title: Tympanic membrane repair using silk fibroin and acellular collagen scaffolds.
abstract: OBJECTIVE
  To evaluate the efficacy of silk fibroin scaffolds (SFS) and acellular collagen scaffolds (ACS) for the repair of tympanic membrane (TM) in a guinea pig acute perforation model.
  
  
  METHODS
  Experimental animal research.
  
  
  METHODS
  Seventy-two albino guinea pigs underwent perforation of the right TM and were divided into four experimental groups (n = 18). The perforations were repaired with SFS, ACS, and paper patch using onlay myringoplasty, or they were allowed to heal spontaneously (control). An additional group of 10 guinea pigs without perforation or scaffold was allocated as a normal TM group. Guinea pigs in each experimental group (n = 6) were evaluated at 7, 14, and 28 days following surgery. TM structural healing was evaluated by otomicroscopy and histology, and functional hearing was analyzed by auditory brainstem responses (ABR). Prior to the study, mechanical properties of SFS and ACS were investigated.
  
  
  RESULTS
  Tensile strength and elasticity of SFS and ACS were within the known range for human TM. Based on otologic and histologic evaluation, TMs treated with SFS or ACS showed complete closure of the perforation at an earlier stage, with a trilaminar structure and more uniform thickness compared to paper patch and control treated groups. ABR assessment demonstrated that SFS or ACS treatment facilitated a faster restoration of hearing function compared to paper patch and control groups.
  
  
  CONCLUSIONS
  The results of this study show that SFS and ACS are effective graft materials and may be utilized as alternatives to current grafts for TM repair.
authors.affiliation: Ear Sciences Centre, School of Surgery, The University of Western Australia, Nedlands, Western Australia, Australia. shen.yi@earscience.org.au
authors.forename: Yi
authors.initials: Y
authors.lastname: Shen
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Redmond
authors.forename: Bing Mei
authors.initials: BM
authors.lastname: Teh
authors.forename: Sheng
authors.initials: S
authors.lastname: Yan
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.forename: Marcus D
authors.initials: MD
authors.lastname: Atlas
authors.forename: Rodney J
authors.initials: RJ
authors.lastname: Dilley
authors.forename: Minghao
authors.initials: M
authors.lastname: Zheng
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Marano
mesh_terms: D000818:Animals; D003094:Collagen; D004195:Disease Models, Animal; D005349:Fibroins / Q000627:therapeutic use*; D006168:Guinea Pigs; D009225:Myringoplasty / Q000379:methods*; D047011:Silk / Q000627:therapeutic use*; D013718:Tensile Strength; D054457:Tissue Scaffolds; D014432:Tympanic Membrane / Q000601:surgery*; D018058:Tympanic Membrane Perforation / Q000601:surgery*; D014945:Wound Healing
chemical_list: D047011:Silk; D003094:Collagen; D005349:Fibroins
keywords: Tympanic membrane; collagen; guinea pig; paper patch; perforation; repair; scaffolds; silk fibroin