Chronic tympanic membrane (TM) perforation is a common problem worldwide. Recent reports have shown epidermal growth factor (EGF) to stimulate healing in approximately 80% of chronic TM perforations in chinchillas when applied in three doses over 1 week. The objective of this controlled study is to evaluate the efficacy of long-term EGF in the closure of TM perforations. Chronic chinchilla TM perforations were treated with EGF for up to 6 weeks. One hundred percent (17 of 17) of treatment group perforations completely healed. However, two new findings with this long dosing scheme were reperforation on long-term follow-up and three TMs with cholesteatomas. It is likely that reperforation was due to a progressive thinning seen with prolonged EGF application. Long-term EGF use is not recommended for the treatment of TM perforations because of possible wound healing impairment and possible cholesteatoma induction.

Azygos vein aneurysm and thrombosis are rare. It resembles a mediastinal mass that can be seen by chest radiograph, computed tomography, and magnetic resonance imaging. This case describes an elderly woman with a mediastinal mass due to azygos vein aneurysm and thrombosis. She was diagnosed by non-invasive procedures. The etiology of the azygos vein aneurysm was portal hypertension secondary to liver cirrhosis. Re-canalization was established by non-invasive management.