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REVIEW

Current trends of biomaterials for tympanic membrane reconstruction

Tatiana N. Gribinichenko1* Snezhana A. Glebskaia1 Ksenia S. Rubalskaia1 Mayya V. Uspenskaya2,3 Roman O. Olekhnovich1,2
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1 Center for Chemical Engineering, Faculty of Bioengineering, School of Life Sciences, Saint Petersburg National Research University of Information Technologies, Mechanics and Optics (ITMO University), Saint Petersburg, Russia
2 Department of Medical Chemistry, Institute of Chemistry, Saint Petersburg State University, St. Petersburg, Russia
3 Institute of Civil Engineering, Peter the Great St. Petersburg Polytechnic University, St. Petersburg, Russia
Submitted: 10 August 2025 | Revised: 24 May 2026 | Accepted: 8 June 2026 | Published: 1 July 2026
© 2026 by the Author(s). Licensee Biomaterials Translational, USA. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 (CC BY-NC-SA 4.0) (https://creativecommons.org/licenses/by-nc-sa/4.0/deed.en)
Abstract

Tympanic membrane (TM) perforations can lead to recurrent middle-ear infections, reduced quality of life, and conductive hearing loss. Repair should not be limited to anatomical closure. The reconstructed membrane should also restore barrier function and preserve sound transmission. TM reconstruction represents both a regenerative and an acoustic–biomechanical challenge. This review systematizes biomaterials used or under development for TM reconstruction. The materials are compared using a design-oriented framework. This framework includes biological performance, mechanical and acoustic compatibility, degradation and stability, surgical handling, and translational readiness. The review encompasses tissue-derived grafts, acellular matrices, natural polymers, synthetic polymers, and composite scaffold systems. Autologous grafts remain the mainstay of routine TM reconstruction. Temporalis fascia and auricular cartilage are particularly widely used. These materials are well-tolerated and familiar to surgeons. They have several limitations, including donor-site trauma, variable thickness and stiffness, and limited control over acoustic behavior. Allogeneic and xenogeneic matrices can reduce the need to harvest the patient’s own tissue. Their use requires reliable processing, infection control, and reduced immunogenicity. Synthetic polymers offer greater control over scaffold geometry, mechanical properties, and degradation. However, they often require additional functionalization due to limited intrinsic bioactivity. Natural polymers, including hyaluronic acid, chitosan, collagen, gelatin, bacterial cellulose, and silk fibroin, can support cell–material interactions. Their independent use may be limited by swelling, limited mechanical integrity, and unstable degradation. Composite systems offer the broadest design space for future TM repair. They can combine bioactivity, mechanical reinforcement, degradation control, and acoustic tuning. However, no single material group is universally suitable. Future scaffolds should be thin, lightweight, cytocompatible, and infection-resistant, and have controlled mechanical properties. Clinical translation will require standardized biological, mechanical, and acoustic testing. It will also require data on long-term hearing outcomes and evidence of functional, not only anatomical, recovery.

Keywords
Allografts
Autografts
Biopolymers
Composite materials
Regenerative medicine
Synthetic polymers
Tissue engineering
Tympanic membrane perforation
Funding
None.
Conflict of interest
The authors declare no competing interests.
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