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CC BY 4.0 · Int Arch Otorhinolaryngol
DOI: 10.1055/s-0044-1787169
Original Article

Platelet-Rich Plasma in Fat Graft Type-1 Tympanoplasty – Should We or Should We Not?

Bikram Choudhury
1   Department of Ear, Nose, and Throat, All India Institute of Medical Sciences (AIIMS), Jodhpur, India
,
Palak Gupta 
1   Department of Ear, Nose, and Throat, All India Institute of Medical Sciences (AIIMS), Jodhpur, India
,
Saptarshi Mandal
2   Department of Transfusion Medicine and Blood Bank, All India Institute of Medical Sciences (AIIMS), Jodhpur, India
,
Vidhu Sharma 
1   Department of Ear, Nose, and Throat, All India Institute of Medical Sciences (AIIMS), Jodhpur, India
,
Kapil Soni
1   Department of Ear, Nose, and Throat, All India Institute of Medical Sciences (AIIMS), Jodhpur, India
,
Darwin Kaushal
1   Department of Ear, Nose, and Throat, All India Institute of Medical Sciences (AIIMS), Jodhpur, India
3   Department of Ear, Nose, and Throat, All India Institute of medical sciences (AIIMS), Jammu, India
› Author Affiliations Funding The authors declare that they have received no funding from agencies in the public, private or non-profit sectors for the conduction of the present study.
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Abstract

Introduction Fat grafts have been in used since 1962 for small central perforations, with a success rate ranging from 86 to 100%. Platelet-rich plasma (PRP) containing platelet concentrations greater than 1 million platelets/μL assist the healing process by various means. Current data suggests improved healing when tympanoplasty is performed using temporalis fascia grafts if PRP is added during surgery.

Objective To assess the effect of PRP on fat grafts in small and moderate-sized central perforations.

Methods The present prospective observational study was conducted with 36 patients who underwent fat graft tympanoplasty with PRP under local anesthesia. Clinical and audiological observations were carried out after 4, 8, and 12 weeks, and a statistical analysis of the observations was performed.

Results We assessed 23 patients with small central perforations and 11 patients with moderate central perforations. An overall success rate of 76.4% was observed, with an 82.6% success rate among patients with small central perforations and 63.6% among those with moderate central perforations. There was no statistically significant difference in the uptake regarding the location of the perforation, but a statistically significant difference was found in terms of hearing improvement following the procedure.

Conclusion The morbidity of conventional tympanoplasty in cases of small-to-moderate central perforations in patients with chronic otitis media vis a vis the results of the procedure needs to be revisited, as in the present study fat grafts placed with PRP under local anesthesia could lead to surgical and audiological outcomes that are as good as those reported in the literature.

Keywords

platelet-rich plasma - tympanoplasty - suppurative otitis media - eardrum perforation


Publication History

Received: 05 December 2023

Accepted: 15 April 2024

Article published online:
04 June 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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