USE OF PLATELET RICH FIBRIN IN REPAIR OF SMALL, NON-HEALING TRAUMATIC PERFORATIONS OF TYMPANIC MEMBRANE
Main Article Content
Keywords
Platelet-rich fibrin (PRF) ,Myringoplasty,Traumatic tympanic membrane perforation , Air-bone gap (ABG)
Abstract
The tympanic membrane (TM) is a delicate translucent fibrous membrane that separates the external ear from the middle ear, and serves as an integral part of the tympano-ossicular system for sound transmission. TM perforation is a common presentation in the ENT clinic and can result from various causes such as trauma, infections of the middle ear and malignant tumours of the ear.1 Traumatic perforations often develop because of a slap injury, blast injury, accident, sporting injury, or instrumental injury, and 53–94% recover spontaneously1-7. Although the rates of closure of traumatic TM perforation are favourable, some otolaryngologists prefer immediate microsurgical procedures to expedite the recovery process. Albeit most traumatic TM perforations heal spontaneously, some cases can result in persistent perforation and hearing loss.8
References
1. Orji FT, Agu CC. Determinants of spontaneous healing in traumatic perforations of the tympanic membrane. Clin Otolaryngol. 2008 Oct; 33(5):420-426.
2. Lou ZC, Lou ZH, Zhang QP. Traumatic tympanic membrane: a study of etiology and factors affecting outcome. Am J Otolaryngol. 2012; 33:549–555.
3. Hempel JM, Becker A, Muller J, Krause E, Berghaus A, Braun T. Traumatic tympanic membrane perforations: clinical and audiometric findings in 198 patients. Otol Neurotol. 2012; 33:1357–1362.
4. Simsek G, Akin I. Early paper patching versus observation in patients with traumatic eardrum perforations: comparisons of anatomical and functional outcomes. J Craniofac Surg. 2014; 25:2030–2032.
5. Persaud R.D., Hajioff M.W. & Chevretton E. Otological trauma resulting from the Soho Nail Bomb in London, April 1999. Clin. Otolaryngol. 2003; 28:203–206.
6. Berger G, Finkelstein Y & Harell M. Non-explosive blast injury of the ear. J. Laryngol. Otol. 1994; 108:395–398.
7. Berger G, Finkelstein Y, Avraham S. Patterns of hearing loss in non-explosive blast injury of the ear. J. Laryngol. Otol. 1997; 111:1137–114.1
8. Gür ÖE, Ensari N, Öztürk MT, Boztepe OF, Gün T, Selçuk ÖT, Renda L. Use of a platelet-rich fibrin membrane to repair traumatic tympanic membrane perforations: a comparative study. Acta Otolaryngol. 2016 Oct; 136(10):1017-23.
9. Sogebi OA, Oyewole EA, Mabifah TO. Traumatic tympanic membrane perforations: characteristics and factors affecting outcome. Ghana Med J. 2018 Mar; 52(1):34-40.
10. El-Rasheedy AI, Abdel-Fattah AA, El-Naga HAA, El-Barbary MM. The role of simple office-based surgery in small central tympanic membrane perforation. Egypt J Otolaryngol. 2019 Jan; 35(1):12–16.
11. Kumar RD. Application of Platelet Rich Fibrin Matrix to Repair Traumatic Tympanic Membrane Perforations: A Pilot Study. Indian J Otolaryngol Head Neck Surg. 2019 Nov; 71(2):1126-1134.
12. Huang J, Teh BM, Zhou C, Shi Y, Shen Y. Tympanic membrane regeneration using platelet-rich fibrin: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol. 2022 Feb; 279(2):557-565.
13. Dohan DM, Choukroun J, Diss A, Dohan SL. Platelet rich fibrin (PRF): a second-generation platelet concentrate. Part I: technological concepts and evoluation. Oral Surg Oral Med Oral Pathol Oral Radiol Oral Endod. 2006; 101:37–44.
14. Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part II: platelet-related biologic features. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006; 101:e45–e50.
