medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2025-450medsovet-9554Research ArticleПРАКТИКАPRACTICEНовые возможности активации регенерации барабанной перепонкиNew possibilities for activating tympanic membrane regenerationhttps://orcid.org/0000-0002-9076-7154БаумО. И.BaumO. I.

Баум Ольга Игоревна, д.ф.-м.н., ведущий сотрудник и заведующая лабораторией биофотоники, Курчатовский комплекс кристаллографии и фотоники

123182, Москва, площадь Академика Курчатова, д. 1

Olga I. Baum, Dr. Sci. (Phys.-Math.), Leading Researcher and Head of the Biophotonics Laboratory, Kurchatov Complex of Crystallography and Photonics

1, Academician Kurchatov Square, Moscow, 123182

baumolga@gmail.comhttps://orcid.org/0000-0002-3700-7367ЗолотоваА. В.ZolotovaA. V.

Золотова Анна Владимировна, к.м.н., доцент, доцент кафедры болезней уха, горла и носа

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Anna V. Zolotova, Cand. Sci. (Med.), Associate Professor, Associate Professor of the Department of Ear, Nose and Throat Diseases

8, Bldg. 2, Trubetskaya St., Moscow, 119991

zolotova_a_v@staff.sechenov.ruhttps://orcid.org/0000-0002-9380-1821КасьяненкоЕ. М.KasianenkoE. M.

Касьяненко Екатерина Михайловна, научный сотрудник, Курчатовский комплекс кристаллографии и фотоники

123182, Москва, площадь Академика Курчатова, д. 1

Ekaterina M. Kasianenko, Researcher, Kurchatov Complex of Crystallography and Photonics

1, Academician Kurchatov Square, Moscow, 123182

ekkassianenko@gmail.comhttps://orcid.org/0000-0002-8552-1395СвистушкинМ. В.SvistushkinM. V.

Свистушкин Михаил Валерьевич, к.м.н., доцент кафедры болезней уха, горла и носа

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Mikhail V. Svistushkin, Cand. Sci. (Med.), Associate Professor of the Department of Ear, Nose and Throat Diseases

8, Bldg. 2, Trubetskaya St., Moscow, 119991

svistushkin_m_v@staff.sechenov.ruhttps://orcid.org/0000-0003-0050-0251БлиноваЕ. В.BlinovaE. V.

Блинова Екатерина Валериевна, д.м.н., профессор, заведующая кафедрой фундаментальной медицины, Национальный исследовательский ядерный университет «МИФИ»; профессор кафедры оперативной хирургии и топографической анатомии, профессор кафедры клинической фармакологии и пропедевтики внутренних болезней, Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)

115409, Москва, Каширское шоссе, д. 31,

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Ekaterina V. Blinova, Dr. Sci. (Med.), Professor, Head of the Department of Fundamental Medicine, National Research Nuclear University MEPhI (Moscow Engineering Physics Institute); Professor of the Department of Operative Surgery and Topographic Anatomy, Professor of the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases, Sechenov First Moscow State Medical University (Sechenov University)

31, Kashirskoye Shosse, Moscow, 115409,

8, Bldg. 2, Trubetskaya St., Moscow, 119991

EVBlinova1@mephi.ruhttps://orcid.org/0000-0001-7414-1293СвистушкинВ. M.SvistushkinV. M.

Свистушкин Валерий Михайлович, д.м.н., профессор, заведующий кафедрой болезней уха, горла и носа

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Valeriy M. Svistushkin, Dr. Sci. (Med.), Professor, Head of the Department of Ear, Nose and Throat Diseases

8, Bldg. 2, Trubetskaya St., Moscow, 119991

svistushkin_m_v@staff.sechenov.ruНациональный исследовательский центр «Курчатовский институт»РоссияNational Research Centre “Kurchatov Institute”Russian FederationПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian FederationПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет);РоссияSechenov First Moscow State Medical University (Sechenov University)Russian FederationПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет); Национальный исследовательский ядерный университет «МИФИ»РоссияSechenov First Moscow State Medical University (Sechenov University); National Research Nuclear University MEPhI (Moscow Engineering Physics Institute)Russian Federation202520112025018178186Copyright © Баум О.И., Золотова А.В., Касьяненко Е.М., Свистушкин М.В., Блинова Е.В., Свистушкин В.M., 20252025Баум О.И., Золотова А.В., Касьяненко Е.М., Свистушкин М.В., Блинова Е.В., Свистушкин В.M.Baum O.I., Zolotova A.V., Kasianenko E.M., Svistushkin M.V., Blinova E.V., Svistushkin V.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/9554

