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In this article, the authors focus on a study of 116 patients with epithelial pearl formation after tympanic membrane regeneration therapy. They inform that epithelial pearl formation occurred in patients, who undergone the therapy suing basic fibroblast growth factor and atelocollagen/silicone membrane and the ratio of incidence of the formation is equal to that after overlay myringoplasty. They mention that pearls developed from residual epithelium at the dissected margin.