Use of ambulatory anesthesia with manually assisted ventilation for tympanic membrane regeneration therapy in children

A Systematic Review of Nonautologous Graft Materials Used in Human Tympanoplasty

“…Sixteen publications, with a total of 1,079 ears, analyzed the efficacy of growth factors with for TM regeneration 12,48,52–65 . Studies employed basic fibroblast growth factor (bFGF) or epidermal growth factor (EGF).…”

“…The exception is the relatively high quality studies on bFGF and EGF that reviewed both acute and traumatic perforations, as well as a relatively high percent of postinfectious perforations (30.6%). Closure rates for chronic perforations range from 57.5% to 100% with some more recent studies from a single group demonstrating higher rates of success, perhaps due to improved surgical/application technique 53,58–61 . A single study using SIS demonstrated successful TM repair in cases of chronic infectious and traumatic perforations; however, these results are from a single surgeon and have not yet been reproduced on a large scale 70 .…”

“…Whereas this clearly represents a dedicated effort to elucidate optimal materials for TM repair, it also raises questions about overlapping patient populations and reproducibility of results. Recently, an RCT using bFGF was performed in the United States 65 in an effort to duplicate previously reported outcomes 53,58–61 . The US authors found no difference in closure rates or hearing outcomes when compared to placebo, raising significant questions about the reproducibility of the earlier results.…”

“…Sixteen publications, with a total of 1,079 ears, analyzed the efficacy of growth factors with for TM regeneration. 12,48,[52][53][54][55][56][57][58][59][60][61][62][63][64][65] Studies employed basic fibroblast growth factor (bFGF) or epidermal growth factor (EGF). A close distribution of acute (47.7%) and chronic (52.3%) perforations were included; however, the majority of cases were of a traumatic etiology (57.7%), whereas only 30.6% were postinfectious (Table II).…”

Regeneration of the tympanic membrane using fibroblast growth factor-2

“…Of the 11 studies on traumatic tympanic membrane perforation in humans, 3 were randomised controlled trials (RCTs), 14 , 19 , 23 4 were prospective controlled studies, 15 , 16 , 18 , 22 1 was a single-arm and exploratory clinical trial, 20 2 were prospective, quasi-randomised, controlled clinical studies, 17 , 24 and 1 was a retrospective cohort study 21 . Of the eight studies on chronic tympanic membrane perforation in humans, one was an RCT, 25 four were prospective single-arm studies, 26 – 29 one was a prospective controlled study 30 and two were retrospective studies 31 , 32 Table I.Summary of fibroblast growth factor-2 effects on experimental tympanic membrane perforation Table II.Summary of fibroblast growth factor-2 effects on human traumatic tympanic membrane perforation Table III.Summary of fibroblast growth factor-2 effects on tympanic membrane perforation with chronic suppurative otitis media…”