Topical platelet rich plasma versus hyaluronic acid during fat graft myringoplasty

Fouad, Yasser Ahmed; Abdelhady, Mohammad; El‐Anwar, Mohammad Waheed; Merwad, Ezzat A.

doi:10.1016/j.amjoto.2018.08.004

Cited by 18 publications

(23 citation statements)

References 19 publications

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“…Saeedi et al 23 reported that adding PRP to conventional sponge gels used in TM perforation repair increased the complete healing rate of TM perforation with fewer complications and less morbidity. Fouad et al 24 found that FGM alone achieved significantly lower success rates than the HAFGM and PRP-FGM. In addition, they found no significant difference between the PRP and HA.…”

Section: Discussionmentioning

confidence: 99%

A Comparison of the Autologous Platelet-Rich Plasma Gel Fat Graft Myringoplasty and the Fat Graft Myringoplasty for the Closure of Different Sizes of Tympanic Membrane Perforations

Ersözlü

Gültekin

2020

Ear Nose Throat J

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Objective: We aimed to evaluate the effect of autologous platelet-rich plasma gel (PRPG) on fat graft myringoplasty (FGM) in tympanic membrane perforations caused by chronic otitis media. Methods: This retrospective study involved 63 patients who underwent operations between 2015 and 2018. Fat graft myringoplasty was performed with the transcanal approach with and without the use of PRPG in the surgical field. The patients were classified into 2 groups: group A, which included 32 patients who underwent FGM with the use of autologous PRPG, and group B, which included 31 patients who underwent FGM alone. Tympanic membrane perforations were divided into 2 groups: small perforations (1-2 mm) in a single quadrant and large perforations (2-4 mm) in at least 2 quadrants. Results: Both groups were statistically matched regarding age and sex. The mean postoperative follow-up was 11.6 and 12.1 months for groups A and B, respectively. Four months postoperatively, the success rate of the graft in group A (100%) was significantly higher than that in group B (83.8%; P = .03). The preoperative and postoperative median air–bone gaps of the groups were similar ( P = .653 and P = .198, respectively). No worsening of the air–bone gap was noted postoperatively in either group. Conclusions: This study demonstrated that autologous PRPG application during FGM allows for a higher success rate than FGM alone. Furthermore, the use of PRPG with FGM for large perforations increases the success rate. Further studies are needed to investigate the PRPG healing effect on other tympanic membrane perforation closure techniques.

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Section: Discussionmentioning

confidence: 99%

A Comparison of the Autologous Platelet-Rich Plasma Gel Fat Graft Myringoplasty and the Fat Graft Myringoplasty for the Closure of Different Sizes of Tympanic Membrane Perforations

Ersözlü

Gültekin

2020

Ear Nose Throat J

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“…Of the 34 nonrepetitive studies identified, eight studies [8][9][10][11][12][13][14][15] including 455 participants with different sizes of TM perforations were eligible for final selection after screening the full texts. These included studies published from 2015 to July 2020 and consisted of five RCTs [9,10,[12][13][14], one prospective study [15], and two retrospective studies [8,11]. Seven of the included studies [8][9][10][12][13][14][15] compared the efficacy of PRP with conventional tympanoplasty or myringoplasty.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…remaining study reported the outcomes of three treatment arms [11], including PRP combined with FGM, hyaluronic acid (HA) with FGM and FGM alone. Within the studies, the follow-up time ranged 3 to 12 months.…”

Section: Plos Onementioning

confidence: 99%

“…All of the included studies [8][9][10][11][12][13][14][15] A sensitivity analysis was performed, which did not change the results of this meta-analysis, indicating the results can be considered consistent and reliable. However, Begg's test did not be performed to reflect the publication bias because the number of included studies was less than ten.…”

Section: Closure Ratesmentioning

confidence: 99%

“…Based on previous evidence, PRP contains many growth factors (e.g., platelet-derived growth factor, PDGF), accelerating the regeneration of endothelial tissue and enhancing tissue healing. [7][8][9][10][11][12][13][14][15][16] Although the majority of human trials have reported promising benefits [8][9][10][11][12][13][14][15], the completed closure rate varies across studies, and the outcomes of both healing and hearing improvements require further evaluation. To the best of our knowledge, no systematic analysis has been performed to compare the efficacy of PRP in TM regeneration surgeries.…”

Section: Introductionmentioning

confidence: 99%

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Comparative efficacy of platelet-rich plasma applied in myringoplasty: A systematic review and meta-analysis

