"TO EVALUATE THE IMPACT OF PLATELET-RICH FIBRIN WITH CONCHAL CARTILAGE GRAFT AND PLATELET-RICH FIBRIN WITH TEMPORALIS FASCIA GRAFT ON ENHANCING AUDITORY FUNCTION FOLLOWING TYMPANOPLASTY: A RANDOMIZED CONTROLLED TRIAL."
Main Article Content
Keywords
.
Abstract
Background: Tympanic membrane perforations can lead to significant hearing loss and often necessitate surgical intervention. Conchal cartilage grafts and temporalis fascia grafts are commonly employed in tympanoplasty procedures. Recent advancements suggest that the incorporation of platelet-rich fibrin (PRF) may enhance the healing process [Saluja et al.,2011][1].
Objective: This study aims to evaluate and compare the effectiveness of PRF combined with conchal cartilage graft versus PRF combined with temporalis fascia graft in the repair of tympanic membrane perforations, with a focus on auditory function improvement [Taneja et al., 2020][2].
Methods: This randomized controlled trial involved 100 patients with tympanic membrane perforations. The patients were randomly assigned into two groups, each consisting of 50 patients: Group A received PRF with conchal cartilage graft, and Group B received PRF with temporalis fascia graft. The primary outcome measure was the improvement in hearing function, assessed through audiometric tests pre- and post-operatively [Erkilet et al., 2009][3].
Results: Both groups exhibited comparable demographic characteristics (p-values: age 0.286; gender 0.423). The mean hearing gain was greater in Group 1 (14.63 dB) compared to Group 2 (13.47 dB), although not statistically significant (p=0.32). At three months post-operatively, complete tympanic membrane healing rates were 98% in Group 1 versus 94% in Group 2 (p=0.371) [Nair et al.,2019][4].
Conclusion: The study suggests that PRF combined with conchal cartilage grafts may provide better auditory function restoration and similar healing outcomes compared to temporalis fascia grafts in tympanoplasty. Further research is warranted to explore the clinical implications of these findings in larger populations [Sharma et al., 2018][5].
References
2. Taneja MK. Role of Platelet Rich Plasma in Tympanoplasty. Indian J Otolaryngol [13] Head Neck Surg. 2020;72(2):247-50.
3. Erkilet E, Koyuncu M, Atmaca S, Yarim M. Platelet-rich plasma improves healing [14] of tympanic membrane perforations: Experimental study. J Laryngol Otol. 2009;123(5):482-87.
4. Nair NP, Alexander A, Abhishekh B, Hegde JS, Ganesan S, Saxena SK. Safety [18] and Efficacy of Autologous Platelet-rich Fibrin on Graft Uptake in Myringoplasty: A Randomized Controlled Trial. Int Arch Otorhinolaryngol. 2019;23(1):77-82.
5. Sharma D, Mohindroo S, Azad RK. Efficacy of platelet rich fibrin in myringoplasty. [19] Int J Otorhinolaryngol Head Neck Surg. 2018;4(3):677-81.
6. Wahid F, Nagra S. Incidence and characteristics of Traumatic Tympanic [10] Membrane perforation. Pak J of Med Sci. 2018;34(5):1099-1103.
7. Ahmed LA, Raza SS. “Temporalis Fascia lateral or medial side up in underlay [8] tympanoplasty type-I Does it make a difference?” J Otolaryngol Advances. 2015;1(1):40-46
8. Dhingra PL, Dhingra S. Diseases of ear, nose and throat and head and neck [7] surgery, 7th edition. 2017;31-33:463.
9. Snow J, Wackym P. 2009 Bllenger’s otorhinolaryngology 17. Shelton CT: [1] People’s Medical Publishing House & BC Decker, p175.
10. Choukroun JI, Braccini F, Diss A, Giordano G, Doglioli P, Dohan DM. Influence of [12] platelet rich fibrin (PRF) on proliferation of human preadipocytes and tympanic keratinocytes: A new opportunity in facial lipostructure (Coleman’s technique) and tympanoplasty. Rev Laryngol Otol Rhinol (Bord). 2007;128(1-2):27-32.
11. Dohan Ehrenfest DM, Rasmusson L, Albrektsson T. Classification of platelet [6] concentrates: From pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF). Trends Biotechnol. 2009;27(3):158-67
12. Prakash S, Thakur A. Platelet concentrates: Past, Present and future. J Maxillofac [5] Oral Surg. 2011;10(1):45-49.
13. Sankarnarayanan G, Prithviraj V, Kumar RV. A Study on efficacy of autologous [17] platelet rich plasma in myringoplasty. Otolaryngology Online Journal. 2013;3(3).
14. Anwar FM, Shenoy VS, Kamath PM, Sreedharan S, Deviprasad D, Domah HA. Study [20] on use of platelet-rich plasma in myringoplasty. Indian J Otol. 2020;26(2):71-74.
15. Hosam M, Shaker M, Aboulwafa A. Effect of topical use of platelet-rich fibrin [9] in repairing central tympanic membrane perforation using the endoscopic inlay butterfly cartilage myringoplasty technique. Egypt J Otolaryngol. 2017;33:557-63.
16. Carlson ER. Bone grafting the jaws in the 21[3] st century: The use of platelet-rich plasma and bone morphogenetic protein. Alpha Omegan. 2000;93:26-30.
17. Raja VS, Naidu EM. Platelet rich fibrin- Evolution of a second-generation platelet [11] concentratre, Indian J Dent Res. 2008;19:42-46.
18. Garg AK. The use of platelet-rich plasma to enhance the success of bone grafts [2] around dental implants. Dental Implantol Update. 2000;11:17-21.
19. Habesoglu M, Oysu C, Sahin S, Sahin-Yilmaz A, Korkmaz D, Tosun A, et al. [15] Platelet-rich fibrin plays a role on healing of acute-traumatic ear drum perforation. J Craniofac Surg. 2014;25(6):2056-58.
20. Braccini F, Tardivet L, Dohan Ehrenfest DM. The relevance of Choukroun’s [16] Platelet-Rich Fibrin (PRF) during middle ear surgery preliminary results. Rev Laryngol Otol Rhinol (Bord). 2009;130(3):175-80.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr. Sanjay Gupta
Professor, Index Medical College
Dr.Navin Agrawal
Professor and HOD, Index Medical College
Dr. Tanmay Singhai
Junior Resident, Index Medical College