The Effect of Epidermal Growth Factor on the Outcomes of Myringoplasty

Abstract Introduction Chronic otitis media is a widespread disease of developing countries. The burden of the disease continues to be high and so is the demand for surgical myringoplasty. This pilot study aimed to compare in adults the outcomes of myringoplasty with and without the application of epidermal growth factor gel (EGF) with respect to the time taken for graft uptake, improvement of hearing, and complications. Materials and Methods This randomized controlled study was undertaken in a tertiary referral public hospital in a span of 2 years with a sample size of 60 patients. All of them underwent diagnostic nasal endoscopy, otoendoscopy, and pure tone audiometry and treated with conventional underlay myringoplasty using temporalis fascia (Group A—30 cases with EGF, Group B—30 controls without EGF). Patients were followed-up at 15, 30, 90 days postoperatively. Results The average time taken for closure of tympanic perforation and graft uptake by group A was lesser than group B. This difference was found to be statistically significant. Residual perforation at 1 month was commoner in group B as compared with group A. The final improvement of the hearing was the same in both the groups in the healed cases. Conclusion The EGF can be used to improve the outcomes of myringoplasty. It can hasten the closure of tympanic membrane perforation and increase the success rates of the surgery.

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Treatment of tympanic membrane perforation with topical epidermal growth factor: progress towards clinical application

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20211567 ◽

2021 ◽

Vol 7 (5) ◽

pp. 768

Author(s):

Puneeth S. Nayak ◽

Anil S. Harugop ◽

Prashant H. Patil ◽

Prasad T. V. R. K. ◽

Lakshmi Goswami

Keyword(s):

Growth Factor ◽

Epidermal Growth Factor ◽

Tympanic Membrane ◽

Tympanic Membrane Perforation ◽

Cost Effective Treatment ◽

Membrane Perforation ◽

Group A ◽

Epidermal Growth ◽

Group B ◽

Chemical Cautery

Background: Chronic otitis media is a widespread disease of developing countries, especially of the lower socio-economic group. Medical cost in hospitals associated with tympanoplasty for treating CSOM is very high. Our study investigates the efficacy of epidermal growth factor along with chemical cautery in healing of chronic tympanic membrane perforation on an outpatient department (OPD) basis. Hence providing a cheaper and cost effective treatment alternative to the patients.Methods: A total number of 70 patients with signs of COM attending ENT OPD were selected. The patients were randomly assigned into 2 groups each with a sample size of 35. Otoendoscopy and pure tone audiometry was performed. Group A was treated with EGF with chemical cautery and group B was treated with only chemical cautery. Both groups were followed up after 15 days, one month and second month of the procedure in ENT outpatient clinic.Results: The success rate of these non-healing perforation was found to be significantly higher in group A (29 [82.86%]) compared with group B (17 [65.71%]) with P value of 0.0070*.Conclusions: This study shows a statistically significant result with topical application of epidermal growth factor in small to medium non-healing central tympanic membrane perforation. Due to the promising result of epidermal growth factor, it could be considered as office myringoplasty.

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EFFICACY OF PERMEATAL ENDOSCOPIC MYRINGOPLASTY IN INACTIVE (MUCOSAL) CHRONIC OTITIS MEDIA

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71isuppl-3.7915 ◽

2021 ◽

Vol 71 (Suppl-3) ◽

pp. S552-55

Author(s):

Saleem Asif Niazi ◽

Shahzad Maqbool ◽

Yousra Riaz ◽

Zafarullah Khan ◽

Shafaq Zaman ◽

...

Keyword(s):

Tympanic Membrane ◽

Chronic Otitis Media ◽

Pure Tone Audiometry ◽

Tympanic Membrane Perforation ◽

Military Hospital ◽

Graft Take ◽

Group A ◽

Endoscopic Myringoplasty ◽

Group B

Objective: To determine the efficacy of permeatal ednoscopic myringoplasty, in inactive (mucosal) COM regarding, graft take and hearing improvement. Study Design: Quasi-experimental study. Place and Duration of Study: ENT Department, Pak Emirates Military Hospital, Rawalpindi, from Aug 2019 to Feb 2020. Methodology: This was conducted on a sample size of n=100. Patients having inactive (mucosal) COM with dry central small, medium and large perforations were included. Patients were divided in to three groups on the basis of age, group A 15-30 years, group B 31-45 years and group C 46-60 years. All the patients underwent per-meatal endoscopic myringoplasty, without raising the tympano-meatal flap, under general anesthesia. Patients were followed up over a period of six months. Graft take was assessed by microscopy. Hearing was assessed by Pure Tone Audiometry (PTA) with improvement in air bone gap to 15db as primary end point. Data was collected on structured performa. Data was analyzed using SPSS version 17. Results: In this study, 33 (33%) were males and 67 (67%) were females. Age ranged 15-60 years. Out of 5 patients lost to follow up. A total of 95 completed their follow up. Based on age of the patients, in group A, successful graft take was 100%. In group B, it was 91% & in group C it dropped to 46%. On the basis of tympanic membrane perforation size, the graft success rate in small perforations was 94.8%; in medium sized perforations it was 86.8% and in large sized perforations of tympanic membrane it was........

