Repair of the tympanic membrane with urinary bladder matrix

Abstract

Objectives/Hypothesis-To test urinary bladder matrix (UBM) as a potential treatment for tympanic membrane (TM) healing and regeneration.Study Design-This prospective pilot study was designed to provide both qualitative and semiquantitative assessment of temporal and spatial healing events in the chinchilla model of chronic TM perforations with and without UBM patching.Methods-Bilateral myringotomies were performed and repeated as necessary to create subtotal perforations over an 8-week period. Myringoplasty was then performed, with left TMs serving as controls and right TMs receiving UBM patches. TMs were excised at 4 weeks, 8 weeks, and 12 weeks. Fixed tissue samples were characterized for gross morphology, then processed for microscopic evaluation.Results-Chronic perforations were maintained with one or more repeated myringotomies. Although both control and patched TMs were thicker than native tissue, patched TMs were transparent and uniform in thickness without any inclusions. UBM patches were readily degraded and replaced by newly deposited and organized host tissue that recapitulated the native TM layers.Conclusions-UBM scaffolds were an effective biological scaffold for TM closure and tissue remodeling, leading to thicker than normal anatomy but otherwise normal morphology. Future studies are required to determine functional and temporal outcomes as well as alternative patch orientations. The results show particular promise as a superior alternative means of reconstructing not only chronic TM perforations but also dimeric TMs associated with retraction pockets and atelectasis.

Extracellular Matrix Degradation Products and Low-Oxygen Conditions Enhance the Regenerative Potential of Perivascular Stem Cells

“…33 The specific molecules within the UBM degradation products that are responsible for the effects reported herein are unknown. ECM facilitates constructive remodeling in a variety of tissues, 29,[34][35][36][37][38][39] and endogenous progenitor/stem cells participate in this process. 6,40 Bioactive degradation products of ECM promote the migration of a variety of cell types, including terminal Schwann cells, 41 endothelial cells, 42 and the perivascular stem cell population used in this present study.…”

Comparing the endothelialisation of extracellular matrix bioscaffolds with coated synthetic vascular graft materials

“…ECM materials are at the forefront of biomaterial research and have been successfully used in a diverse range of medical applications [13][14][15]. As our understanding of these materials increases, it is becoming more apparent that they possess many properties that would make them ideal for use in vascular tissue engineering.…”

“…The aim of this study is to compare the endothelialisation of the most commonly employed graft coating clinically; fibrincoated expanded polytetrafluoroethylene (ePTFE) with novel decellularised xenogenic extracellular matrix (ECM) scaffolds. ECM scaffolds support the growth of several cell types [10][11][12] and have already proven successful in reconstructing a wide range of specialised tissues [13][14][15]. The ECM scaffolds we are examining are derived from the porcine urinary bladder wall -Urinary Bladder Matrix (UBM) and porcine jejunum -Small Intestine Submucosa (SIS).…”

A Healing Method of Tympanic Membrane Perforations Using Three-Dimensional Porous Chitosan Scaffolds

“…[1][2][3][4][5] With recent rapid advances in regenerative medicine fields related to biomaterials, tissue engineering, drug delivery, and stem cell therapy, novel methods to heal TM perforations have been studied as alternatives to surgical repairs of TM perforations. Many researchers have attempted to regenerate TM using biomaterials, such as collagen, 6 hyaluronic acid, 7 Poly(B-benzyl-L-aspartate-co-L-leucine)50/50, calcium alginate, 9 silk, 10,11 chitosan, 3,12 AlloDerm, 2 or urinary bladder matrix, 13 which is based on the paper patch technique. These studies demonstrated that biomaterials as an artificial TM patch may play a role in potential therapy for healing TM perforations without surgical treatments.…”