Safety and Efficacy of Autologous Platelet-rich Fibrin on Graft Uptake in Myringoplasty: A Randomized Controlled Trial

Nair, Nithin Prakasan; Alexander, Arun; Abhishekh, B; Hegde, Jyotirmay S; Ganesan, Sivaraman; Saxena, Sunil

doi:10.1055/s-0038-1649495

Cited by 19 publications

(8 citation statements)

References 15 publications

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“…PRF usage has found to be effective in reducing the incidence of post-operative infection as concluded in a study conducted in Egypt by Fawzy T et al 21 An Indian study also showed similar results. 22 This was comparable to our study where 8% cases and 32% controls reported post-operative infection. The presence of WBCs in high concentrations in our technique for preparing PRF must have had a role against infection with its bactericidal effect.…”

Section: Discussionsupporting

confidence: 90%

Efficacy of Platelet Rich Fibrin in Myringoplasty

2020

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Objective: To determine the efficacy of usage of topical autologous platelet rich fibrin (PRF) in improving outcomes of myringoplasty regarding graft uptake and hearing improvement. Methods: This study was conducted in the ENT department of Holy Family Hospital, Rawalpindi, over a period of six months from August 2019 to January 2020. It was designed as a prospective single blinded randomized controlled trial. The study involved a total of 50 participants in whom myringoplasty was done through post auricular approach using underlay technique. In 25 patients topical drops of PRF were used. Outcomes were compared after three months with the control group (n=25), who underwent myringoplasty without PRF. Results: After three months follow-up, graft uptake was reported 78% and 52% in cases and controls, respectively (P=0.070). Mean hearing improvement was 18 dB and 6 dB in cases and controls, respectively (P=0.014). Postoperative infection occurred in 8% of the cases, and in 32% controls (P=0.037). Conclusion: Topical use of Platelet-Rich Fibrin during myringoplasty results in improved graft uptake. Hence, resulting in much improved hearing, significant reduction in infection rates and decrease in perforation sizes. doi: https://doi.org/10.12669/pjms.37.1.3059 How to cite this:Riaz N, Ajmal M, Khan MS. Efficacy of Platelet Rich Fibrin in Myringoplasty. Pak J Med Sci. 2021;37(1):212-216. doi: https://doi.org/10.12669/pjms.37.1.3059 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionsupporting

confidence: 90%

Efficacy of Platelet Rich Fibrin in Myringoplasty

2020

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“…Previously published studies reported a wide range of graft success rates after tympanoplasty between 64% and 100%. 14 , 15 , 16 , 17 In our study, we achieved a graft success rate of 100% in the case (ciprofloxacin) group and 97.7% in the control (betamethasone) group in patients with equal or more than 50% of tympanic membrane perforation.…”

Section: Discussionmentioning

confidence: 53%

Does intraoperative ciprofloxacin‐soaked gelfoam have adverse effects on graft success rate? A randomized, double‐blind controlled trial

Faramarzi

Kazemi

Shishegar

et al. 2021

Laryngoscope Investig Oto

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Objectives: The aim of this study was to evaluate whether intraoperative ciprofloxacin-soaked gelfoam is safe in tympanoplasty or not.Method: In this randomized, double-blind controlled clinical study, we included 100 patients between 18 and 60 years old, having perforation ≥50% of the tympanic membrane and dry ear for at least 2 months who were a candidate for underlay tympanoplasty via postauricular approach. We used ciprofloxacin soaked gelfoam in the case group and betamethasone soaked gelfoam in the control group for packing the middle ear cavity and external auditory canal during their operation. The graft success rate and tympanogram after 6 months follow-up period was considered as the primary outcome. Also, we evaluated the postoperative hearing results 6 months after the surgery as the secondary outcomes.Results: Postoperative microscopic otoscopy showed a graft success rate of 100% (44/44) and 97.7% (42/43) in the case and control groups, respectively. The level of improvement between the two groups was not significant for air-bone gap (ciprofloxacin: 9.01 ± 7.89 dB, betamethasone 5.31 ± 10.53 dB, P = .160), and speech reception thresholds (SRT; ciprofloxacin: 10.23 ± 8.62 dB, betamethasone 7.33 ± 12.60 dB, P = .260). 93.2% of all the ears in the case group and 81.4% of those in the control group achieved postoperative air-bone gap within 20 dB, but the difference between them was not significant (P = .118). Conclusions:We found that the application of ciprofloxacin impregnated gelfoam in the middle ear, and the external auditory canal had no adverse effect on the graft success rate in tympanoplasty. Levels of evidence: 1b.

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“…However Nair et al documented 100% graft uptake using platelet rich fibrin even in presence of middle ear inflammation. Also they concluded that platelet rich fibrin increased the chances of graft uptake even in larger perforations [21].…”

Section: Discussionmentioning

confidence: 98%

Novel Use of Platelet Rich Fibrin Membrane in Transcanal Myringoplasty: A Prospective Study

Shukla

Kaurav

Vatsyayan

2020

Indian J Otolaryngol Head Neck Surg

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Being rich in growth factors platelet rich fibrin (PRF) has been used for decades for its healing properties in cosmetic surgeries but its use in transcanal myringoplasty is a novel approach that remains unexplored. In todays era of minimally invasive surgery not only does it provide as a great alternative to conventional myringoplasty but also outshines it. It reduces post operative pain, hospital stay and unlike the conventional technique that uses termporalis fascia as a graft material, PRF myringoplasty if required can be reperformed on the same patient multiple times with minimal risk. This procedure comes as a boon for patients with recurrent graft defects because after multiple revision surgeries, temporalis fascia can be deficient and other graft materials like cartilage/perichondrium or fascia lata etc. have to be harvested surgically for myringoplasty. In PRF myringoplasty there is no upper limit in the number of times the PRF membrane can be made and also it does not entail any surgical incision for graft harvest. A prospective study involving 41 patients was conducted at Netaji Subhash Chandra Bose Medical College, Jabalpur where in the tympanic membrane perforations were repaired using PRF membrane with a successful outcome in 85.4% of the patients included in this study.

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Safety and Efficacy of Autologous Platelet-rich Fibrin on Graft Uptake in Myringoplasty: A Randomized Controlled Trial

Cited by 19 publications

References 15 publications

Efficacy of Platelet Rich Fibrin in Myringoplasty

Efficacy of Platelet Rich Fibrin in Myringoplasty

Does intraoperative ciprofloxacin‐soaked gelfoam have adverse effects on graft success rate? A randomized, double‐blind controlled trial

Novel Use of Platelet Rich Fibrin Membrane in Transcanal Myringoplasty: A Prospective Study

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