Hyaluronan Improves the Healing of Experimental Tympanic Membrane Perforations. A Comparison of Preparations with Different Rheologic Properties

Preparations of hyaluronan at various concentrations and molecular weights were topically applied to experimental tympanic membrane (TM), perforations in the rat and their ability to improve the healing pattern was elucidated. The perforation occupied the upper posterior quadrant of the TM. Alterations in healing rate and quality of the healed TM were examined by otomicroscopy and in histologic sections. Hyaluronan enhanced the healing rate and resulted in less opacity and structural alteration of the scar area. Closure time for the TM perforation was correlated to the concentration of hyaluronan but not to its molecular weight or viscosity. Improved scar quality was obtained in the presence of hyaluronan irrespective of its rheologic properties. Hyaluronan improved the restoration of the fibrous connective tissue layer. Treatment of TM perforation in man with hyaluronan at high concentrations should be considered as an alternative to myringoplasty.