title: Behavior of poly(glycerol sebacate) plugs in chronic tympanic membrane perforations.
abstract: The tympanic membrane (TM), separating the external and middle ear, consists of fibrous connective tissue sandwiched between epithelial layers. To treat chronic ear infections, tympanostomy drainage tubes are placed in surgically created holes in TMs which can become chronic perforations upon extrusion. Perforations are repaired using a variety of techniques, but are limited by morbidity, unsatisfactory closure rates, or minimal regeneration of the connective tissue. A more effective, minimally-invasive therapy is necessary to enhance the perforation closure rate. Current research utilizing decellularized or alignate materials moderately enhance closure but the native TM architecture is not restored. Poly(glycerol sebacate) (PGS) is a biocompatible elastomer which supports cell migration and enzymatically degrades in contact with vascularized tissue. PGS spool-shaped plugs were manufactured using a novel process. Using minimally invasive procedures, these elastomeric plugs were inserted into chronic chinchilla TM perforations. As previously reported, effective perforation closure occurred as both flange surfaces were covered by confluent cell layers; >90% of perforations were closed at 6-week postimplantation. This unique in vivo environment has little vascularized tissue. Consequently, PGS degradation was minimal over 16-week implantation, hindering regeneration of the TM fibrous connective tissue. PGS degradation must be enhanced to promote complete TM regeneration.
authors: Center for Regenerative Medicine, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA. csundback@partners.org
authors: C A
authors: CA
authors: Sundback
authors: J
authors: J
authors: McFadden
authors: A
authors: A
authors: Hart
authors: K M
authors: KM
authors: Kulig
authors: A M
authors: AM
authors: Wieland
authors: M J N
authors: MJ
authors: Pereira
authors: I
authors: I
authors: Pomerantseva
authors: C J
authors: CJ
authors: Hartnick
authors: P T
authors: PT
authors: Masiakos
mesh_terms: D000818:Animals; D002682:Chinchilla; D002908:Chronic Disease; D003651:Decanoates; D005990:Glycerol / Q000031:analogs & derivatives*; D006801:Humans; D008422:Materials Testing; D011108:Polymers; D019736:Prostheses and Implants; D013997:Time Factors; D014432:Tympanic Membrane / Q000473:pathology; D018058:Tympanic Membrane Perforation / Q000473:pathology / Q000628:therapy*; D014945:Wound Healing
chemical_list: D003651:Decanoates; D011108:Polymers; C469892:poly(glycerol-sebacate); D005990:Glycerol