Platelet-Rich Plasma Application for Acute Tympanic Membrane Perforations.

Abstract

To assess the efficacy of the application of platelet-rich plasma (PRP) in the healing process of acute tympanic membrane perforations (TMPs). Acute TMPs were made in both the ears of 12 New Zealand rabbits. Plasma gel was applied at the right tympanic membrane (TM) of the same animal until the perforations were closed. The left TM was left untreated. On days 1, 4, 7, 10, 13, 16, 21, 28, and 35, the TMs were monitored to check the closure of perforations. The days of perforation closure for the 2 groups were compared using the paired t-test. The animals were sacrificed 2 months after making the perforations. Seven histopathological parameters were reviewed by 2 blinded pathologists: acute inflammation, chronic inflammation, edema in the lamina propria, congestion in the lamina propria, sclerosis, fibroblastic reaction, and an increase in the thickness of the squamous epithelial layer. The presence or absence of each histological parameter in both groups was compared using the Pearson Chi-square test. The average number of days for closure in the plasma gel group was 12 (range 8-18 days) and that in the control group was 17.7 (range 8-31 days). The difference was statistically significant (p=0.0145). There was no sclerosis or fibroblastic reaction in any of the specimens. No statistically significant difference was seen between the 2 groups with respect to acute inflammation, chronic inflammation, edema in the lamina propria, congestion in the lamina propria, and an increase in thickness of the squamous epithelial layer (p>0.05). Platelet-rich plasma fastens TMP closure; in long term, the eventual outcome is both microscopically and macroscopically same for the control as well as study groups in a rabbit traumatic TMP model. We believe that this study will encourage the clinical use of PRP for acute TMPs and trigger clinical studies in this field.