title: Repair of tympanic membrane perforation using novel adjuvant therapies: a contemporary review of experimental and tissue engineering studies.
abstract: OBJECTIVE
  To perform a contemporary review of experimental studies to describe the effects of various novel adjuvant therapies in enhancing tympanic membrane (TM) perforation healing.
  
  
  METHODS
  A PubMed search for articles from January 2000 to June 2012 related to TM perforation, along with the references of those articles, was performed. Inclusion and exclusion criteria were applied to all experimental studies assessing adjuvant therapies to TM healing.
  
  
  RESULTS
  Many studies have assessed the efficacy of biomolecules or growth factors, such as epidermal growth factors and basic fibroblast growth factors, in TM regeneration with significant success. More recent strategies in TM tissue engineering have involved utilizing bioengineered scaffold materials, such as silk fibroin, chitosan, calcium alginate, and decellularized extracellular matrices. Most scaffold materials demonstrated biocompatibility and faster TM perforation healing rates.
  
  
  CONCLUSIONS
  Although several studies have demonstrated promising results, many questions still remain, such as the adequacy of animal models and long-term biocompatibility of adjuvant materials. As well, further studies comparing various adjuvant substances and bioscaffolds are required prior to clinical application.
authors.affiliation: IWK Health Centre, Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada. Paul.Hong@iwk.nshealth.ca
authors.forename: Paul
authors.initials: P
authors.lastname: Hong
authors.forename: Manohar
authors.initials: M
authors.lastname: Bance
authors.forename: Paul F
authors.initials: PF
authors.lastname: Gratzer
mesh_terms: D000818:Animals; D001672:Biocompatible Materials; D017024:Chemotherapy, Adjuvant; D004195:Disease Models, Animal; D004815:Epidermal Growth Factor / Q000627:therapeutic use; D016222:Fibroblast Growth Factor 2 / Q000627:therapeutic use; D005349:Fibroins / Q000627:therapeutic use; D006801:Humans; D020380:Needs Assessment; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D023822:Tissue Engineering / Q000379:methods*; D054457:Tissue Scaffolds; D016896:Treatment Outcome; D018058:Tympanic Membrane Perforation / Q000188:drug therapy* / Q000601:surgery; D014945:Wound Healing / Q000187:drug effects* / Q000502:physiology
chemical_list: D001672:Biocompatible Materials; D016222:Fibroblast Growth Factor 2; D004815:Epidermal Growth Factor; D005349:Fibroins