Endoscopic Regenerative Medicine for Tympanic Membrane

  • Shin-ichi KanemaruEmail author


Applying the principles of modern in situ tissue engineering, we developed a new regenerative treatment for tympanic membrane (TM) perforation using a combination of basic fibroblast growth factor (b-FGF), gelatin sponge, and fibrin glue, without the need for conventional surgical procedures or cell transplantation. Neither skin incisions nor the harvesting of autologous tissues is required to fully regenerate normal tympanic membrane (TM) morphology. With this technique, high success/cure rates and optimal hearing improvements are possible. Moreover, it can be performed within 20 min and is a simple, easy, and minimally invasive surgery. However, there are many cases in which it is difficult to visualize the entire TM perforation and tympanic cavity using a standard microscope. We thus attempted to apply this regeneration procedure to such cases using an endoscope and achieved a very high success rate for TM regeneration. This expands the application of endoscopic middle ear surgery to include TM regeneration.


Regeneration Tympanic membrane Gelatin sponge Basic fibroblast growth factor Middle ear surgery Tissue engineering 


  1. 1.
    Zdrahala RJ, Zdrahala IJ. In vivo tissue engineering: part I. Concept genesis and guidelines for its realization. J Biomater Appl. 1999;14:192–209.CrossRefGoogle Scholar
  2. 2.
    Kimura Y, Tsuji W, Yamashiro H, et al. In situ adipogenesis in fat tissue augmented by collagen scaffold with gelatin microspheres containing basic fibroblast growth factor. J Tissue Eng Regen Med. 2010;4:55–61.PubMedGoogle Scholar
  3. 3.
    Richter W. Mesenchymal stem cells and cartilage in situ regeneration. J Intern Med. 2009;266:390–405.CrossRefGoogle Scholar
  4. 4.
    Kanemaru S, Umeda H, Kitani Y, et al. Regenerative treatment for tympanic membrane perforation. Otol Neurotol. 2011;32:1218–23.CrossRefGoogle Scholar
  5. 5.
    Omae K, Kanemaru SI, Nakatani E, et al. Regenerative treatment for tympanic membrane perforation using gelatin sponge with basic fibroblast growth factor. Auris Nasus Larynx. 2017;44(6):664–71.CrossRefGoogle Scholar
  6. 6.
    Tarabichi M. Transcanal endoscopic management of cholesteatoma. Otol Neurotol. 2010;31:580–8.PubMedGoogle Scholar
  7. 7.
    Tarabichi M, Marchioni D, Presutti L, et al. Endoscopic transcanal ear anatomy and dissection. Otolaryngol Clin N Am. 2013;46:131–54.CrossRefGoogle Scholar
  8. 8.
    Knutsson J, von Unge M, Rask-Andersen H. Localization of progenitor/stem cells in the human tympanic membrane. Audiol Neurootol. 2011;16:263–9.CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  1. 1.Department of Otolaryngology – Head and Neck SurgeryMedical Research Institute, Kitano HospitalOsakaJapan
  2. 2.Translational Research Informatics Center, Foundation for Biomedical Research and InnovationKobeJapan

Personalised recommendations