{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T20:08:24Z","timestamp":1769976504960,"version":"3.49.0"},"reference-count":37,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,4,17]],"date-time":"2015-04-17T00:00:00Z","timestamp":1429228800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"FAPESP (S\u00e3o Paulo Research Foundation), S\u00e3o Paulo, Brazil"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>In recent years, there has been a tendency to search for regulatory substances that can optimize the healing process of perforated tympanic membranes (TMs). The purpose of this study was to determine the effects of using topical insulin on the healing process of traumatic TMs perforations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Experimental.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Tympanic membranes of 20 Wistar rats were perforated in two sections, anterior and posterior to the malleus. The rats were divided into two groups: control and insulin. The insulin group was treated with topical regular insulin. The TMs were histologically examined 3, 5, and 7 days after the perforation through a morphometric analysis of the epithelial layer thickness, perforation size, TM cross\u2010sectional area, semiquantitative and qualitative evaluation of the collagen production by polarization microscopy, and immunohistochemical evaluation of epithelial cells and myofibroblasts markers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Insulin accelerated the healing process of the perforated TMs (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01); stimulated early thickening of the outer epithelial layer (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01); contributed to a larger identification of the antipankeratin antibody as epithelial marker (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05); and increased labeling of smooth muscle anti\u2010alpha\u2010actin antibody (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05), indicating greater proliferation of myofibroblasts. When the topical insulin was used, it resulted in a greater formation of collagen tissue (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05), with thicker and better\u2010organized collagen fibers (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Insulin accelerated the healing process of TMs traumatic perforations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>N\/A. <jats:italic>Laryngoscope<\/jats:italic>, 126:156\u2013162, 2016<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.25300","type":"journal-article","created":{"date-parts":[[2015,4,17]],"date-time":"2015-04-17T17:50:00Z","timestamp":1429293000000},"page":"156-162","source":"Crossref","is-referenced-by-count":17,"title":["The topical use of insulin accelerates the healing of traumatic Tympanic membrane perforations"],"prefix":"10.1002","volume":"126","author":[{"given":"Marcos Miranda","family":"Araujo","sequence":"first","affiliation":[{"name":"Department of Ophthalmology Otolaryngology and Head and Neck Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adriana Andrade Batista","family":"Murashima","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Otolaryngology and Head and Neck Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vani Maria","family":"Alves","sequence":"additional","affiliation":[{"name":"Department of Cell and Molecular Biology and Pathogenic Bioagents Faculty of Medicine of Ribeir\u00e3o Preto, University of S\u00e3o Paulo Ribeir\u00e3o Preto S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria C\u00e9lia","family":"Jamur","sequence":"additional","affiliation":[{"name":"Department of Cell and Molecular Biology and Pathogenic Bioagents Faculty of Medicine of Ribeir\u00e3o Preto, University of S\u00e3o Paulo Ribeir\u00e3o Preto S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miguel Angelo","family":"Hyppolito","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Otolaryngology and Head and Neck Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,4,17]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"World Health Organization.Prevention of Hearing Impairment from Chronic Otitis Media. 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