15. Habesoglu M, Oysu C, Sahin S, Sahin-Yilmaz A, Korkmaz D, Tosun A. Platelet-rich fibrin for the repair of tympanic membrane. Otolaryngology—Head and Neck Surgery. 2012 Aug; 147(2):P218-220.
16. Shukla A, Kaurav YS, Vatsyayan R. Novel Use of Platelet Rich Fibrin Membrane in Transcanal Myringoplasty: A Prospective Study. Indian J Otolaryngol Head Neck Surg. 2020 Sep ;72(3):355-362.
17. Huang J, Teh BM, Zhou C, Shi Y, Shen Y. Tympanic membrane regeneration using platelet-rich fibrin: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol. 2022 Feb; 279(2):557-565.
18. Nair NP, Alexander A, Abhishekh B, Hegde JS, Ganesan S, Saxena SK. Safety and Efficacy of Autologous Platelet-rich Fibrin on Graft Uptake in Myringoplasty: A Randomized Controlled Trial. Int Arch Otorhinolaryngol. 2019 Jan; 23(1):77-82.
19. Riaz N, Ajmal M, Khan MS. Efficacy of Platelet Rich Fibrin in Myringoplasty. Pak J Med Sci. 2021 Jan-Feb; 37(1):212-216.
20. Kütük SG, Özdaş T. Impact of platelet-rich fibrin therapy in tympanoplasty type 1 surgery on graft survival and frequency-specific hearing outcomes: a retrospective analysis in patients with tympanic membrane perforation due to chronic otitis media. The Journal of Laryngology & Otology. 2019 Dec;133(12):1068-73.
21. Hosam M, Shaker M & Aboulwafa A. Effect of topical use of platelet-rich fibrin in repairing central tympanic membrane perforation using the endoscopic inlay butterfly cartilage myringoplasty technique. Egypt J Otolaryngol. 2017; 33:557–563.
22. Mohanty R, Harkut R, Mhashal S, Kadao Y. Advancement in Tympanic Membrane Repair: Exploring the Potential of Platelet Rich Fibrin. Indian J Otolaryngol Head Neck Surg. 2024 Aug;76(4):2962-2967.
23. Aboelnaga HA, Elsharnouby MK, Ali AA, Elkamshishi TA, Abdelhafez TA. Evaluation of the use of autologous platelet-rich fibrin in myringoplasty operation. The Egyptian Journal of Otolaryngology. 2022 Dec;38(1):142.
24. Braccini F, Tardivet L, Dohan Ehrenfest DM. The relevance of Choukroun's Platelet-Rich Fibrin (PRF) during middle ear surgery: preliminary results. Rev Laryngol Otol Rhinol (Bord). 2009;130(3):175-80.
25. Al-Arman AM, Moneir W, Amer HE, Ebada HA. Platelet rich fibrin augmented tympanoplasty versus cartilage tympanoplasty: a randomized clinical trial. Eur Arch Otorhinolaryngol. 2024 Nov;281(11):5739-5746.
26. Yavuz R, Arslan S, Imamoglu M, Isik AU, Bahadir O, Y Cobanoglu HB, Yavuz HB. Impact of titanium-prepared platelet-rich fibrin in type 1 fascia graft tympanoplasty on graft survival and hearing outcomes. Niger J Clin Pract. 2023 Jul;26(7):921-927.
27. Tiple C, Chirila M, Vesa SC, Stamate MC. Plasma-Rich Fibrin-Regenerative Material in Tympanic Membrane Surgery. Medicina (Kaunas). 2023 Jul 13;59(7):1292.
28. Saini S, Khan SR, Kumar MB, Singh K, Pandey P. The Impact of Topical Application of Platelet-Rich Fibrin on Graft Survival in Surgeries for Chronic Otitis Media. Cureus. 2024 Jan 29;16(1):e53202.
29. Mathew NV, Menon SS, Ramaswamy B, Nayak DR. A randomised control trial to assess the efficacy of platelet rich fibrin in type 1 tympanoplasty. Indian Journal of Otology. 2021 Apr–Jun; 27(2):84-89.
