Otological therapeutic usage of epidermal growth factor in healing of Tympanic membrane perforation- A Clinical Observational study

Abstract

Background: Chronic tympanic membrane (TM) perforations are a prevalent
complication of chronic otitis media (COM), especially in low-resource settings.
Conventional treatment via tympanoplasty, though effective, is limited by cost, need
for surgical expertise, and hospital infrastructure. Epidermal growth factor (EGF),
known for its role in epithelial proliferation and tissue repair, has emerged as a
promising non-invasive therapeutic alternative.
Objective: To evaluate the efficacy of topical recombinant human EGF (rhEGF) in
promoting the healing of chronic small central TM perforations, when used in
conjunction with chemical cauterization.
Methods: This single-blind randomized controlled trial was conducted over one year
and included 150 patients with dry, non-healing small central TM perforations.
Patients were randomized into two equal groups: Group A received topical EGF with
chemical cautery, while Group B received cautery alone. Outcomes were assessed at
15 days, 1 month, and 2 months post-intervention, based on TM closure and
audiometric improvement.
Results: Group A demonstrated significantly higher rates of TM closure (60%) and
overall improvement (82.86%) compared to Group B (28.57% and 65.71%,
respectively). EGF application led to more complete closures and greater reduction
in perforation size. Hearing thresholds also improved in patients with successful TM
healing.
Conclusion: Topical EGF, when applied after edge cauterization, is a safe, effective,
and economical outpatient treatment for small chronic TM perforations. It offers a
viable alternative to surgical tympanoplasty, especially in resource-limited
environments.