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A comparative study on topical recombinant human epidermal growth factor vs conventional betadine dressing in management of diabetic wounds

International Surgery Journal ◽

10.18203/2349-2902.isj20205868 ◽

2020 ◽

Vol 8 (1) ◽

pp. 115

Author(s):

Ajay Kundal ◽

Manu Kohli ◽

Sudershan Kapoor

Keyword(s):

Wound Healing ◽

Growth Factor ◽

Epidermal Growth Factor ◽

Significant Role ◽

Cardio Vascular Disease ◽

Group A ◽

Epidermal Growth ◽

Cardio Vascular ◽

Group B ◽

Diabetic Wounds

Background: Major complications of diabetes mellitus include cardio vascular disease, chronic kidney disease, diabetic foot ulcers and non-healing wounds. Lack of knowledge and awareness has led to worsening of wounds which can involve deeper tissues and bones also. If treated on time majority of patients can be prevented from undergoing major debilitating surgical procedures such as amputation of toes, foot etc.Methods: In this proposed study, 60 cases of diabetic wounds were studied for healing who were randomly allocated into two groups of 30 patients each. Group A included topical recombinant epidermal growth factor (EGF) application and group B included conventional Betadine dressing for wound healing.Results: Anaemia had a significant role in delaying wound healing in group B patients. Blood sugars had no significant role in delaying wound healing in this study as patients in group A had mean FBS more than group B and still the wound healing was observed better in group A patients. Topical recombinant EGF resulted in faster wound healing than conventional dressings in diabetic wounds. 90% wound healing rates were seen with topical EGF dressings in comparison to 36.67% in conventional betadine dressings. Signs of wound healing i.e., early granulation, decreased discharge, early wound closure were seen faster in group A. Moreover, all patients in group A showed healthy granulation tissue by the end of our study.Conclusions: We concluded that topical recombinant EGF resulted in faster and better wound healing than conventional betadine dressing.

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Heparin-binding epidermal growth factor inhibits apoptosis in cisplatin-resistant pancreatic cancer cells via upregulation of EGFR and ERCC 1 expressions

Tropical Journal of Pharmaceutical Research ◽

10.4314/tjpr.v18i6.3 ◽

2021 ◽

Vol 18 (6) ◽

pp. 1167-1171

Author(s):

Lingyang Zhou ◽

Yuming Wang ◽

Shenghong Lan ◽

Mingfu Hu ◽

Lipeng Lu

Keyword(s):

Pancreatic Cancer ◽

Cell Proliferation ◽

Growth Factor ◽

Epidermal Growth Factor ◽

Cancer Cells ◽

Heparin Binding ◽

Pancreatic Cancer Cells ◽

Group A ◽

Epidermal Growth ◽

Group B

Purpose: To investigate the influence of heparin-binding epidermal growth factor (HB-EGF) on apoptosis in cisplatin-resistant pancreatic cancer cells, as well as its mechanism of action. Methods: Pancreatic cancer cisplatin-resistant cells (BXPC-3/CDDP) were transfected with HB-EGF small interfering RNA (siRNA). The cells were randomly assigned to four groups, namely, BXPC-3 group (group A), BXPC-3/CDDP group (group B), transfected group A (group Asi) and transfected group B (group Bsi). Cell proliferation was determined using MTT assay, and the levels of expression of HBEGF, epidermal growth factor receptor (EGFR) and excision repair cross-complementation group 1 (ERCC 1) were determined using Western blotting. The extent of apoptosis was determined by flow cytometry. Results: Cell proliferation was increased in group B, relative to group A, but was significantly decreased after transfection with HB-EGF siRNA (p < 0.05). The half-maximal inhibitory concentration (IC50) of group Bsi was reduced, relative to group Asi (p < 0.05). The expression of HB-EGF was significantly upregulated in group B, relative to group A (p < 0.05). In contrast, HB-EGF siRNA transfection of the cells significantly down-regulated HB-EGF expression (p < 0.05). Early apoptosis was significantly higher in group A than in groups B and Bsi. Higher levels of apoptosis were seen in group Bsi, relative to group B after inhibition of HB-EGF expression (p < 0.05). Conclusion: These results indicate that HB-EGF is resistant to cisplatin, and it inhibits apoptosis in pancreatic cancer cells via the upregulation of EGFR and ERCC 1 expressions.