30. Shetty N, Anchan SV, Jalisatgi RR, Naik AS, Pandurangi A, Siddappa R, Yadrami PG. Topical use of Autologous Platelet Rich Fibrin in Tympanoplasty: A Prospective Interventional Study. Journal of Clinical & Diagnostic Research. 2022 Jun 1;16(6).
31. Sharma D, Mohindroo S, Azad RK. Efficacy of platelet rich fibrin in myringoplasty. Int J Otorhinolaryngol Head Neck Surg. 2018 May;4(3):677-81.
32. Arora K, Kaintura M, Maithani T, Hernot S, Pandey AK, Varma A, Dogra R. A Comparative Analysis of Patients Undergoing Type 1 Tympanoplasty Using Platelet-Rich Fibrin versus Patients Undergoing Conventional Type 1 Tympanoplasty Without the use of Platelet-Rich Fibrin. Saudi Journal of Otorhinolaryngology Head and Neck Surgery. 2023 Apr 1;25(2):58-63.
33. Shindy M, El-Shimi O, Belal M, Abdelalim AA. Use of platelet Rich Fibrin in Acute traumatic tympanic membrane perforation compared with the conservative treatment. Benha Medical Journal. 2020 Sep 1;37(3):512-23.
34. Patel PM, Chhatbar YB, Sharma S, Vaghela PB, Tadvi PB. Platelet Rich Fibrin Graft in Myringoplasty: Pitfalls and Challenges. Indian Journal of Otolaryngology and Head & Neck Surgery. 2024 Aug;76(4):3277-82.
35. el Awady MK, Sharkawy ME, abo Mohamed NM. Effect of addition of platelet-rich fibrin to tragal perichondrium graft in the endoscopic trans-canal myringoplasty. The Egyptian Journal of Otolaryngology. 2021 Dec;37:1-6.
36. Hammouda M, Heiba MH, Ibrahim HO, Sourial MS. Endoscopic transcanal underlay myringoplasty using a platelet-rich fibrin (PRF) membrane. The Egyptian Journal of Otolaryngology. 2024 May 2;40(1):50.
37. Kakeri AA, Patel AF. A comparative study of outcome of myrigngoplasty with and without use of autologous platelet rich fibrin.
38. Aslam S, Asghar A, Bukhari SM, Akhtar S, Mumtaz H, Wasim MF. Role of fibrin glue for better success rate in myringoplasty. Pak Armed Forces Med J. 2021 Dec 2;71(suppl‐3):S603-6.
39. Choukroun J, Adda F, Schoeffler C, Vervelle AP. Une opportunité en paro-implantologie: le PRF. Implantodontie. 2001 Jan 1;42(55):e62.
40. Carniol ET, Bresler A, Shaigany K, Svider P, Baredes S, Eloy JA, Ying YM. Traumatic Tympanic Membrane Perforations Diagnosed in Emergency Departments. JAMA Otolaryngol Head Neck Surg. 2018 Feb 1;144(2):136-139.
A. T. FH, Prasad K. U. R. A clinical study of traumatic tympanic membrane perforation. Int J Otorhinolaryngol Head Neck Surg [Internet]. 2021 Sep. 27 [cited 2025 Mar. 17];7(10):1668-72.
41. Puttamadaiah GM, Bhanuprakash PN, Viswanatha B, Patil KI, Menon PA. Traumatic Perforation of Tympanic Membrane: A Prospective Study in a Tertiary Care Institute. Indian Journal of Otology. 2022 Apr 1;28(2):111-5.
42. Sagiv D, Migirov L, Glikson E, Mansour J, Yousovich R, Wolf M, Shapira Y. Traumatic Perforation of the Tympanic Membrane: A Review of 80 Cases. J Emerg Med. 2018 Feb;54(2):186-190.
43. Sarojamma RS, Satish HS. A clinical study of traumatic perforation of tympanic membrane. IOSR J Dent Med Sci. 2014 Apr;13(4):24-8.
44. Karimi K, Rockwell H. The benefits of platelet-rich fibrin. Facial Plastic Surgery Clinics. 2019 Aug 1;27(3):331-40.
2. Lou ZC, Lou ZH, Zhang QP. Traumatic tympanic membrane: a study of etiology and factors affecting outcome. Am J Otolaryngol. 2012; 33:549–555.
