The Reconstruction of Tympanic Membrane Perforations using Various Biomaterials: A Narrative Review

Abstract

Tympanic Membrane Perforations (TMP), resulting from trauma or infections, can result in auditory impairment and recurring infections. Conventional surgical techniques, such as tympanoplasty, employ autologous grafts such fascia and cartilage; however, these approaches can be invasive, result in scarring and are subject to limitations including graft rejection and increased costs. Biomaterials such as Hyaluronic Acid (HA), collagen and gelatin sponges are being explored for Tympanic Membrane (TM) repair to resolve these issues. HA, recognised for its function in tissue regeneration, has demonstrated efficacy in facilitating TM healing by cell proliferation and revascularisation. Techniques such as HA fat graft myringoplasty have attained success rates of up to 92.7%. Collagen, another crucial biomaterial, promotes fibroblast proliferation and aids in the restoration of the TM’s fibrous layer. Repairs utilising collagen have exhibited success rates between 66.7% and 92%, contingent upon the extent of the perforation. Gelatin sponges, commonly utilised as scaffolds in the healing process, offer structural support and mitigate inflammation. These biomaterials have substantial advantages, including diminished surgical complications, expedited healing period and minimised scarring, rendering them advantageous substitutes for conventional grafts. Biomaterials are particularly advantageous in situations where autologous tissue grafting is impractical, offering effective and novel techniques for TM restoration. The review discusses advancements in the treatment of TMPs employing biomaterials.

Keywords

• chronic otitis media
• myringoplasty
• regenerative medicine
• tissue engineering
• tympanic membrane reconstruction
• tympanoplasty