Preliminary results of the application of a silk fibroin scaffold to otology

Abstract

The surgical treatment to repair chronic tympanic membrane perforations is myringoplasty. Although multiple autologous grafts, allografts, and synthetic graft materials have been used over the years, no single graft material is superior for repairing all perforation types. Recently, the remarkable properties of silk fibroin protein have been studied, with biomedical and tissue engineering applications in mind, across a number of medical and surgical disciplines. The present study examines the use of silk fibroin for its potential suitability as an alternative graft in myringoplasty surgery by investigating the growth and proliferation of human tympanic membrane keratinocytes on a silk fibroin scaffold in vitro. Light microscopy, immunofluorescent staining, and confocal imaging all reveal promising preliminary results. The biocompatibility, transparency, stability, high tensile strength, and biodegradability of fibroin make this biomaterial an attractive option to study for this utility.

A prospective cohort study of the silk fibroin patch in chronic tympanic membrane perforation

“…Silk fibroin supports adhesion, proliferation, and cell differentiation of cells in vitro, including human TM keratinocytes . A rat study reported hearing and healing benefits of silk fibroin membranes using only myringoplasty .…”

Phenotypic and genotypic profile of human tympanic membrane derived cultured cells

“…This research highlights the need for the evaluation and monitoring the phenotype of experimental cells at both low and high passage numbers to maintain experimental reliability and validity. A stable and committed keratinocyte cell population (in vitro) derived from the hTM is essential in our current goal of developing a biocompatible scaffold tailored specifically to enhancing keratinocyte growth with the long-term aim of utilization in myringoplasty (Ghassemifar et al 2010;Levin et al 2010 …”

“…By utilizing in vitro models that are biologically relevant to the tissue and parental cell type, important information can be revealed with a view towards reconstruction and replacement of diseased or damaged structures (Atala 2006), in this case chronic perforations of the hTM. We have reported the culture of hTM epithelial cells (hTMk) on silk substrates (Levin et al 2010) with the aim of testing alternative grafts for repairing perforated human eardrums. However, if cultured primary cells are to be used as the progenitors of an engineered tissue or organ, their phenotypic and genotypic integrity must be maintained throughout the culture process.…”

Effect of local irradiation with 630 and 860 nm low-level lasers on tympanic membrane perforation repair in guinea pigs

“…[6][7][8][9][10][11] For more than four decades, low-level laser therapy has been regarded in many medical fields as an efficient approach to wound healing, inflammation reduction and disease treatment. However, in light of the costs involved, long hospitalisation period and consequences of surgery, more recent studies have focused on alternative treatment approaches such as myringoplasty, graft myringoplasty and, most recently, laser therapy.…”