3. Hempel JM, Becker A, Muller J, Krause E, Berghaus A, Braun T. Traumatic tympanic membrane perforations: clinical and audiometric findings in 198 patients. Otol Neurotol. 2012; 33:1357–1362.
4. Simsek G, Akin I. Early paper patching versus observation in patients with traumatic eardrum perforations: comparisons of anatomical and functional outcomes. J Craniofac Surg. 2014; 25:2030–2032.
5. Persaud R.D., Hajioff M.W. & Chevretton E. Otological trauma resulting from the Soho Nail Bomb in London, April 1999. Clin. Otolaryngol. 2003; 28:203–206.
6. Berger G, Finkelstein Y & Harell M. Non-explosive blast injury of the ear. J. Laryngol. Otol. 1994; 108:395–398.
7. Berger G, Finkelstein Y, Avraham S. Patterns of hearing loss in non-explosive blast injury of the ear. J. Laryngol. Otol. 1997; 111:1137–114.1
8. Gür ÖE, Ensari N, Öztürk MT, Boztepe OF, Gün T, Selçuk ÖT, Renda L. Use of a platelet-rich fibrin membrane to repair traumatic tympanic membrane perforations: a comparative study. Acta Otolaryngol. 2016 Oct; 136(10):1017-23.
9. Sogebi OA, Oyewole EA, Mabifah TO. Traumatic tympanic membrane perforations: characteristics and factors affecting outcome. Ghana Med J. 2018 Mar; 52(1):34-40.
10. El-Rasheedy AI, Abdel-Fattah AA, El-Naga HAA, El-Barbary MM. The role of simple office-based surgery in small central tympanic membrane perforation. Egypt J Otolaryngol. 2019 Jan; 35(1):12–16.
11. Kumar RD. Application of Platelet Rich Fibrin Matrix to Repair Traumatic Tympanic Membrane Perforations: A Pilot Study. Indian J Otolaryngol Head Neck Surg. 2019 Nov; 71(2):1126-1134.
12. Huang J, Teh BM, Zhou C, Shi Y, Shen Y. Tympanic membrane regeneration using platelet-rich fibrin: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol. 2022 Feb; 279(2):557-565.
13. Dohan DM, Choukroun J, Diss A, Dohan SL. Platelet rich fibrin (PRF): a second-generation platelet concentrate. Part I: technological concepts and evoluation. Oral Surg Oral Med Oral Pathol Oral Radiol Oral Endod. 2006; 101:37–44.
14. Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part II: platelet-related biologic features. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006; 101:e45–e50.
15. Habesoglu M, Oysu C, Sahin S, Sahin-Yilmaz A, Korkmaz D, Tosun A. Platelet-rich fibrin for the repair of tympanic membrane. Otolaryngology—Head and Neck Surgery. 2012 Aug; 147(2):P218-220.
16. Shukla A, Kaurav YS, Vatsyayan R. Novel Use of Platelet Rich Fibrin Membrane in Transcanal Myringoplasty: A Prospective Study. Indian J Otolaryngol Head Neck Surg. 2020 Sep ;72(3):355-362.
17. Huang J, Teh BM, Zhou C, Shi Y, Shen Y. Tympanic membrane regeneration using platelet-rich fibrin: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol. 2022 Feb; 279(2):557-565.
18. Nair NP, Alexander A, Abhishekh B, Hegde JS, Ganesan S, Saxena SK. Safety and Efficacy of Autologous Platelet-rich Fibrin on Graft Uptake in Myringoplasty: A Randomized Controlled Trial. Int Arch Otorhinolaryngol. 2019 Jan; 23(1):77-82.
19. Riaz N, Ajmal M, Khan MS. Efficacy of Platelet Rich Fibrin in Myringoplasty. Pak J Med Sci. 2021 Jan-Feb; 37(1):212-216.
20. Kütük SG, Özdaş T. Impact of platelet-rich fibrin therapy in tympanoplasty type 1 surgery on graft survival and frequency-specific hearing outcomes: a retrospective analysis in patients with tympanic membrane perforation due to chronic otitis media. The Journal of Laryngology & Otology. 2019 Dec;133(12):1068-73.
