Biomaterials and Biological Therapies in Tympanic Membrane Regeneration: Systematic Review and Perspective.

OBJECTIVE

Chronic tympanic membrane perforations generally require surgical repair, most often via tympanoplasty. While effective, these procedures involve anesthesia, carry significant costs, and may not always be accessible. The objective of this review is to explore biomaterials and biological therapies that could promote tympanic membrane regeneration and potentially reduce the need for surgery.

DATA SOURCES: PubMed and Google Scholar between September 1958 and December 2025.

REVIEW

METHODS

A PRISMA-guided systematic review of clinical studies about biomaterials or biological therapies for tympanic membrane repair was conducted. In parallel, a narrative literature review was performed, without date restrictions, to integrate experimental and translational data about tympanic membrane repair. A synthesis was used to contextualize findings across experimental and clinical domains.

RESULTS

Of 573 abstracts identified, 83 studies were included in the systematic review: 21 about bioactive biomaterials (hyaluronic acid, silk fibroin) and 62 about biological therapies (Growth factors, platelet concentrates, serum).

CONCLUSION

This review shows that clinical studies on this subject are limited and challenging to conduct. Platelet concentrates derivates have shown promising results for promoting closure of chronic tympanic membrane perforations, while evidence for other biomaterials and biological therapies is more limited, partly because autologous materials are generally easier to study in clinical settings.