Effect of adding platelet-rich plasma to fat grafts in myringoplasty

Fawzy, Tamer; Hussein, Mohamed; Eid, Said; Guindi, S

doi:10.4103/ejo.ejo_53_18

Cited by 8 publications

(19 citation statements)

References 14 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.…”

Section: Discussionmentioning

confidence: 53%

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: Discussionmentioning

confidence: 53%

Efficacy of Platelet Rich Fibrin in Myringoplasty

2020

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“…These included studies published from 2015 to July 2020 and consisted of five RCTs [ 9 , 10 , 12 – 14 ], one prospective study [ 15 ], and two retrospective studies [ 8 , 11 ]. Seven of the included studies [ 8 – 10 , 12 – 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 ].…”

Section: Resultsmentioning

confidence: 99%

“…Seven of the included studies [ 8 – 10 , 12 – 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 ].…”

Section: Resultsmentioning

confidence: 99%

“…Among the control groups, two group underwent FGM [ 8 , 14 ], and one group underwent PM [ 13 ]. The other four groups of patients underwent tympanoplasty surgery [ 9 , 10 , 12 , 15 ]. The remaining study reported the outcomes of three treatment arms [ 11 ], including PRP combined with FGM, hyaluronic acid (HA) with FGM and FGM alone.…”

Section: Resultsmentioning

confidence: 99%

“…All of the included studies [ 8 – 15 ] reported the completed closure rate after surgery. The closure rate ranged from 85.7% to 100% (median 92.5%) in the PRP treatment groups and from 55% to 92% (median 82.6%) in the control groups.…”

Section: Resultsmentioning

confidence: 99%

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

Huang

Shi

et al. 2021

PLoS ONE

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Background Tympanic 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. Methods A 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. Results A 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. Conclusion The 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.

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Efficacy of autologous platelet-rich plasma on graft uptake in myringoplasty: a single-blinded randomized control trial

Vignesh

Coumare

Gopalakrishnan

et al. 2022

Egypt J Otolaryngol

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Background and aim Chronic otitis media is defined as a chronic inflammation of the middle ear cleft producing irreversible pathological changes. The myringoplasty aims at the reconstruction of the tympanic membrane using a graft material. Autologous platelet-rich plasma can be used along with the graft to have a successful outcome. The aim of the study was to assess the efficacy of autologous platelet-rich plasma on graft uptake in myringoplasty. Methods This was a randomized controlled trial with a sample size of 76 patients. All patients were above 18 and below 55 years of age diagnosed with chronic suppurative otitis media and were planned for myringoplasty. The participants were randomly allotted to two groups by block randomization (block of 4). Intra-operatively, group I (n=38) received platelet-rich plasma–soaked gel foam and group II (n=38) was taken as the control group who received saline-soaked gel foam and examined by a blinded examiner at the end of 1st and 3rd months. Results The mean air-bone gap reduction post-operatively in the platelet-rich plasma group was 8.68 ± 4.8 (P value 0.034) and 6.05 ± 4.05 in the control group. The improvement in pure-tone average in the platelet-rich plasma group (P = 0.009) is more than that in the control group. The graft uptake was higher among the platelet-rich plasma group than the control group both at 1st and 3rd months (P value 0.049) which were statistically significant. Conclusion The present study concludes that the usage of platelet-rich plasma in the conventional myringoplasty technique has improved the success rate of graft uptake and reduced the graft migration. Trial registration Clinical Trials Registry-India (ICMR-NIMS) CTRI/2020/04/024416. Date of registration: 01/04/2020. Date of enrolment of the first participant to the trial: 06/04/2020. URL of the trial registry: http://www.ctri.nic.in. Highlights Usage of autologous platelet-rich plasma (PRP) in conventional myringoplasty in underlay technique. Assessment of graft uptake, percentage of perforation closure, and the audiological outcome. Significant mean reduction of ABG in the PRP group. Significant improvement in PTA average in the PRP group. Graft uptake and percentage of perforation closure were higher in the PRP group and the control group. PRP is also beneficial in revision cases.

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Effect of adding platelet-rich plasma to fat grafts in myringoplasty

Cited by 8 publications

References 14 publications

Efficacy of Platelet Rich Fibrin in Myringoplasty

Efficacy of Platelet Rich Fibrin in Myringoplasty

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

Efficacy of autologous platelet-rich plasma on graft uptake in myringoplasty: a single-blinded randomized control trial

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