Effect of Silver Nitrate and Epidermal Growth Factor on Nonhealing Tympanic Membrane Perforations: A Randomized Controlled Study

Abstract

Abstract Introduction Most tympanic membrane perforations in chronic otitis media require surgical myringoplasty for closure. This study aimed to find out a simple nonsurgical outpatient procedure to close these perforations that could reduce the hospital stay, medical cost, and morbidity in these patients. Materials and Methods The study was conducted in a tertiary referral hospital in a single-blind randomized controlled trial design with two groups, each with a sample size of 40 ears. Only small-size central nonhealing traumatic and chronic otitis media perforations were recruited. Pure tone audiometry and otomicroscopy were performed in all eligible patients who consented to take part in the study. Group 1 was treated with silver nitrate chemical cautery alone. Group 2 received epidermal growth factor gel application in addition to chemical cautery. Both the groups were followed up for a minimum period of 3 months. The same investigations were performed during follow-up. Results and Observations The outcome was considered a success whether there was closure of perforation or reduction in the size of perforation. The success rate of these nonhealing perforations was found to be significantly higher in group 2 (71.42%) than in group 1 (47.36%). Hearing gain was observed in closed perforations of both the groups. Conclusion Epidermal growth factor application enhances the healing effect of silver nitrate in small nonhealing tympanic membrane perforations. The encouraging results of epidermal growth factor have vast applications in improving outcomes of surgical myringoplasty and treatment of residual perforations remaining after the same.