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Extent of bronchioloalveolar pattern and expression of the epidermal growth factor receptor in surgically resected lung adenocarcinomas

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.20065 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 20065-20065

Author(s):

I. J. Dahabreh ◽

J. Janinis ◽

E. A. Karagiani ◽

A. Dountsis ◽

K. Vasilikos ◽

...

Keyword(s):

Epidermal Growth Factor Receptor ◽

Growth Factor ◽

Epidermal Growth Factor ◽

Growth Factor Receptor ◽

Female Ratio ◽

Histologic Subtype ◽

Egfr Expression ◽

Group A ◽

Epidermal Growth ◽

Group B

20065 Background: An increasing number of studies are exploring relations between the bronchioloalveolar differentiation of adenocarcinomas and clinical, radiological and molecular parameters. We investigated the potential relation between the extent of the bronchioloalveolar carcinoma (BAC) component of adenocarcinomas and the expression of the epidermal growth factor receptor (EGFR) protein. Methods: We retrospectively reviewed data from all patients who underwent surgery for lung cancer in our hospital between February 1, 2001 and May 31, 2005 (n = 366), and in whom pathologic analysis had revealed an adenocarcinoma histologic subtype. Paraffin embedded tissue samples were retrieved and re-examined. Samples exhibiting either a pure BAC histology or a mixed adenocarcinoma histology with a >50% BAC component (n = 46) were selected for EGFR expression analysis by immunohistochemical staining. Patient demographics, stage and tumor differentiation data were recorded. Histological analysis was carried out using the WHO 1999/2004 criteria for lung cancers. For EGFR expression evaluation, samples were assigned a score ranging from 0 to +3. Expression was considered positive when the score was +1 or higher. Statistical analysis was performed using the chi-square test. Results: Of the 46 tumor samples examined, 10 had a BAC component of 50–79% (group A), 18 had BAC component of 80–99% (group B) and 18 exhibited a pure BAC histology (group C). Male/female ratio was 61.3%/38.7%. Mean age at presentation was 61.6 years. Among group A, 4 patients were EGFR positive and 6 were EGFR negative. 16 group B patients were EGFR positive and 2 were EGFR negative. Similarly, 16 group C patients were EGFR positive and 2 were EGFR negative. This distribution suggests that EGFR is more often expressed with increasing BAC component (p = 0.0041). No correlation was observed between demographics and EGFR expression or the extent of BAC pattern. Conclusions: EGFR expression is related to the extent of the BAC component in adenocarcinomas, with statistical significance. Study of a larger number of patients and correlation of this finding with EGFR and Ras mutational status and responsiveness to therapy are warranted. No significant financial relationships to disclose.

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Urinary epidermal growth factor in patients with gliomas: significance of the factor as a glial tumor marker

Journal of Neurosurgery ◽

10.3171/jns.1993.79.3.0408 ◽

1993 ◽

Vol 79 (3) ◽

pp. 408-413 ◽

Cited By ~ 5

Author(s):

Hiroshi Kanno ◽

Yasuhiro Chiba ◽

Yoshikazu Kyuma ◽

Akimune Hayashi ◽

Hiroyuki Abe ◽

...

Keyword(s):

Radiation Therapy ◽

Growth Factor ◽

Epidermal Growth Factor ◽

Tumor Marker ◽

Glial Tumor ◽

Total Removal ◽

Glial Tumors ◽

Group A ◽

Epidermal Growth ◽

Group B

✓ Epidermal growth factor (EGF) content in urine from patients with glial tumors was examined by radioimmunoassay techniques with labeled human EGF and its rabbit EGF polyclonal antibody. There was no cross-reaction with transforming growth factor-α, which has a common receptor with EGF. Forty glial tumors were divided into three groups according to the clinical stage: Samples from Group A patients were obtained before therapy and/or after biopsy; in these patients a large volume of tumor was apparent on computerized tomography (CT). Group B samples were obtained after gross total removal of the tumor and/or chemo- and radiation therapy; these patients showed a small volume of residual tumor on CT. Samples from Group C patients were obtained after gross tumor total removal and/or chemo- and radiation therapy; no tumor was detected on CT scans in these patients. Urinary EGF levels in Group A samples were statistically significantly higher than in samples from healthy individuals (p < 0.001), Group B patients (p < 0.10), and Group C patients (p < 0.02). In addition, high-grade glial tumors in Group A cases showed a significantly higher level of urinary EGF than low-grade tumors in Group A patients (p < 0.05), or patients with meningioma (p < 0.02), metastatic brain tumor (p < 0.05), and cerebral infarction (p < 0.001). Longitudinal changes of urinary EGF levels in glioma patients mostly synchronized with the clinical course and therapeutic interventions. Therefore, urinary EGF, as a glial tumor marker, may be of practical value for diagnosing a malignant glioma and evaluating for the efficacy of chemo- and radiation therapy.

