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In response to Tympanic membrane repair using silk fibroin and acellular collagen scaffolds
Author(s) -
Shen Yi,
Teh Bing Mei,
Dilley Rodney J.
Publication year - 2016
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.25935
Subject(s) - research centre , medicine , china , library science , history , archaeology , computer science
We appreciate Dr. Lou’s comments on our successful repair of traumatic tympanic membrane (TM) perforations in guinea pigs with biomaterial scaffolds. In the letter, Dr. Lou compares other effective approaches to the treatment of traumatic TM perforations such as using growth factors (GF) alone or in combination with biomaterials. Indeed, recent advances in tissue engineering have provided numerous alternative therapies for TM regeneration. It is evident that some scaffolds and GFs interact to achieve TM repair with different mechanisms. Scaffolds offer structural support to guide regenerating tissue, whereas GFs enhance cellular proliferation and migration. Because not all GFs or scaffolds are effective adjuncts to healing, the efficacy for each needs to be established experimentally to optimize outcomes. Whether one single approach will provide the best outcome for the complex set of conditions seen clinically is not yet clear. In our study, silk and collagen patches not only shortened the closure time but also enhanced the quality of the neomembrane. This finding is similar to other previous studies, illustrating that a patching material is beneficial in guiding the regenerating epithelial growth. Moreover, Dr. Lou suggested that studies of patch materials should be performed on chronic TM perforations, to which we completely agree and had published this view in our article. The majority (up to 94%) of acute TM perforations heal spontaneously without any intervention, so there is limited benefit to accelerate healing of an acute or traumatic perforation. In this study, we utilized an acute animal model due to the lack of an appropriate chronic perforation animal model at that stage. Various attempts have been made to create a chronic perforation model in rodents; however, most only delayed healing rather than produced chronic wounds. Recently, our research group has developed a chronic perforation rat model using ventilation tube and mitomycin C/dexamethasone treatment, which we are now using to evaluate various treatments for chronic perforations. The future will tell whether studies of ventilation tube-related mechanisms may also provide insight to treatment of other mechanisms that produce chronic TM perforations.