With over 200,000 cases a year, ruptured eardrums due to traumatic injury and patients with chronic ear infections are a common illness among many. Following the Boston Marathon bombing in 2013, however, there was a rush of cases that emphasized the need for improvement in standard surgical techniques. As a result of the extensive damage inflicted by the shockwave, the ruptured eardrums of most patients were beyond self repair and a tympanoplasty, originating in the 1950s, was no longer the most efficient treatment thought to date.
During a tympanoplasty, the ruptured eardrum is commonly patched with a graft of the patient’s tissue, either a connective tissue called fascia or the tragus. The surgeon slips the new tissue behind or on top of the hole in the eardrum. To hold the tissue in place, a tiny wad of material is packed behind the ruptured area. The procedure is done with a microscope in an operating room, though more recently endoscopes have allowed for less invasive procedures. While the current treatment is often successful, no tissue can conduct sound in the eardrum quite like the eardrum tissue itself. This is where regenerative medicine comes into play- the process of using a patient’s own cells to restore the human body whether injured by trauma, damaged by disease, or worn by time.
Recently, researchers contacted biomedical engineers from the Wyss Institute, Nicole Black and Jennifer Lewis, to work on a new graft which they later named the “PhonoGraft”. Soon thereafter, the 3D-printing company Desktop Health acquired the small synthetic device as they saw its potential to replace tympanoplasties, a much more complex and less advanced treatment. The Phonograft, having been worked on for a total of six years, was identified via biodegradable materials which work within the ear and leaves behind a healed eardrum that ideally works as well as it did before it ruptured. This material can be 3D-printed and cut into custom sizes and shapes at the time of surgery, making it adaptable to perforations of various sizes and locations to best suit a patient’s needs.
Because the Phonograft is biodegradable, it decreases the risk for ear infections and serves as a medium for the eardrum itself to grow back rather than relying on donor tissue. The Phonograft is also made from a completely synthetic material, making it relatively cheap to produce and easier to transport than a device that uses biological materials like proteins or cells. Moving forward, this treatment is designed to transform repair of a ruptured eardrum from one requiring general anesthesia to one using local anesthesia, and it could shorten current tympanoplasty procedures from around 150 minutes to 20 minutes of a surgeon’s time, along with eight hours of outpatient care to a single hour.
For decades, regenerative medicine has enhanced medical treatments and brought the most innovative procedures to life. Regenerative medicine rehabilitates the body and restores it to its original function. Treatments such as tissue regeneration, organ transplant, and advanced stem cell research have broadened the scope of this $156 billion global industry. These processes reinstate hope in patients where there is very little light at the end of the tunnel. Now, with the new Phonograft, regenerative medicine is doing just that by conquering one of the most common diseases and traumatic injuries.
Using this material to heal a ruptured eardrum is just the beginning, researchers say. Micheal Jafar, President and CEO of Desktop Health said, “I immediately thought of at least five — we know that would potentially be 10 — use cases beyond just the eardrum … the synthetic material and the way it was tooling was very interesting to me, I’ll bet we’ll learn a lot about what this property can do in the body beyond just the eardrum.” With regenerative medicine, there is hope for new procedures such as the Phonograft to advance less efficient and more time-consuming treatments. Together, let us educate ourselves on these topics so we can continue to advance medical innovations and provide the best possible care for our family and friends.