A Comparison of the Autologous Platelet-Rich Plasma Gel Fat Graft Myringoplasty and the Fat Graft Myringoplasty for the Closure of Different Sizes of Tympanic Membrane Perforations

Abstract

Objective: We aimed to evaluate the effect of autologous platelet-rich plasma gel (PRPG) on fat graft myringoplasty (FGM) in tympanic membrane perforations caused by chronic otitis media. Methods: This retrospective study involved 63 patients who underwent operations between 2015 and 2018. Fat graft myringoplasty was performed with the transcanal approach with and without the use of PRPG in the surgical field. The patients were classified into 2 groups: group A, which included 32 patients who underwent FGM with the use of autologous PRPG, and group B, which included 31 patients who underwent FGM alone. Tympanic membrane perforations were divided into 2 groups: small perforations (1-2 mm) in a single quadrant and large perforations (2-4 mm) in at least 2 quadrants. Results: Both groups were statistically matched regarding age and sex. The mean postoperative follow-up was 11.6 and 12.1 months for groups A and B, respectively. Four months postoperatively, the success rate of the graft in group A (100%) was significantly higher than that in group B (83.8%; P = .03). The preoperative and postoperative median air–bone gaps of the groups were similar ( P = .653 and P = .198, respectively). No worsening of the air–bone gap was noted postoperatively in either group. Conclusions: This study demonstrated that autologous PRPG application during FGM allows for a higher success rate than FGM alone. Furthermore, the use of PRPG with FGM for large perforations increases the success rate. Further studies are needed to investigate the PRPG healing effect on other tympanic membrane perforation closure techniques.

The Effect of Epidermal Growth Factor on the Outcomes of Myringoplasty

“…Higher surgical success rates have been reported by all of them in ►Table 5 who used PRP. Ersozlu and Gultekin et al 7 claimed 100% success rates with PRP gel fat graft myringoplasty in 4 months follow-up. However, there was no difference in audiological results.…”

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

“…Of the 34 nonrepetitive studies identified, eight studies [8][9][10][11][12][13][14][15] including 455 participants with different sizes of TM perforations were eligible for final selection after screening the full texts. These included studies published from 2015 to July 2020 and consisted of five RCTs [9,10,[12][13][14], one prospective study [15], and two retrospective studies [8,11]. Seven of the included studies [8][9][10][12][13][14][15] compared the efficacy of PRP with conventional tympanoplasty or myringoplasty.…”

“…These included studies published from 2015 to July 2020 and consisted of five RCTs [9,10,[12][13][14], one prospective study [15], and two retrospective studies [8,11]. Seven of the included studies [8][9][10][12][13][14][15] compared the efficacy of PRP with conventional tympanoplasty or myringoplasty. Among the seven studies in which the experimental groups received PRP three involved fat graft myringoplasty (FGM) [8,9,14], one used conchal perichondrium myringoplasty (PM) [13], and three involved temporalis fascia tympanoplasty (TFT) [10,12,15].…”

“…Seven of the included studies [8][9][10][12][13][14][15] compared the efficacy of PRP with conventional tympanoplasty or myringoplasty. Among the seven studies in which the experimental groups received PRP three involved fat graft myringoplasty (FGM) [8,9,14], one used conchal perichondrium myringoplasty (PM) [13], and three involved temporalis fascia tympanoplasty (TFT) [10,12,15]. Among the control groups, two group underwent FGM [8,14], and one group underwent PM [13].…”

“…Based on previous evidence, PRP contains many growth factors (e.g., platelet-derived growth factor, PDGF), accelerating the regeneration of endothelial tissue and enhancing tissue healing. [7][8][9][10][11][12][13][14][15][16] Although the majority of human trials have reported promising benefits [8][9][10][11][12][13][14][15], the completed closure rate varies across studies, and the outcomes of both healing and hearing improvements require further evaluation. To the best of our knowledge, no systematic analysis has been performed to compare the efficacy of PRP in TM regeneration surgeries.…”