21. Hosam M, Shaker M & Aboulwafa A. Effect of topical use of platelet-rich fibrin in repairing central tympanic membrane perforation using the endoscopic inlay butterfly cartilage myringoplasty technique. Egypt J Otolaryngol. 2017; 33:557–563.
22. Mohanty R, Harkut R, Mhashal S, Kadao Y. Advancement in Tympanic Membrane Repair: Exploring the Potential of Platelet Rich Fibrin. Indian J Otolaryngol Head Neck Surg. 2024 Aug;76(4):2962-2967.
23. Aboelnaga HA, Elsharnouby MK, Ali AA, Elkamshishi TA, Abdelhafez TA. Evaluation of the use of autologous platelet-rich fibrin in myringoplasty operation. The Egyptian Journal of Otolaryngology. 2022 Dec;38(1):142.
24. Braccini F, Tardivet L, Dohan Ehrenfest DM. The relevance of Choukroun's Platelet-Rich Fibrin (PRF) during middle ear surgery: preliminary results. Rev Laryngol Otol Rhinol (Bord). 2009;130(3):175-80.
25. Al-Arman AM, Moneir W, Amer HE, Ebada HA. Platelet rich fibrin augmented tympanoplasty versus cartilage tympanoplasty: a randomized clinical trial. Eur Arch Otorhinolaryngol. 2024 Nov;281(11):5739-5746.
26. Yavuz R, Arslan S, Imamoglu M, Isik AU, Bahadir O, Y Cobanoglu HB, Yavuz HB. Impact of titanium-prepared platelet-rich fibrin in type 1 fascia graft tympanoplasty on graft survival and hearing outcomes. Niger J Clin Pract. 2023 Jul;26(7):921-927.
27. Tiple C, Chirila M, Vesa SC, Stamate MC. Plasma-Rich Fibrin-Regenerative Material in Tympanic Membrane Surgery. Medicina (Kaunas). 2023 Jul 13;59(7):1292.
28. Saini S, Khan SR, Kumar MB, Singh K, Pandey P. The Impact of Topical Application of Platelet-Rich Fibrin on Graft Survival in Surgeries for Chronic Otitis Media. Cureus. 2024 Jan 29;16(1):e53202.
29. Mathew NV, Menon SS, Ramaswamy B, Nayak DR. A randomised control trial to assess the efficacy of platelet rich fibrin in type 1 tympanoplasty. Indian Journal of Otology. 2021 Apr–Jun; 27(2):84-89.
30. Shetty N, Anchan SV, Jalisatgi RR, Naik AS, Pandurangi A, Siddappa R, Yadrami PG. Topical use of Autologous Platelet Rich Fibrin in Tympanoplasty: A Prospective Interventional Study. Journal of Clinical & Diagnostic Research. 2022 Jun 1;16(6).
31. Sharma D, Mohindroo S, Azad RK. Efficacy of platelet rich fibrin in myringoplasty. Int J Otorhinolaryngol Head Neck Surg. 2018 May;4(3):677-81.
32. Arora K, Kaintura M, Maithani T, Hernot S, Pandey AK, Varma A, Dogra R. A Comparative Analysis of Patients Undergoing Type 1 Tympanoplasty Using Platelet-Rich Fibrin versus Patients Undergoing Conventional Type 1 Tympanoplasty Without the use of Platelet-Rich Fibrin. Saudi Journal of Otorhinolaryngology Head and Neck Surgery. 2023 Apr 1;25(2):58-63.
33. Shindy M, El-Shimi O, Belal M, Abdelalim AA. Use of platelet Rich Fibrin in Acute traumatic tympanic membrane perforation compared with the conservative treatment. Benha Medical Journal. 2020 Sep 1;37(3):512-23.
34. Patel PM, Chhatbar YB, Sharma S, Vaghela PB, Tadvi PB. Platelet Rich Fibrin Graft in Myringoplasty: Pitfalls and Challenges. Indian Journal of Otolaryngology and Head & Neck Surgery. 2024 Aug;76(4):3277-82.
