea
| | - Ji-Chul Yoo
- c Central Research Institute, SewonCellontech Co., Ltd, Wooyoung Techno Center , Seoul , Republic of Korea
| | - Hyun Jung Park
- a School of Medicine , Nano-Bio Regenerative Medical Institute, Hallym University , Chuncheon , Republic of Korea
| | - Ju Yeon Jeong
- a School of Medicine , Nano-Bio Regenerative Medical Institute, Hallym University , Chuncheon , Republic of Korea
| | - Ye Been Seo
- a School of Medicine , Nano-Bio Regenerative Medical Institute, Hallym University , Chuncheon , Republic of Korea
| | - Md Tipu Sultan
- a School of Medicine , Nano-Bio Regenerative Medical Institute, Hallym University , Chuncheon , Republic of Korea
| | - Soon Hee Kim
- a School of Medicine , Nano-Bio Regenerative Medical Institute, Hallym University , Chuncheon , Republic of Korea
| | - Ok Joo Lee
- a School of Medicine , Nano-Bio Regenerative Medical Institute, Hallym University , Chuncheon , Republic of Korea
| | - Chan Hum Park
- a School of Medicine , Nano-Bio Regenerative Medical Institute, Hallym University , Chuncheon , Republic of Korea.,b Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine , Chuncheon Sacred Heart Hospital, Hallym University , Chuncheon , Republic of Korea
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Improved tympanic membrane regeneration after myringoplastic surgery using an artificial biograft. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2017; 73:48-58. [DOI: 10.1016/j.msec.2016.12.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 10/24/2016] [Accepted: 12/04/2016] [Indexed: 01/17/2023]
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31
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Tympanic membrane organ culture using cell culture well inserts engrafted with tympanic membrane tissue explants. Biotechniques 2017; 62:109-114. [DOI: 10.2144/000114523] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 01/18/2017] [Indexed: 11/23/2022] Open
Abstract
Tissue engineering approaches using growth factors and various materials for repairing chronic perforations of the tympanic membrane are being developed, but there are surprisingly few relevant tissue culture models available to test new treatments. Here, we present a simple three-dimensional model system based on micro-dissecting the rat tympanic membrane umbo and grafting it into the membrane of a cell culture well insert. Cell outgrowth from the graft produced sufficient cells to populate a membrane of similar surface area to the human tympanic membrane within 2 weeks. Tissue grafts from the annulus region also showed cell outgrowth but were not as productive. The umbo organoid supported substantial cell proliferation and migration under the influence of keratinocyte growth medium. Cells from umbo grafts were enzymatically harvested from the polyethylene terephthalate (PET) membrane for expansion in routine culture and cells could be harvested consecutively from the same graft over multiple cycles. We used harvested cells to test cell migration properties and to engraft a porous silk scaffold material as proof-of-principle for tissue engineering applications. This model is simple enough to be widely adopted for tympanic membrane regeneration studies and has promise as a tissue-equivalent model alternative to animal testing.
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32
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Zhang D, Huang Z, Sun P, Huang H, Zhang Y, Dai J, Liu J, Shi Q. Acceleration of Healing of Traumatic Tympanic Membrane Perforation in Rats by Implanted Collagen Membrane Integrated with Collagen-Binding Basic Fibroblast Growth Factor. Tissue Eng Part A 2016; 23:20-29. [PMID: 27733103 DOI: 10.1089/ten.tea.2016.0265] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Traumatic tympanic membrane (TM) perforation is very common in clinical practice. Several biomaterials have been reported to play a role in TM reparation, whereas their functional recovery is limited when used alone. Meanwhile, the administration of biofactors could promote functional recovery, but rapid distribution and short half-time obstruct their application. To study the effect of traumatic TM regeneration, we prepared collagen membrane (CM) integrated with collagen-binding basic fibroblast growth factor (CBD-bFGF) and implanted into the injury site of perforated TM in Sprague-Dawley rats. The study on CBD-bFGF in vitro showed that CBD-bFGF accelerated the proliferation of human fibroblast cell HS-865 biologically and was released from CM gradually. In vivo study, through the gross anatomy, auditory brainstem responses assay, histological staining, and transmission electron microscopy observation at d7, d14, and d28 after the acute TM perforation, we found that CBD-bFGF-integrated CM promoted the healing rate at an early stage (∼7 days), reduced the healing time of perforated TM, and notably retrieved the structure and hearing of TM. These findings suggest that CM modified with CBD-bFGF could be therapeutically appropriate for the treatment of TM perforation.
