A trans-well-based cellular model for the rapid pre-evaluation of tympanic membrane repair materials.

It is important to have a standardized tympanic membrane (TM) perforation platform to evaluate the various myringoplasty materials that have been studied and developed extensively during recent years. However, currently there are no cellular models specifically designed for this purpose, and animal models remain unsatisfactory. The purpose of this study is to propose an inexpensive, readily available, well-controlled, and easy-to-create cellular model as a substitute for use in the evaluation of TM repairing materials. A trans-well model was created using a cell culture insert with a round hole created at the center of the polycarbonate membrane. HaCaT cells were cultured on the fenestrated culture insert, and the desired myringoplasty graft was placed at the center of the window for one week and observed by fluorescent microscopy under vital staining. Under this cellular model, there was notable migration of HaCaT cells onto the positive control graft (rabbit fascia), while only a few cell clusters were observed on the negative control graft (paper). Model validation showed that the cell migration ratio for the PLLA + 1% hyaluronic acid (HA) graft is significantly higher than using myringoplasty paper, poly L-lactide (PLLA), or PLLA + 0.5% HA (p < 0.05). This trans-well-based cellular model might be a useful pre-evaluation platform for the evaluation of TM repairing materials. The model is inexpensive, readily available, easy to create, and standardized for use.

Hyaluronic acid fat graft myringoplasty vs fat patch fat graft myringoplasty.

We aim to compare the hyaluronic acid to fat graft myringoplasty (HAFGM) technique to a recently described modified-FGM (M-FGM) in the repair of tympanic membrane perforation (TMP). We also aim to evaluate the hearing level improvement postoperatively. We conducted a prospective study in an adult tertiary care center between 2012 and 2013. Adult patients presenting with simple TMP were operated on randomly using either HAFGM or M-FGM under local anesthesia in outpatients' settings. Success was considered when complete closure is achieved. Audiometric parameters were evaluated pre and postoperatively. Twenty-four patients were included in the study (HAFGM: 10 patients and M-FGM: 14 patients). Complete closure was achieved in 80 % in HAFGM vs 42.8 % in the M-FGM (p = 0.03). The study was abandoned due to the low success rate in first 14 patients of the M-FGM group. The pure tone audiometry was improved postoperatively in the HAFGM only. The study was aborted because of the unsatisfactory obtained results using the MFGM. It also shows the beneficial effect of hyaluronic acid application to FGM for a successful TMP repair.