35. el Awady MK, Sharkawy ME, abo Mohamed NM. Effect of addition of platelet-rich fibrin to tragal perichondrium graft in the endoscopic trans-canal myringoplasty. The Egyptian Journal of Otolaryngology. 2021 Dec;37:1-6.
36. Hammouda M, Heiba MH, Ibrahim HO, Sourial MS. Endoscopic transcanal underlay myringoplasty using a platelet-rich fibrin (PRF) membrane. The Egyptian Journal of Otolaryngology. 2024 May 2;40(1):50.
37. Kakeri AA, Patel AF. A comparative study of outcome of myrigngoplasty with and without use of autologous platelet rich fibrin.
38. Aslam S, Asghar A, Bukhari SM, Akhtar S, Mumtaz H, Wasim MF. Role of fibrin glue for better success rate in myringoplasty. Pak Armed Forces Med J. 2021 Dec 2;71(suppl‐3):S603-6.
39. Choukroun J, Adda F, Schoeffler C, Vervelle AP. Une opportunité en paro-implantologie: le PRF. Implantodontie. 2001 Jan 1;42(55):e62.
40. Carniol ET, Bresler A, Shaigany K, Svider P, Baredes S, Eloy JA, Ying YM. Traumatic Tympanic Membrane Perforations Diagnosed in Emergency Departments. JAMA Otolaryngol Head Neck Surg. 2018 Feb 1;144(2):136-139.
A. T. FH, Prasad K. U. R. A clinical study of traumatic tympanic membrane perforation. Int J Otorhinolaryngol Head Neck Surg [Internet]. 2021 Sep. 27 [cited 2025 Mar. 17];7(10):1668-72.
41. Puttamadaiah GM, Bhanuprakash PN, Viswanatha B, Patil KI, Menon PA. Traumatic Perforation of Tympanic Membrane: A Prospective Study in a Tertiary Care Institute. Indian Journal of Otology. 2022 Apr 1;28(2):111-5.
42. Sagiv D, Migirov L, Glikson E, Mansour J, Yousovich R, Wolf M, Shapira Y. Traumatic Perforation of the Tympanic Membrane: A Review of 80 Cases. J Emerg Med. 2018 Feb;54(2):186-190.
43. Sarojamma RS, Satish HS. A clinical study of traumatic perforation of tympanic membrane. IOSR J Dent Med Sci. 2014 Apr;13(4):24-8.
44. Karimi K, Rockwell H. The benefits of platelet-rich fibrin. Facial Plastic Surgery Clinics. 2019 Aug 1;27(3):331-40.
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Sep 30, 2026
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How to Cite
Aida Sanasam, Subham Debnath, Thongam Kalpana Devi, Ningombam Jiten Singh, Sarzu Salam, & Puyam Sobita Devi. (2026). USE OF PLATELET RICH FIBRIN IN REPAIR OF SMALL, NON-HEALING TRAUMATIC PERFORATIONS OF TYMPANIC MEMBRANE. Journal of Population Therapeutics and Clinical Pharmacology, 32(11), 1993-2007. https://doi.org/10.53555/303kht49
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Author Biographies
Aida Sanasam
Senior Resident Manipur university Email ID: [email protected]
Subham Debnath
Senior Resident Manipur university Email ID: [email protected]
Thongam Kalpana Devi
Assistant professor Manipur university Email ID: [email protected]
Ningombam Jiten Singh
Assistant Professor Manipur university Email ID: [email protected]
Sarzu Salam
Post graduate trainee Manipur university Email ID: [email protected]
Puyam Sobita Devi
Professor University - Manipur Email ID: [email protected]
How to Cite
Aida Sanasam, Subham Debnath, Thongam Kalpana Devi, Ningombam Jiten Singh, Sarzu Salam, & Puyam Sobita Devi. (2026). USE OF PLATELET RICH FIBRIN IN REPAIR OF SMALL, NON-HEALING TRAUMATIC PERFORATIONS OF TYMPANIC MEMBRANE. Journal of Population Therapeutics and Clinical Pharmacology, 32(11), 1993-2007. https://doi.org/10.53555/303kht49
