Comparison Between the Effect of Topical Platelet-Rich Fibrin and Absorbable Gelatin Sponge on Graft Uptake in Type 1 Tympanoplasty

局部应用富血小板纤维蛋白和可吸收明胶海绵对I型鼓室成形术中移植片吸收效果的比较

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Abstract

BACKGROUND: Chronic otitis media (COM) is an inflammatory process in the middle-ear space that results in long-standing or permanent changes in the tympanic membrane. Platelet-rich fibrin (PRF) is a unique platelet concentrate that is being used in various fields due to its capability to augment healing. AIMS: Our study aimed to assess whether the use of PRF facilitated graft uptake when compared to the traditional practice of using gel foam to augment graft uptake. METHODOLOGY: A prospective and interventional randomized comparative study was conducted with 100 patients, who all underwent type 1 tympanoplasty using the temporalis fascia as the graft material through the underlay technique performed via a post-aural approach with PRF in one group (Group A) and without PRF in the other (Group B). Postoperative follow-up was done at the end of the first, second, and third months after surgery for the assessment of graft uptake, postoperative infection, and hearing status. RESULTS: The graft uptake rate in the two groups was 98% (Group A) and 88% (Group B) but was not statistically significant (p=0.11). The infection rate in the postoperative period was low in both groups, being 2% and 12% in Groups A and B, respectively. However, there was an improvement in the air-bone gap of 24.8 dB in the PRF group, while it was only 19 dB in the control group (p=0.008), which was statistically significant. CONCLUSION: It was concluded from our study that PRF helps in better graft uptake and less postoperative infection rate and contributes to a marked enhancement in hearing.

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