Новые возможности активации регенерации барабанной перепонки

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.

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