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Affiliation(s)
- Dan Zhang
- 1 Department of ENT, The First Affiliated Hospital of Soochow University , Suzhou, P.R. China
| | - Zhen Huang
- 1 Department of ENT, The First Affiliated Hospital of Soochow University , Suzhou, P.R. China
| | - Peng Sun
- 1 Department of ENT, The First Affiliated Hospital of Soochow University , Suzhou, P.R. China
| | - Haiping Huang
- 1 Department of ENT, The First Affiliated Hospital of Soochow University , Suzhou, P.R. China
| | - Yunmei Zhang
- 1 Department of ENT, The First Affiliated Hospital of Soochow University , Suzhou, P.R. China
| | - Jianwu Dai
- 2 State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology , Chinese Academy of Sciences, Beijing, P.R. China
| | - Jisheng Liu
- 1 Department of ENT, The First Affiliated Hospital of Soochow University , Suzhou, P.R. China
| | - Qin Shi
- 3 Department of Orthopedics, The First Affiliated Hospital of Soochow University , Suzhou, P.R. China
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33
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Allardyce BJ, Rajkhowa R, Dilley RJ, Xie Z, Campbell L, Keating A, Atlas MD, von Unge M, Wang X. Comparative acoustic performance and mechanical properties of silk membranes for the repair of chronic tympanic membrane perforations. J Mech Behav Biomed Mater 2016; 64:65-74. [PMID: 27479895 DOI: 10.1016/j.jmbbm.2016.07.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 07/13/2016] [Accepted: 07/14/2016] [Indexed: 11/26/2022]
Abstract
The acoustic and mechanical properties of silk membranes of different thicknesses were tested to determine their suitability as a repair material for tympanic membrane perforations. Membranes of different thickness (10-100μm) were tested to determine their frequency response and their resistance to pressure loads in a simulated ear canal model. Their mechanical rigidity to pressure loads was confirmed by tensile testing. These membranes were tested alongside animal cartilage, currently the strongest available myringoplasty graft as well as paper, which is commonly used for simpler procedures. Silk membranes showed resonant frequencies within the human hearing range and a higher vibrational amplitude than cartilage, suggesting that silk may offer good acoustic energy transfer characteristics. Silk membranes were also highly resistant to simulated pressure changes in the middle ear, suggesting they can resist retraction, a common cause of graft failure resulting from chronic negative pressures in the middle ear. Part of this strength can be explained by the substantially higher modulus of silk films compared with cartilage. This allows for the production of films that are much thinner than cartilage, with superior acoustic properties, but that still provide the same level of mechanical support as thicker cartilage. Together, these in vitro results suggest that silk membranes may provide good hearing outcomes while offering similar levels of mechanical support to the reconstructed middle ear.
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Affiliation(s)
| | - Rangam Rajkhowa
- Deakin University, Institute for Frontier Materials, Geelong, Australia
| | - Rodney J Dilley
- Ear Science Institute Australia and Ear Sciences Centre, School of Surgery, University of Western Australia, Australia
| | - Zhigang Xie
- Deakin University, Institute for Frontier Materials, Geelong, Australia
| | - Luke Campbell
- Department of Otolaryngology, University of Melbourne, Australia
| | - Adrian Keating
- School of Mechanical and Chemical Engineering, The University of Western Australia, Australia
| | - Marcus D Atlas
- Ear Science Institute Australia and Ear Sciences Centre, School of Surgery, University of Western Australia, Australia
| | - Magnus von Unge
- Dept. ENT, Akershus University Hospital and the University of Oslo, Oslo, Norway; Center for Clinical Research, Västerås, University of Uppsala, Sweden
| | - Xungai Wang
- Deakin University, Institute for Frontier Materials, Geelong, Australia.
