Ear Sciences Centre, School of Surgery, The University of Western Australia, M507, 35 Stirling Highway, Nedlands, Western Australia, 6009, Australia.
Expert Opin Biol Ther. 2012 Jan;12(1):23-36. doi: 10.1517/14712598.2012.634792. Epub 2011 Nov 8.
Tympanic membrane perforation represents a significant morbidity, especially if it occurs during a child's speech and language development. Recently, there has been an increased interest in hyaluronic-acid-related research and products as a potential therapeutic option for tympanic membrane perforation repair.
This review describes the physical and chemical properties of hyaluronic acid and examines the role of hyaluronic acid in wound healing, in particular on the tympanic membrane. It also reviews the safety and efficacy of hyaluronic acid and its derivatives in animal studies as well as in clinical trials. Finally, it considers the potential future clinical applications in tympanic membrane perforation repair.
Hyaluronic acid has been found to accelerate tympanic membrane perforation closure, shorten the period of healing, produce a better quality neo-membrane and improve hearing. More importantly, hyaluronic acid is biodegradable, safe and biocompatible in the ear. Recently, there has been a trend towards the use of modified hyaluronic acid. However, there is a lack of higher-level evidence to support the use of hyaluronic acid in tympanic membrane perforations in the clinical setting. More large-scale randomised control trials are warranted before these bio-devices will be used routinely.
鼓膜穿孔是一种严重的疾病，尤其是在儿童言语和语言发育期间发生穿孔时。最近，人们对透明质酸相关的研究和产品产生了浓厚的兴趣，将其作为鼓膜穿孔修复的潜在治疗选择。
本文描述了透明质酸的物理和化学特性，并研究了透明质酸在创伤愈合中的作用，特别是在鼓膜上的作用。本文还回顾了透明质酸及其衍生物在动物研究和临床试验中的安全性和有效性。最后，本文考虑了其在鼓膜穿孔修复中的潜在未来临床应用。
透明质酸已被发现可加速鼓膜穿孔闭合，缩短愈合时间，产生更好质量的新膜并改善听力。更重要的是，透明质酸在耳部具有可生物降解性、安全性和生物相容性。最近，人们开始倾向于使用修饰后的透明质酸。然而，目前缺乏更高水平的证据来支持在临床环境中使用透明质酸治疗鼓膜穿孔。在这些生物器械常规使用之前，需要进行更多大规模的随机对照试验。
