Abstract
Abstract
Background
Platelet-rich fibrin (PRF) which is considered a second-generation platelet-rich plasma having a high content of growth factors could be implied as a sealant and adjuvant to grafting materials during tympanoplasty operation. This work aimed to evaluate the role of autologous platelet-rich fibrin as an adjuvant in type 1 tympanoplasty (myringoplasty) for the closure of central tympanic membrane perforations. A prospective comparative study was conducted including one-hundred patients with chronic suppurative otitis media with dry central TM perforations. The patients were classified into two equal groups: group A (case group) was subjected to myringoplasty operation with the use of autologous PRF added to the temporalis fascia graft, and group B (control group) was subjected to myringoplasty operation using graft only without PRF. Both groups were assessed for successful closure of perforation defined as an intact eardrum, success in terms of hearing defined as closure of air-bone gap down to 10 dB or lesser, and hearing gain at 6 months postoperatively.
Results
At 6 months postoperatively, the success rate (graft taking) in group A (90%) was significantly higher than in group B (70%). Success in terms of air-bone gap closure (< 10 dB) revealed that in group A, success was achieved in 39 patients (78%), which was significantly higher than in group B 27 patients (54 %). Air-bone gap at 6 months postoperatively was more in the graft taken cases in the case group than in the control group with a significant difference. There was a nonsignificant correlation between graft uptake and either hemoglobin or platelet concentrations in both groups. In addition, there was a nonsignificant correlation between graft uptake and the size of the perforation in both groups.
Conclusion
Platelet-rich fibrin is a cheap, cost-effective, and completely autologous platelet concentrate with enriched growth factors. It improves the overall success rate of myringoplasty with no noticeable side effects.
Publisher
Springer Science and Business Media LLC
Subject
Otorhinolaryngology,General Medicine
Reference16 articles.
1. Botirov AJ, Isroilov RI, Matkuliyev KH, Akhundjanov NO, Djuraev JA, Zokirova ZJ (2020) Clinical and morphological results of xenografts to use in myringoplasty. Int Tinnitus J 24(1):1–6
2. O'Leary S, Darke A, Currie K, Ozdowska K, Patel H (2019) Outcomes of primary myringoplasty in indigenous children from the Northern Territory of Australia. Int J Pediatr Otorhinolaryngol 127:109634
3. Mandour YMH, Mohammed S, Menem MA (2019) Bacterial cellulose graft versus fat graft in closure of tympanic membrane perforation. Am J Otolaryngol 40(2):168–172
4. Gupta S, Goil P, Thakurani S (2020) Autologous platelet rich plasma as a preparative for resurfacing burn wounds with split thickness skin grafts. World J Plastic Surg 9(1):29
5. El-Anwar MW, Nofal AAF, Khalifa M, Quriba AS (2016) Use of autologous platelet-rich plasma in complete cleft palate repair. Laryngoscope 4:67–69