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34
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Acoustic Properties of Collagenous Matrices of Xenogenic Origin for Tympanic Membrane Reconstruction. Otol Neurotol 2016; 37:692-7. [DOI: 10.1097/mao.0000000000001012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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35
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Lee JH, Kim DK, Park HS, Jeong JY, Yeon YK, Kumar V, Bae SH, Lee JM, Moon BM, Park CH. A prospective cohort study of the silk fibroin patch in chronic tympanic membrane perforation. Laryngoscope 2016; 126:2798-2803. [PMID: 27297322 DOI: 10.1002/lary.25980] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 01/27/2016] [Accepted: 02/23/2016] [Indexed: 11/08/2022]
Abstract
OBJECTIVES/HYPOTHESIS Silk fibroin patching has been used to repair acute tympanic membrane perforations. Here, we describe the advantages and outcomes of this technique for chronic tympanic membrane perforations. STUDY DESIGN Individual cohort study. METHODS Forty patients were enrolled; half underwent perichondrium myringoplasty, and the silk fibroin patch technique was applied in the remaining patients. We compared the closure, otorrhea, and complication rates; closure time; postoperative hearing gain; and patient satisfaction between the two groups. RESULTS Demographic data (gender, site, age, duration, preoperative air-bone gap, and perforation size and location) were not significantly different between the two groups. The closure rates and times, complication rates, and postoperative hearing gains were also similar in both groups. The mean operative time, otorrhea rate, and complication rate were also significantly better in the silk fibroin patch group. The intraoperative dizziness scores were higher in the conventional perichondrium myringoplasty group. CONCLUSIONS Success rates were similar for the silk fibroin patch technique and conventional perichondrium myringoplasty; however, patching was an easier, faster procedure. Our results suggest that the silk fibroin patch technique is a suitable treatment for chronic tympanic membrane perforation. LEVEL OF EVIDENCE 2b Laryngoscope, 126:2798-2803, 2016.
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Affiliation(s)
- Jun Ho Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, School of Medicine, Hallym University, Gangwon, South Korea.,Nano-Bio Regenerative Medical Institute, Hallym University, Gangwon, South Korea
| | - Dong-Kyu Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, School of Medicine, Hallym University, Gangwon, South Korea.,Nano-Bio Regenerative Medical Institute, Hallym University, Gangwon, South Korea
| | - Hae Sang Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, School of Medicine, Hallym University, Gangwon, South Korea.,Nano-Bio Regenerative Medical Institute, Hallym University, Gangwon, South Korea
| | - Ju Yeon Jeong
- Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, School of Medicine, Hallym University, Gangwon, South Korea
| | - Yeung Kyu Yeon
- Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, School of Medicine, Hallym University, Gangwon, South Korea
| | - Vijay Kumar
- Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, School of Medicine, Hallym University, Gangwon, South Korea
| | - Sung Hee Bae
- Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, School of Medicine, Hallym University, Gangwon, South Korea
| | - Jung Min Lee
- Nano-Bio Regenerative Medical Institute, Hallym University, Gangwon, South Korea
