EFFECT OF EPIDERMAL GROWTH-FACTOR ON TYMPANIC MEMBRANES WITH CHRONIC PERFORATIONS - A CLINICAL-TRIAL

Epidermal growth factor is an important modulator of cell growth, and its role in normal wound healing is well documented, Epidermal growth factor receptors have been identified in tympanic membranes of differe nt animals, The ability of epidermal growth factor to promote healing of tympanic membrane perforations has recently been shown in experimen tal animals, We performed a double-blind, placebo-controlled study of the effect of epidermal growth factor applied locally on the tympanic membrane for I week in patients with chronic perforations, Seventeen a dult patients took part in the study, eight in the epidermal growth fa ctor group and nine in the placebo group. Three placebo-treated patien ts were later treated with epidermal growth factor, and five patients received repeated epidermal growth factor treatment, Perforation size was measured as a percentage of the tympanic membrane area before and at least I month (mean, 2.6 months) after treatment, One perforation i n the placebo group healed completely, but none of the epidermal growt h factor-treated perforations closed. Perforations became slightly sma ller in both groups (mean decrease, 0.3% and 2.7% for epidermal growth factor and placebo, respectively), but these changes in size were not statistically significant for either group, At otomicroscopy, a proli feration reaction with thickening of the tympanic membrane and pseudom embrane formation at the perforation edge could be seen in some ears, Histologically, a sample from one epidermal growth factor-treated ear demonstrated signs of hypertrophic epithelium when compared with the m orphology of a placebo-treated tympanic membrane. The only complicatio ns were two mild infections in the placebo group, Hearing remained sta ble after epidermal growth factor treatment.