The influence of inhibition of the epidermal growth factor receptor on tympanic membrane wound healing in rats

Abstract

Recently, a report on a bilateral tympanic membrane (TM) perforation in a patient after long-term treatment with erlotinib was published. The object of this study was to investigate the destructive potential of topical applied epidermal growth factor receptor (EGFR) inhibitors on wound healing of experimental TM perforation in rats by evaluating closure rates and histology. In 12 rats, erlotinib (10 mg/ml) was applied to one TM of each animal and cetuximab (5 mg/ml) to the other side daily for 12 consecutive days. Both the erlotinib group (11.8 days) and cetuximab group (9 days) had prolonged healing latencies compared to a reference value (7 days). We observed differences in the histologic parameters between both groups. Our results suggest that in normal TM, the inhibition of EGFR does not lead to a persistent perforation. However, in case of preexisting TM pathology, a spontaneous perforation in patients under long-term treatment of EGFR inhibitors seems to be possible.

Keywords::

• Epidermal growth factor receptor inhibitor
• erlotinib
• cetuximab
• wound healing
• tympanic membrane

Acknowledgements

The authors acknowledge Ulrich Stefenelli for his support in the statistical evaluation. Mrs Wolter and the staff of the Department of Laboratory Animal Science, University of Greifswald, are thanked for expert technical assistance.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.