| | - Bo Mi Moon
- Nano-Bio Regenerative Medical Institute, Hallym University, Gangwon, South Korea
| | - Chan Hum Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, School of Medicine, Hallym University, Gangwon, South Korea.,Nano-Bio Regenerative Medical Institute, Hallym University, Gangwon, South Korea
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36
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Lou ZC, Tang YM, Chen HY, Xiao J. The perforation margin phenotypes and clinical outcome of traumatic tympanic membrane perforation with a Gelfoam patch: our experience from a retrospective study of seventy-four patients. Clin Otolaryngol 2016; 40:389-92. [PMID: 25639704 DOI: 10.1111/coa.12386] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Z C Lou
- Department of Otorhinolaryngology, The Affiliated YiWu Hospital of Wenzhou Medical College, Zhejiang, China
| | - Y M Tang
- Department of pathology, The Affiliated YiWu Hospital of Wenzhou Medical College, Zhejiang, China
| | - H Y Chen
- Department of Otorhinolaryngology, The Affiliated YiWu Hospital of Wenzhou Medical College, Zhejiang, China
| | - J Xiao
- Molecular Pharmacology Research Center, School of Pharmacy, Wenzhou Medical University, Zhejiang, China
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37
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Goncalves S, Bas E, Goldstein BJ, Angeli S. Effects of Cell-Based Therapy for Treating Tympanic Membrane Perforations in Mice. Otolaryngol Head Neck Surg 2016; 154:1106-14. [PMID: 26980912 DOI: 10.1177/0194599816636845] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 02/11/2016] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To investigate the effectiveness of scaffold-embedded mesenchymal stem cells (MSCs) as a topical treatment for healing tympanic membrane perforations (TMPs) in a mouse model. STUDY DESIGN Prospective animal study. SETTING Experimental. SUBJECTS AND METHODS In vitro: under sterile conditions, porcine-derived (Gelita-Spon [GS]), hyaluronate-derived (EpiDisc [ED]), and polyvinyl alcohol (PVA) scaffolds were cut into small pieces and cocultured with murine bone marrow-derived MSCs (BM-MSCs) expressing green fluorescent protein (GFP) for 72 hours. The cultures were either analyzed by confocal microscopy or used for subsequent in vivo experiments. In vivo: 26 mice were divided into 3 groups (ie, control [n = 9], GS [n = 8], ED [n = 9]). Under general anesthesia, TMPs of equal sizes were performed bilaterally using a sterile 27-gauge needle under a surgical microscope. The BM-MSCs embedded within GS or ED scaffolds were soaked in phosphate-buffered saline and then topically applied on right TMPs, and scaffolds alone were applied on left TMPs 6 to 8 hours after injury. Control mice did not receive treatment. On day 7, animals were euthanized and bullae were harvested for histological analysis. RESULTS In vitro: BM-MSCs grew well on both GS (P = .0012) and ED (P = .0001) scaffolds compared with PVA. In vivo: 100% of untreated (control) TMPs remained open after 7 days. Animals treated with MSC-embedded ED scaffolds had a higher percentage of TMP closure (P = .016) and a thicker neotympanum (P = .0033) than control animals. The experimentally applied BM-MSCs engrafted and differentiated into epithelial cells suggested by the colocalized expression of cytokeratin-19 and GFP. CONCLUSIONS The topical application of bone marrow-derived MSCs enhances the healing of TMPs in this animal model and is a promising alternative to tympanoplasty.
