الفهرس 
Criteria for considering studies for this work
Epidermal Growth Factor (EGF):Only 14 pages are availabe for public view
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Abstract
Summary Tympanic membrane perforation (TMP) is a common disorder that may lead to hearing loss and many other complications. About one fifth of cases do not heal spontaneously. Spontaneously healed perforations might be acoustically suboptimal. Trials to replace traditional interventions by safe, successful, rapid, easy and cost / effective intervention have been recently reported in several studies. Of these the use of healing promoting factors (HPFs) as epidermal growth factor (EGF), fibroblast growth factor (FGF), hyaluronic acid (HA) and platelet rich plasma (PRP) in the management of TMPs either with or without autologous graft. In this review we analyzed data extracted from the available studies. The aim of this meta-analysis was to find out the prognostic effects of different healing promoting factors in healing of tympanic membrane perforations. Studies and Method: the present study included 18 articles yielded from searching specialized journals and electronic data-bases: EMBASE, PubMed, CENTRAL, CINHAL, Cochrane library, Google scholar, MEDLINE, EBSCO and literature references for published, unpublished and ongoing trials in the last 20 years. The included studies were either: Randomized controlled trials, Prospective, Retrospective. The studies were categorized into 4 groups as regard the added healing promoting factor. Data were extracted from the full-text articles and analyzed via Cochrane Collaboration’s Review Manager (Rev.Man) software. Random effect model metaanalysis were performed to overcome potential heterogeneity which was assessed via I2.Studies in which patients fulfilling any of the following were included: Acute or chronic TMP of any size, With no evidence of active otitis media, cholesteatoma or retraction pocket formation, Without suspected ossicular chain pathology on microscopic examination, Air-bone gap (ABG) of 30 dB or better.