Comparative efficacy of platelet-rich plasma applied in myringoplasty: A systematic review and meta-analysis.

Juntao Huang,Yi Hu,Cuiting Lv,Yunbin Shi,Yi Shen,Linrong Wu,Ahmed Negida

doi:10.1371/journal.pone.0245968

Juntao Huang, Yi Hu + Show 5 more

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https://doi.org/10.1371/journal.pone.0245968

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Abstract

BackgroundTympanic membrane (TM) perforation is quite common in the clinical setting. Chronic TM perforations require surgical treatments such as myringoplasty. Currently, platelet-rich plasma (PRP) is a novel, effective substance that is increasingly utilized for TM perforation repair. This study aims to evaluate the effectiveness of PRP in the application of TM perforation repair.MethodsA systematic search was conducted to screen the Medline, Embase, Cochrane, Scopus and Web of Science databases up to July 2020. Studies were identified in accordance with the selection criteria by two coauthors independently. Data regarding the healing and hearing outcomes were pooled and analyzed via Review Manager version 5.3 and STATA version 12.0 software. Odds ratio (OR) was utilized to compare the closure rate. Furthermore, the results of hearing improvements and incidence of complications were also compared to evaluate the effectiveness of PRP.ResultsA total of eight studies with 455 participants were eligible according to the selection criteria. Compared to conventional surgery, the OR of closure was 2.70 (95% CI: 1.27 to 5.76, P = 0.01, I2 = 0%) in randomized controlled trial (RCT) subgroup and 6.18 (95% CI: 2.22 to 17.25, P = 0.0005, I2 = 0) in non-RCT subgroup. The overall OR of closure was 3.69 (95% CI: 2.02 to 6.74, P<0.0001, I2 = 0%), suggesting a significant effect on the healing of TM perforation. Between preoperative and postoperative hearing results, there is no statistical difference between the PRP and the control groups. Additionally, the use of PRP resulted in a lower incidence of complication than the use of conventional approaches.ConclusionThe application of PRP during the TM surgeries can enhance the closure rate, provide similar hearing improvements and decrease the incidence of postoperative complications. Given these advantages, PRP can be considered an effective treatment for TM regeneration.

Highlights

Tympanic membrane (TM) perforation represents a common problem in otology clinics
This study aims to evaluate the effectiveness of platelet-rich plasma (PRP) in the application of TM perforation repair
The Odds ratio (OR) of closure was 2.70 in randomized controlled trial (RCT) subgroup and 6.18 in non-RCT subgroup

Summary

Introduction

Tympanic membrane (TM) perforation represents a common problem in otology clinics. Acute perforation tends to heal spontaneously [1], and when the disease shows a chronic progression, surgery is usually required [2]. Tympanoplasty with autografts (e.g., temporalis fascia) is the gold standard surgical treatment for TM perforation and achieves high success rates according to a previous study [3]. An ideal repair material has yet to be identified because of various limitations [4,5]. Tympanic membrane (TM) perforation is quite common in the clinical setting. Chronic TM perforations require surgical treatments such as myringoplasty. Platelet-rich plasma (PRP) is a novel, effective substance that is increasingly utilized for TM perforation repair. This study aims to evaluate the effectiveness of PRP in the application of TM perforation repair.

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