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Affiliation(s)
- Stefania Goncalves
- Department of Otolaryngology-Head and Neck Surgery, University of Miami Miller School of Medicine, University of Miami Ear Institute, Miami, Florida, USA
| | - Esperanza Bas
- Department of Otolaryngology-Head and Neck Surgery, University of Miami Miller School of Medicine, University of Miami Ear Institute, Miami, Florida, USA
| | - Bradley J Goldstein
- Department of Otolaryngology-Head and Neck Surgery, University of Miami Miller School of Medicine, University of Miami Ear Institute, Miami, Florida, USA Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Simon Angeli
- Department of Otolaryngology-Head and Neck Surgery, University of Miami Miller School of Medicine, University of Miami Ear Institute, Miami, Florida, USA
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38
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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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39
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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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40
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Wang AY, Shen Y, Liew LJ, Wang JT, von Unge M, Atlas MD, Dilley RJ. Rat model of chronic tympanic membrane perforation: Ventilation tube with mitomycin C and dexamethasone. Int J Pediatr Otorhinolaryngol 2016; 80:61-8. [PMID: 26746614 DOI: 10.1016/j.ijporl.2015.11.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 11/12/2015] [Accepted: 11/13/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Chronic tympanic membrane perforation (TMP) in a clinical setting may attract surgical intervention. With the advent of modern biomaterials, new options are available for myringoplasty but safety and efficacy need evaluation in a chronic TMP animal model. The aim of this study was to evaluate the efficacy of ventilation tube (VT) insertion in conjunction with topical application of mitomycin C/dexamethasone (M/D) for the creation of chronic TMP in rats. METHODS Thirty male Sprague-Dawley rats underwent myringotomy of the right tympanic membrane (TM) and were divided into three experimental groups: spontaneous healing (myringotomy control), VT insertion for 2 weeks and VT insertion for 2 weeks in conjunction with topical application of M/D (VT-M/D). All TMs were regularly assessed by otoscopy for 10 weeks and then animals were sacrificed for histological evaluation. RESULTS In the VT-M/D group, seven out of ten (70%) perforations were patent at 10 weeks (mean patency, 57.9 days; P<0.01). The VT group had two out of ten (20%) perforations patent at 10 weeks (mean patency, 26.5 days; P<0.01), while all TMPs from the myringotomy control group were closed by day 9 (mean patency, 7.2 days). Histologically, the TMPs patent at week 10 had a stratified squamous epithelialized rim, keratinocyte layer thickening around the perforation edge as well as increased collagen deposition and macrophage infiltration. CONCLUSION Chronic TMP in a rat model was successfully created by VT insertion and the efficacy was increased in combination with topical application of M/D.
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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.
| | - 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
| | - 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
| | - 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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A trans-well-based cellular model for the rapid pre-evaluation of tympanic membrane repair materials. Eur Arch Otorhinolaryngol 2015; 273:2027-34. [DOI: 10.1007/s00405-015-3768-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 08/25/2015] [Indexed: 10/23/2022]
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Searching for a rat model of chronic tympanic membrane perforation: Healing delayed by mitomycin C/dexamethasone but not paper implantation or iterative myringotomy. Int J Pediatr Otorhinolaryngol 2015; 79:1240-7. [PMID: 26060147 DOI: 10.1016/j.ijporl.2015.05.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 05/14/2015] [Accepted: 05/16/2015] [Indexed: 01/31/2023]
Abstract
OBJECTIVES Surgical intervention such as myringoplasty or tympanoplasty is an option in the current clinical management of chronic tympanic membrane perforation (TMP). Animal models of chronic TMP are needed for pre-clinical testing of new materials and to improve existing techniques. We evaluated several reported animal model techniques from the literature for the creation of chronic TMPs. The aim of this study was to evaluate production of chronic TMPs in a rat model using topical mitomycin C/dexamethasone, paper insertion into middle ear cavity (MEC) or re-myringotomy. METHODS Forty male Sprague-Dawley rats underwent myringotomy of the right tympanic membrane (TM) and were randomly divided into 3 experimental groups: application of topical mitomycin C/dexamethasone, paper insertion into middle ear cavity, or re-myringotomy. Control perforations were allowed to close spontaneously. TMs were assessed regularly with otoscopy for 8 weeks. At the end of 8 weeks, animals were sacrificed for histology. RESULTS The closure of TMPs was significantly delayed by mitomycin C/dexamethasone (mean patency, 18.9 days; P≤0.01) compared with the control (mean patency, 7 days), but was not significantly delayed in the paper insertion group (mean patency, 9.4 days; P=0.74). Repeated myringotomy of closed perforations (mean number of myringotomies, 8.9 per ear) stimulated acceleration of closure rather than delay. Histologically, the mitomycin C/dexamethasone group had almost normal TM morphology, while the paper insertion group revealed inflammatory and granulomatous responses. The re-myringotomy group had a thickened TM fibrous layer with collagen deposition. CONCLUSIONS Mitomycin C/dexamethasone delayed TMP closure in rats but the effect was not sufficiently long-lasting to be defined as a chronic TMP. Neither paper insertion into middle ear cavity nor re-myringotomy created chronic TMP in rats.