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Effect of Epidermal Growth Factor with Silastic Scaffold on Tympanic Membrane Perforations of Chronic Otitis Media

Annals of Otology and Neurotology ◽

10.1055/s-0041-1735386 ◽

2021 ◽

Author(s):

Vikram Kemmannu Bhat ◽

Suhas Suresh Desai ◽

Darshan Hiremath

Keyword(s):

Growth Factor ◽

Epidermal Growth Factor ◽

Tympanic Membrane ◽

Otitis Media ◽

Nitrate Solution ◽

Chronic Otitis Media ◽

Pure Tone Audiometry ◽

Disease Stage ◽

Tympanic Membrane Perforations ◽

Epidermal Growth

Abstract Aims The burden of chronic otitis media continues to be high, especially in developing countries. The demand for corrective procedure of surgical myringoplasty, which is considered the gold standard for tympanic membrane perforations, is also growing. Hence, there is a need to innovate simpler alternative office procedures that could save effort, time, waiting period, and expenditure. Materials and Methods This prospective study of 84 patients with mucosal chronic otitis media was undertaken in a tertiary referral hospital. All patients underwent eustachian tube function test, diagnostic nasal endoscopy, and pure tone audiometry. The size of the perforation was assessed endoscopically. All perforations were freshened first with silver nitrate solution. Silastic pieces were placed medial and lateral to the perforation with epidermal growth factor gel in between. Patients were followed up for 3 months. Results The perforations were classified into three groups (healed, partially healed, and nonhealed) based on the treatment response at the end of the first and third follow-up months. Completely healed and partially healed perforations were considered as “success” and were found to be 79% in this study. Significant association was found between healing status and type of anesthesia. However, the disease stage, size of perforation, and the duration of procedure did not affect the healing status. Conclusion Silastic enhanced myringoplasty with epidermal growth factor is a simple, effective, and economical procedure that can become an alternative to surgical myringoplasty for chronic otitis media.

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Comparative study between over underlay with classical underlay techniques of tympanoplasty

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20201687 ◽

2020 ◽

Vol 6 (5) ◽

pp. 918

Author(s):

Prashanth Kudure Basavaraj ◽

Manjunatha H. Anandappa ◽

Veena Prabhakaran ◽

Nishtha Sharma ◽

Shreyas Karkala

Keyword(s):

Hearing Loss ◽

Informed Consent ◽

Conductive Hearing Loss ◽

Hearing Threshold ◽

Chronic Otitis Media ◽

Success Rates ◽

Hearing Improvement ◽

Group A ◽

Group B ◽

Conductive Hearing

Background: The objective of the study was to compare the over underlay tympanoplasty technique with classical underlay tympanoplasty in terms of hearing impairment, graft acceptance and complications.Methods: 60 patients of chronic otitis media, mucosal, inactive, aged between 16-60 years who presented to ENT OPD with small, medium, large and subtotal perforations having mild to moderate conductive hearing loss were included in the study. After taking informed consent, patients were randomly divided into 2 groups containing 30 patients each. In group A, graft was placed medial to the handle of malleus and medial to the annulus (underlay technique), while in group B, graft was placed lateral to the handle of malleus and medial to the annulus (over underlay technique). Both groups were reviewed after 6 months. Pre-operative and post-operative air bone gap were compared. Surgery was considered successful based on post-operative graft uptake, hearing improvement and maintenance of middle ear space. Results: In group A, re-perforation was seen in 8 cases (26.7%) whereas only 3 cases (10%) in group B had re-perforation. Medialization was noted among 4 patients in group A (13.3%), and was absent in group B. Lateralization was absent in both the groups. Post-operative hearing threshold in group A was 6.2±4.56 dB and in group B was 11.45±7.38 dB.Conclusions: Over underlay tympanoplasty is a safer technique as compared to classical underlay, showing lower rates of re-perforation or medialization and a significant improvement in hearing. Hence over-underlay is an effective method, having higher success rates.

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