DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20211567

Treatment of tympanic membrane perforation with topical epidermal growth factor: progress towards clinical application

Puneeth S. Nayak, Anil S. Harugop, Prashant H. Patil, Prasad T. V. R. K., Lakshmi Goswami

Abstract


Background: Chronic otitis media is a widespread disease of developing countries, especially of the lower socio-economic group. Medical cost in hospitals associated with tympanoplasty for treating CSOM is very high. Our study investigates the efficacy of epidermal growth factor along with chemical cautery in healing of chronic tympanic membrane perforation on an outpatient department (OPD) basis. Hence providing a cheaper and cost effective treatment alternative to the patients.

Methods: A total number of 70 patients with signs of COM attending ENT OPD were selected. The patients were randomly assigned into 2 groups each with a sample size of 35. Otoendoscopy and pure tone audiometry was performed. Group A was treated with EGF with chemical cautery and group B was treated with only chemical cautery. Both groups were followed up after 15 days, one month and second month of the procedure in ENT outpatient clinic.

Results: The success rate of these non-healing perforation was found to be significantly higher in group A (29 [82.86%]) compared with group B (17 [65.71%]) with P value of 0.0070*.

Conclusions: This study shows a statistically significant result with topical application of epidermal growth factor in small to medium non-healing central tympanic membrane perforation. Due to the promising result of epidermal growth factor, it could be considered as office myringoplasty.  


Keywords


Chronic otitis media, Tympanic membrane perforation, Epidermal growth factor, Carbolic acid

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References


Berman S.Otitis media in developing countries. Pediatrics. 1995;96:126-31.

Dvorak DW, Abbas G, Ali T, Stevenson S, Welling DB. Repair of chronic tympanic membrane perforations with long-term epidermal growth factor. Laryngoscope. 1995;105(12 Pt 1):1300-1304.

Ma Y, Zhao H, Zhou X. Topical Treatment with Growth Factors for Tympanic Membrane Perforations: Progress Towards Clinical Application. Acta Oto-Laryngological. 2002;122(6):586-599.

Browning GG. The prevalence of middle ear disease in the adult British population. Clin Otolaryngol Allied Sci. 1992;17(4):317-21.

Bennett KE, Haggard MP. Accumulation of factors influencing children's middle ear disease: risk factor modeling on a large population cohort. J Epidemiol Community Health. 1998;52(12):786-793.

Tsang MW, Wong WK, Hung CS, et al. Human epidermal growth factor enhances healing of diabetic foot ulcers. Diabetes Care. 2003;26(6):1856-1861.

Chauvin K, Bratton C, Parkins C. Healing large tympanic membrane perforations using hyaluronic acid, basic fibroblast growth factor, and epidermal growth factor. Otolaryngol Head Neck Surg. 1999;121(1):43-473.

Ramsay HA, Heikkonen EJ, Laurila PK. Effect of epidermal growth factor on tympanic membranes with chronic perforations: a clinical trial. Otolaryngol Head Neck Surg. 1995;113(4):375-3793.

Cho, Lee KS Shin DG, Park D, Chon YD,Myong K. The importance of vascular endothelial growth factor in the healing of acute tympanic membrane perforation. Am J Otolaryngol. 2009;31:309-14.

Johnson AP, Smallman LA, Kent SE. The Mechanism of Healing of Tympanic Membrane Perforations. Acta Oto-Laryngologica. 1990;109:5-6:406-415.

Maria SPL, Redmond SL, Atlas MD, Ghassmifar R. The role of epidermal growth in the healing tympanic membrane following perforation in rats. J Mol Histol. 2010;41(6):309-314.

Brown GL, Nanney LB, Griffen J. Enhancement of wound healing by topical treatment with epidermal growth factor. N Engl J Med. 1989;321:76-9.

Altman DG, Schulz KF, Moher D. CONSORT GROUP.The revised CONSORT statement for reporting randomized trials: explanation and elaboration. Ann Intern Med. 2001;134(8):663-694.

Vikram B, Bijiraj V, Vidyashree M. Effect of Silver Nitrate and Epidermal Growth Factor on Nonhealing Tympanic Membrane Perforations: A Randomized Controlled Study. Ann Otol Neurotol. 2018;01:029-033.900-6.