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Clinical outcomes of silk patch in acute tympanic membrane perforation. Clin Exp Otorhinolaryngol 2015; 8:117-22. [PMID: 26045909 PMCID: PMC4451535 DOI: 10.3342/ceo.2015.8.2.117] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 10/02/2014] [Accepted: 10/13/2014] [Indexed: 11/25/2022] Open
Abstract
Objectives The silk patch is a thin transparent patch that is produced from silk fibroin. In this study, we investigated the treatment effects of the silk patch in patients with traumatic tympanic membrane perforation (TTMP). Methods The closure rate, otorrhea rate, and closure time in all patients and the closure time in successful patients were compared between the paper patch and silk patch groups. Results Demographic data (gender, site, age, traumatic duration, preoperative air-bone gap, and perforation size and location) were not significantly different between the two groups. The closure rate and otorrhea rate were not significantly different between the two groups. However, the closure time was different between the two groups (closure time of all patients, P=0.031; closure time of successful patients, P=0.037). Conclusion The silk patch which has transparent, elastic, adhesive, and hyper-keratinizing properties results in a more efficient closure time than the paper patch in the treatment of TTMP patients. We therefore believe that the silk patch should be recommended for the treatment of acute tympanic membrane perforation.
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Wang AY, Shen Y, Wang JT, Friedland PL, Atlas MD, Dilley RJ. Animal models of chronic tympanic membrane perforation: a 'time-out' to review evidence and standardize design. Int J Pediatr Otorhinolaryngol 2014; 78:2048-55. [PMID: 25455522 DOI: 10.1016/j.ijporl.2014.10.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 10/01/2014] [Accepted: 10/04/2014] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To review the literature on techniques for creation of chronic tympanic membrane perforations (TMP) in animal models. Establishing such models in a laboratory setting will have value if they replicate many of the properties of the human clinical condition and can thus be used for investigation of novel grafting materials or other interventions. METHODS A literature search of the PubMed database (1950-August 2014) was performed. The search included all English-language literature published attempts on chronic or delayed TMP in animal models. Studies of non English-language or acute TMP were excluded. RESULTS Thirty-seven studies were identified. Various methods to create TMP in animals have been used including infolding technique, thermal injury, re-myringotomy, and topical agents including chemicals and growth factor receptor inhibitors. The most common type of animal utilized was chinchilla, followed by rat and guinea pig. Twenty three of the 37 studies reported success in achieving chronic TMP animal model while 14 studies solely delayed the healing of TMP. Numerous experimental limitations were identified including TMP patency duration of <8 weeks, lack of documentation of total number of animals attempted and absence of proof for chronicity with otoscopic and histologic evidence. CONCLUSION The existing literature demonstrates the need for an ideal chronic TMP animal model to allow the development of new treatments and evaluate the risk of their clinical application. Various identified techniques seem promising, however, a need was identified for standardization of experimental design and evidence to address multiple limitations.
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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.
| | - 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
| | - Peter L Friedland
- 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
| | - 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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Lee SW, Kim SG. Membranes for the Guided Bone Regeneration. Maxillofac Plast Reconstr Surg 2014; 36:239-46. [PMID: 27489841 PMCID: PMC4283533 DOI: 10.14402/jkamprs.2014.36.6.239] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 10/07/2014] [Accepted: 10/17/2014] [Indexed: 11/17/2022] Open
Abstract
Many kinds of membrane have been used for the guided bone regeneration (GBR) technique. However, most membranes do not fulfill all requirements for the ideal membrane for the GBR technique. Among them, collagen membrane has been most widely used. However, its high price and weak tensile strength in wet condition are limitations for wide clinical application. Synthetic polymers have also been used for the GBR technique. Recently, silk based membrane has been considered as a membrane for the GBR technique. Despite many promising preclinical data for use of a silk membrane, clinical data regarding the silk membrane has been limited. However, silk based material has been used clinically as vessel-tie material and an electrospun silk membrane was applied successfully to patients. No adverse effect related to the silk suture has been reported. Considering that silk membrane can be provided to patients at a cheap price, its clinical application should be encouraged.
