Repairing the eardrum: The sound of self-healing


A new way to heal ruptured eardrums could soon be music to the ears of doctors and patients. A ruptured eardrum is relatively common. As well as being painful, it makes it hard to hear and exposes the ear to infection. That’s because the eardrum acts as a barrier, keeping bacteria and other nasties out of the middle ear. Its other main role is carrying sound waves to the bones that enable us to hear. To do this effectively, the eardrum needs to be thin; the membrane is just a fraction of a millimetre thick. But this makes it easy to tear. A tear is most often caused by infection which leads to a build-up of pressure behind the eardrum. But a tear might also be caused by a sudden change of pressure outside the ear, or a misplaced cotton bud. Almost all small tears heal naturally over the course of several weeks but large tears may need to be repaired by a doctor. At the moment, surgery is the only option. The surgeon takes a small patch of skin from just above the ear, and stitches it onto the damaged eardrum. This works most of the time, but as with all surgery, it can be expensive and time-consuming. Plus there are risks, including complications from the anaesthetic and nerve damage. Now, an alternative is within earshot. Rather than covering the tear with a patch of skin, scientists are trying to coax the eardrum into repairing itself. The idea is to build a scaffold which can bridge the tear, then add a growth factor to encourage the eardrum’s own cells to close the wound. The scaffold that seems to work best is a sponge made from gelatin. It can be cut to any size; it’s a 3D structure so cells can grow inside it as well as on its surface, and it can be easily absorbed by the body after doing its job. Japanese researchers found that by cutting a sponge down to the size of the tear and loading it with a fibroblast growth factor – a chemical normally produced by the body during wound healing – they could stimulate the eardrum to repair itself. The sponge scaffold is stuck in place using fibrin glue that forms a clot, like when blood clots to seal a wound. There’s no need for a skin graft, and the procedure only requires a local anaesthetic. The sponge has been tested in patients, and seems to work well. We’re expecting results from a much larger clinical trial later this year. So listen out for a new kind of treatment for ruptured eardrums soon…

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