Abstract
BackgroundMyringoplasty operation is the reconstruction of the tympanic membrane (TM) which is performed to prevent recurrent discharge of the ear and to improve the hearing impairment which is caused by TM perforation. Platelets are the key factors in tissue repair mechanisms. They provide essential growth factors, which stimulate fibroblasts to create extracellular matrix deposition and neovascularization. The aim of this study is the assessment of the topical use of autologous platelet-rich fibrin (PRF) in the improvement of myringoplasty success rate.ResultsPatients were divided to two groups, group A included 20 patients who were submitted to myringoplasty operation with adding of PRF from the same patient, and group B included 20 patients who were submitted to myringoplasty operation without adding of PRF. At 6 months postoperatively, the success rate (graft taking) in case group A (95%) was significantly higher than in the control group (70%) (P value = 0.037). Success in terms of hearing gain of the air-bone gap was more than 10 dB achieved in 19 patients (95%) in case group A, and 14 patients (70%) in control group B were with a statistically non-significant difference (P value = 0.079). There was no effect of PRF use on hearing gain in graft-taken cases because hearing gain is related to the closure of TM.ConclusionTopical PRF application over tragal perichondreal graft during myringoplasty is successful, safe, and highly efficient with no complications. PRF improves healing of chronic TM perforations and prevents postoperative infection.
Highlights
Myringoplasty operation is the reconstruction of the tympanic membrane (TM) which is performed to prevent recurrent discharge of the ear and to improve the hearing impairment which is caused by TM perforation
Aim of the work The aim of this study is to assess the effectiveness of the addition of platelet-rich fibrin (PRF) to the graft in endoscopic trans-canal myringoplasty to enhance healing and improve the success rate of myringoplasty. This prospective case control study was conducted on 40 patients, presented with dry central TM perforation caused by tubotympanic chronic suppurative otitis media (CSOM)
A small tragal skin incision 2 mm was done below the dome of the tragus, Patients were divided to two groups: group A included 20 patients who were submitted to myringoplasty operation with adding of PRF from the same patient, and group B included 20 patients who were submitted to myringoplasty operation without adding of PRF
Summary
Myringoplasty operation is the reconstruction of the tympanic membrane (TM) which is performed to prevent recurrent discharge of the ear and to improve the hearing impairment which is caused by TM perforation. Platelets are the key factors in tissue repair mechanisms. They provide essential growth factors, which stimulate fibroblasts to create extracellular matrix deposition and neovascularization. There are several trials carried out to close the tympanic membrane (TM) perforations and restore hearing loss. These procedures include the use of different graft materials, such as fat, perichondrium, temporalis fascia, and synthetic materials [2]. Platelets are rich in growth factors which stimulate extracellular matrix deposition and neovascularization. Plasma contains many factors including nutrients, vitamins, hormones, electrolytes, growth factors, and proteins that are essential for cell life and tissue healing [3, 4].
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