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Affiliation(s)
- Sang-Woon Lee
- Correspondence to Seong-Gon Kim, Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, 7 Jukheon-gil, Gangneung 210-702, Korea, Tel: 82-33-640-2468, Fax: 82-33-641-2477, E-mail:
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Wang AY, Shen Y, Wang JT, Eikelboom RH, Dilley RJ. Animal models of chronic tympanic membrane perforation: in response to plasminogen initiates and potentiates the healing of acute and chronic tympanic membrane perforations in mice. Clin Transl Med 2014; 3:5. [PMID: 24669846 PMCID: PMC3987050 DOI: 10.1186/2001-1326-3-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Accepted: 03/10/2014] [Indexed: 11/10/2022] Open
Abstract
Tympanic membrane perforations (TMP) are relatively common but are typically not treated in their acute stage, as most will heal spontaneously in 7–10 days. Those cases which fail to heal within 3 months are called chronic TMP which attract surgical intervention (e.g. myringoplasty), typically with a temporalis fascia autograft. New materials for the repair of chronic TMP are being developed to address deficiencies in the performance of autografts by undergoing evaluation in animal models prior to clinical study. However, there is currently a lack of ideal chronic TMP animal models available, hindering the development of new treatments. Various techniques and animal species have been investigated for the creation of chronic TMP with varied success. In the present commentary, we bring to the attention of readers the recent report by Shen et al. in Journal of Translational Medicine. The study reported the creation of a chronic TMP animal model in plasminogen gene deficient mice. However, the short observation time (9, 19 days), lack of success rate and the scarcity of solid evidence (e.g. otoscopic & histologic images) to confirm the chronicity of TMP warrant a more thorough discussion.
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Affiliation(s)
- Allen Y Wang
- Ear Sciences Centre, School of Surgery, The University of Western Australia, 35 Stirling Highway, Nedlands, WA 6009, Australia.
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Jun HJ, Oh KH, Yoo J, Han WG, Chang J, Jung HH, Choi J. A new patch material for tympanic membrane perforation by trauma: the membrane of a hen egg shell. Acta Otolaryngol 2014; 134:250-4. [PMID: 24320021 DOI: 10.3109/00016489.2013.857784] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION The egg shell membrane (ESM) patch may promote tympanic membrane (TM) healing in acute traumatic TM perforation. OBJECTIVE To evaluate the use of ESM for treating acute traumatic TM perforation. METHODS We reviewed charts of patients with traumatic TM injury from 2008 to 2011. Treatments were an ESM patch or a perforation edge approximation. We divided patients into two groups according to the treatment used. Each patient was matched by treatment onset and perforation size. We compared healing ratio, healing time, and frequency of otorrhea between the perforation edge approximation group and the ESM patch group. Matched t tests were used for analysis. RESULTS The healing ratio of the TM showed no significant difference between the two groups, but the time to heal was significantly shorter in the ESM patch group than in the perforation edge approximation group.
