title: A review on the use of hyaluronic acid in tympanic membrane wound healing.
abstract: BACKGROUND
  Tympanic membrane perforation represents a significant morbidity, especially if it occurs during a child's speech and language development. Recently, there has been an increased interest in hyaluronic-acid-related research and products as a potential therapeutic option for tympanic membrane perforation repair.
  
  
  METHODS
  This review describes the physical and chemical properties of hyaluronic acid and examines the role of hyaluronic acid in wound healing, in particular on the tympanic membrane. It also reviews the safety and efficacy of hyaluronic acid and its derivatives in animal studies as well as in clinical trials. Finally, it considers the potential future clinical applications in tympanic membrane perforation repair.
  
  
  CONCLUSIONS
  Hyaluronic acid has been found to accelerate tympanic membrane perforation closure, shorten the period of healing, produce a better quality neo-membrane and improve hearing. More importantly, hyaluronic acid is biodegradable, safe and biocompatible in the ear. Recently, there has been a trend towards the use of modified hyaluronic acid. However, there is a lack of higher-level evidence to support the use of hyaluronic acid in tympanic membrane perforations in the clinical setting. More large-scale randomised control trials are warranted before these bio-devices will be used routinely.
authors: Ear Sciences Centre, School of Surgery, The University of Western Australia, M507, 35 Stirling Highway, Nedlands, Western Australia, 6009, Australia. bm_teh@yahoo.co.uk
authors: Bing Mei
authors: BM
authors: Teh
authors: Yi
authors: Y
authors: Shen
authors: Peter L
authors: PL
authors: Friedland
authors: Marcus D
authors: MD
authors: Atlas
authors: Robert J
authors: RJ
authors: Marano
mesh_terms: D000162:Acoustics; D000818:Animals; D001672:Biocompatible Materials / Q000737:chemistry; D002986:Clinical Trials as Topic; D004548:Elasticity; D006801:Humans; D006820:Hyaluronic Acid / Q000737:chemistry / Q000378:metabolism* / Q000494:pharmacology; D008956:Models, Chemical; D016032:Randomized Controlled Trials as Topic; D012449:Safety; D014432:Tympanic Membrane / Q000187:drug effects* / Q000293:injuries; D018058:Tympanic Membrane Perforation / Q000188:drug therapy*; D014783:Viscosity; D014945:Wound Healing
chemical_list: D001672:Biocompatible Materials; D006820:Hyaluronic Acid