Tympanic membrane (TM) perforations can be closed in the outpatient clinic using a variety of materials, such as fascia, fat, connective tissue, paper patches, and Gelfoam. Such minimally invasive surgery or conservative treatment is especially effective when the perforation is small, fresh, and dry. However, in some cases, these procedures fail to close a perforation, mainly because of decreased re generation activity of the TM at the margin of the perforation. To improve the success rate of

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... n servative treatment, we applied two new methods: using basis fibroblast growth factor (bFGF) combined with atelocollagen/silicon bilayer membranes as a patch material, and using amniotic mem brane combined with amniotic membrane.