Repair of chronic tympanic membrane perforations with long-term epidermal growth factor.
Chronic tympanic membrane (TM) perforation is a common problem worldwide. Recent reports have shown epidermal growth factor (EGF) to stimulate healing in approximately 80% of chronic TM perforations in chinchillas when applied in three doses over 1 week. The objective of this controlled study is to evaluate the efficacy of long-term EGF in the closure of TM perforations. Chronic chinchilla TM perforations were treated with EGF for up to 6 weeks. One hundred percent (17 of 17) of treatment group perforations completely healed. However, two new findings with this long dosing scheme were reperforation on long-term follow-up and three TMs with cholesteatomas. It is likely that reperforation was due to a progressive thinning seen with prolonged EGF application. Long-term EGF use is not recommended for the treatment of TM perforations because of possible wound healing impairment and possible cholesteatoma induction.
Dvorak
D W
DW
Department of Otolaryngology, Ohio State University, Columbus 43210, USA.
Abbas
G
G
Ali
T
T
Stevenson
S
S
Welling
D B
DB
D000818:Animals; D002682:Chinchilla; D018424:Cholesteatoma, Middle Ear / Q000209:etiology / Q000473:pathology; D002908:Chronic Disease; D004334:Drug Administration Schedule; D004724:Endoscopy; D004815:Epidermal Growth Factor / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005500:Follow-Up Studies; D005781:Gelatin Sponge, Absorbable; D008137:Longitudinal Studies; D010919:Placebos; D012008:Recurrence; D012421:Rupture; D012965:Sodium Chloride; D013997:Time Factors; D014432:Tympanic Membrane / Q000187:drug effects* / Q000293:injuries* / Q000473:pathology; D014945:Wound Healing
D010919:Placebos; D012965:Sodium Chloride; D004815:Epidermal Growth Factor