В статье описана проблема перфорации барабанной перепонки, которая остается одной из актуальных в современной оториноларингологии. Приведена классификация дефектов тимпанальной мембраны, рассмотрены дискуссионные вопросы, касающиеся необходимости и сроков проведения хирургического лечения. Для лучшего понимания процессов заживления подробно описано строение барабанной перепонки. Проведен обзор литературы по регенерации тимпанальной мембраны с указанием клеточных процессов, происходящих на разных этапах ее восстановления. Отдельный раздел статьи посвящен нарушениям регенерации, приводящих к формированию стойкой перфорации тимпанальной мембраны. Разобраны причины развития данной патологии. Отдельное внимание авторы уделили обзору работ, посвященных латентным эпителиальным стволовым клеткам, которые были обнаружены в тимпанальной мембране. Наличие собственного регенеративного потенциала в виде эпителиальных клеток-предшественников, а также знания об их локализации позволяют предположить, что стимуляция их дифференцировки и пролиферации приводит к закрытию как острой, так и хронической перфорации барабанной перепонки. С помощью методов тканевой инженерии возможен запуск регенерации этих клеток. Авторы статьи обращают внимание на новый метод восстановления дефектов тимпанальной мембраны, альтернативный классическому хирургическому лечению, а именно на активацию ее регенеративных центров при помощи лазерного излучения. Оно оказывает свое воздействие на клеточном и молекулярном уровнях, восстанавливая метаболизм и микроциркуляцию тканей. Представлены эффекты от излучения лазеров на стимуляцию различных клеток. Авторами статьи описаны преимущества лазерной стимуляции эндогенного регенераторного потенциала барабанной перепонки и перспективы ее применения в клинической практике.

The article describes the problem of perforation of the tympanic membrane, which remains one of the most pressing in modern otolaryngology. A classification of tympanic membrane defects is given, debatable issues of the need and timing of surgical treatment are discussed. For a better understanding of the healing processes, the structure of the tympanic membrane is described in detail. A review of the literature on the regeneration of the tympanic membrane is conducted, indicating the cellular processes occurring at different stages of its recovery. A separate section of the article is devoted to regeneration disorders leading to the formation of persistent perforation of the tympanic membrane. The causes of this pathology are analyzed. The authors paid special attention to the review of works devoted to latent epithelial stem cells that were found in the tympanic membrane. The presence of intrinsic regenerative potential in the form of epithelial progenitor cells, as well as knowledge of their localization, suggest that stimulation of their differentiation and proliferation leads to closure of both acute and chronic perforation of the tympanic membrane. Using tissue engineering methods, it is possible to initiate regeneration of these cells. The authors of this article draw attention to a new alternative to classical surgical treatment method for restoring tympanic membrane defects, namely, activation of its regenerative centers using laser radiation. It has an effect at the cellular and molecular levels, restoring metabolism and microcirculation of tissues. The effects of laser radiation on the stimulation of various cells are presented. The authors of the article describe the advantages of laser stimulation of the endogenous regenerative potential of the tympanic membrane and the prospects for its use in clinical practice.

перфорация барабанной перепонкилазерное излучениепрогениторные стволовые клеткистимуляция лазерным излучениемрегенеративный потенциал барабанной перепонкиtympanic membrane perforationlaser radiationprogenitor stem cellslaser stimulationregenerative potential of the tympanic membraneИсследование выполнено за счет гранта Российского научного фонда №25-15-00341This research was supported by the Russian Science Foundation grant No. 25-15-00341ReferencesLim DJ. Structure and function of the tympanic membrane: a review. Acta Otorhinolaryngol Belg. 1995;49(2):101–115. Available at: https://pubmed.ncbi.nlm.nih.gov/7610903/.Lim DJ. Structure and function of the tympanic membrane: a review. Acta Otorhinolaryngol Belg. 1995;49(2):101–115. Available at: https://pubmed.ncbi.nlm.nih.gov/7610903/.Volandri G, Di Puccio F, Forte P, Carmignani C. Biomechanics of the tympanic membrane. 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The authors declare that there are no conflicts of interest present.