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.
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