Huang

Shi

et al. 2021

PLoS ONE

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Background Tympanic membrane (TM) perforation is quite common in the clinical setting. Chronic TM perforations require surgical treatments such as myringoplasty. Currently, platelet-rich plasma (PRP) is a novel, effective substance that is increasingly utilized for TM perforation repair. This study aims to evaluate the effectiveness of PRP in the application of TM perforation repair. Methods A systematic search was conducted to screen the Medline, Embase, Cochrane, Scopus and Web of Science databases up to July 2020. Studies were identified in accordance with the selection criteria by two coauthors independently. Data regarding the healing and hearing outcomes were pooled and analyzed via Review Manager version 5.3 and STATA version 12.0 software. Odds ratio (OR) was utilized to compare the closure rate. Furthermore, the results of hearing improvements and incidence of complications were also compared to evaluate the effectiveness of PRP. Results A total of eight studies with 455 participants were eligible according to the selection criteria. Compared to conventional surgery, the OR of closure was 2.70 (95% CI: 1.27 to 5.76, P = 0.01, I2 = 0%) in randomized controlled trial (RCT) subgroup and 6.18 (95% CI: 2.22 to 17.25, P = 0.0005, I2 = 0) in non-RCT subgroup. The overall OR of closure was 3.69 (95% CI: 2.02 to 6.74, P<0.0001, I2 = 0%), suggesting a significant effect on the healing of TM perforation. Between preoperative and postoperative hearing results, there is no statistical difference between the PRP and the control groups. Additionally, the use of PRP resulted in a lower incidence of complication than the use of conventional approaches. Conclusion The application of PRP during the TM surgeries can enhance the closure rate, provide similar hearing improvements and decrease the incidence of postoperative complications. Given these advantages, PRP can be considered an effective treatment for TM regeneration.

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Comparing Myringoplasty to Type I Tympanoplasty in Tympanic Membrane Repair: A Systematic Review and Meta‐analysis

Jungbauer

Jeong

Nguyen

et al. 2023

Otolaryngol.--head neck surg.

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Objective To compare the anatomic success rates of type I tympanoplasty (tympanoplasty) versus myringoplasty. By our definition, tympanoplasty involves entering the middle ear via elevation of a tympanomeatal flap, while myringoplasty involves surgery to the drumhead without middle ear exposure. Data Sources PubMed, Scopus, CINAHL, Cochrane. Review Methods To be included, studies must have documented surgical technique, tympanic membrane (TM) perforation size (as % of TM), and success rate using tissue or alloplastic grafts. Exclusion criteria included series with more than 10% of patients with cholesteatoma or middle ear pathology. A meta‐analysis of weighted summary proportions under the random effects model was performed, and proportion differences (PD) were calculated. A secondary analysis of hearing outcomes was performed. Results Eighty‐five studies met inclusion, with a tympanoplasty cohort of n = 7966 and n = 1759 for myringoplasty. For perforations, less than 50% of the TM, the success rate for tympanoplasty and myringoplasty was 90.2% and 91.4%, respectively (PD: 1.2%, p = .19). In perforations greater than 50%, tympanoplasty and myringoplasty success rates were 82.8% and 85.3%, respectively (PD: 2.5%, p = .29). For both procedures, perforations less than 50% of the TM had higher success rates than perforations greater than 50% of the TM (p < .01). Both techniques endorsed significant improvements to air‐bone gap (ABG) metrics. Conclusion Our analysis suggests that the anatomic success rate is similar for tympanoplasty and myringoplasty, regardless of perforation size, and that smaller perforations experience higher success rates in both techniques. ABG outcomes were also similar between procedure techniques.

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Topical platelet rich plasma versus hyaluronic acid during fat graft myringoplasty

Cited by 18 publications

References 19 publications

A Comparison of the Autologous Platelet-Rich Plasma Gel Fat Graft Myringoplasty and the Fat Graft Myringoplasty for the Closure of Different Sizes of Tympanic Membrane Perforations

A Comparison of the Autologous Platelet-Rich Plasma Gel Fat Graft Myringoplasty and the Fat Graft Myringoplasty for the Closure of Different Sizes of Tympanic Membrane Perforations

Comparative efficacy of platelet-rich plasma applied in myringoplasty: A systematic review and meta-analysis

Comparing Myringoplasty to Type I Tympanoplasty in Tympanic Membrane Repair: A Systematic Review and Meta‐analysis

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