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Affiliation(s)
- Hyung Jin Jun
- Department of Otolaryngology-Head and Neck Surgery, Korea University College of Medicine , Seoul , Korea
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Shen Y, Redmond SL, Papadimitriou JM, Teh BM, Yan S, Wang Y, Atlas MD, Marano RJ, Zheng M, Dilley RJ. The biocompatibility of silk fibroin and acellular collagen scaffolds for tissue engineering in the ear. Biomed Mater 2014; 9:015015. [PMID: 24457429 DOI: 10.1088/1748-6041/9/1/015015] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Recent experimental studies have shown the suitability of silk fibroin scaffold (SFS) and porcine-derived acellular collagen I/III scaffold (ACS) as onlay graft materials for tympanic membrane perforation repair. The aims of this study were to further characterize and evaluate the in vivo biocompatibility of SFS and ACS compared with commonly used materials such as Gelfoam and paper in a rat model. The scaffolds were implanted in subcutaneous (SC) tissue and middle ear (ME) cavity followed by histological and otoscopic evaluation for up to 26 weeks. Our results revealed that SFS and ACS were well tolerated and compatible in rat SC and ME tissues throughout the study. The tissue response adjacent to the implants evaluated by histology and otoscopy showed SFS and ACS to have a milder tissue response with minimal inflammation compared to that of paper. Gelfoam gave similar results to SFS and ACS after SC implantation, but it was found to be associated with pronounced fibrosis and osteoneogenesis after ME implantation. It is concluded that SFS and ACS both were biocompatible and could serve as potential alternative scaffolds for tissue engineering in the ear.
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Affiliation(s)
- Yi Shen
- Ear Sciences Centre, School of Surgery, The University of Western Australia, Nedlands 6009, Western Australia, Australia. Ear Science Institute Australia, Subiaco 6008, Western Australia, Australia. Department of Otolaryngology, Head & Neck, Ningbo Lihuili Hospital (Ningbo Medical Centre), Ningbo 315041, Zhejiang, People's Republic of China
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Lee H, Jang CH, Kim GH. A polycaprolactone/silk-fibroin nanofibrous composite combined with human umbilical cord serum for subacute tympanic membrane perforation; an in vitro and in vivo study. J Mater Chem B 2014; 2:2703-2713. [DOI: 10.1039/c4tb00213j] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Jang CH, Cho YB, Yeo M, Lee H, Min EJ, Lee BH, Kim GH. Regeneration of chronic tympanic membrane perforation using 3D collagen with topical umbilical cord serum. Int J Biol Macromol 2013; 62:232-40. [PMID: 24016669 DOI: 10.1016/j.ijbiomac.2013.08.049] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Revised: 08/28/2013] [Accepted: 08/30/2013] [Indexed: 11/28/2022]
Abstract
Chronic tympanic membrane (TM) perforation is one of the most common otology complications. Current surgical management of TM perforation includes myringoplasty and tympanoplasty. The purpose of this study was to evaluate the efficacy and feasibility of three dimensional (3D) porous collagen scaffolds with topically applied human umbilical cord serum (UCS) for the regeneration of chronic TM perforation in guinea pigs. To achieve this goal, we fabricated porous 3D collagen scaffolds (avg. strut diameter of 236 ± 51 μm, avg. pore size of 382 ± 67 μm, and a porosity of 96%) by using a 3 axis robot dispensing and low temperature plate systems. Guinea pigs were used in a model of chronic TM perforation. In the experimental group (n=10), 3D collagen scaffold was placed on the perforation and topically applied of UCS every other day for a period of 8 days. The control group ears (n=10) were treated with paper discs and phosphate buffered saline (PBS) only using the same regimen. Healing time, acoustic-mechanical properties, and morphological analysis were performed by otoendoscopy, auditory brainstem response (ABR), single-point laser Doppler vibrometer (LDV), optical coherence tomography (OCT), and light microscopic evaluation. The closure of the TM perforation was achieved in 100% of the experimental group vs. 43% of the control group, and this difference was statistically significant (p=0.034). The ABR threshold at all frequencies of the experimental group was significantly recovered to the normal level compared to the control group. TM vibration velocity in the experimental group recovered similar to the normal control level. The difference is very small and they are not statistically significant below 1 kHz (p=0.074). By OCT and light microscopic examination, regenerated TM of the experimental group showed thickened fibrous and mucosal layer. In contrast, the control group showed absence of fibrous layer like a dimeric TM.
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Affiliation(s)
- Chul Ho Jang
- Department of Otolaryngology, Chonnam National University Medical School, Gwangju, South Korea; Research Center for Resistant Cells, Chosun Medical School, Gwangju, South Korea
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