MYRINGOPLASTY OF CENTRAL TYMPANIC MEMBRANE PERFORATION WITH A FAT GRAFT FROM THE EAR LOBULE AND PLATELET RICH PLASMA.

AbstractObjective:The aim of this study was to investigate the effect of local application of platelet-rich plasma to perforated rat tympanic membranes, in terms of healing time and histopathological outcome.Methods:Eighty-eight tympanic membranes of 44 rats were given a standard 3 mm perforation, and platelet-rich plasma was applied to the right tympanic membrane perforations. The left tympanic membranes were left to heal spontaneously, as controls. The 44 rats were divided into two groups. In group one, comprising 20 rats, daily otomicroscopic examination of the tympanic membrane perforations was performed. The 24 rats in group two were subdivided into four subgroups of six rats each; these subgroups were sacrificed sequentially on days three, seven, 14 and 28 for histopathological examination, regardless of tympanic membrane healing stage.Results:In group one, the mean tympanic membrane healing times for tympanic membrane perforations receiving platelet-rich plasma and controls were respectively 10.2 ± 2.1 and 13.0 ± 2.9 days (mean ± standard deviation). This difference was statistically significant (p < 0.001). In group two, histopathological evaluation of tympanic membrane perforation healing at days three, seven, 14 and 28 did not reveal any statistically significant difference, individually or within the four groups as a whole.Conclusion:These findings suggest that earlier healing of tympanic membrane perforations occurred in the platelet-rich plasma group compared with the control group. These findings suggest that platelet-rich plasma is effective in accelerating tympanic membrane perforation healing, and that it may be effective in human subjects, particularly as it is an autologous material.

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Platelet-Rich Plasma Fat Graft versus Cartilage Perichondrium for Repair of Medium-Size Tympanic Membrane Perforations

Otolaryngology ◽

10.1177/0194599818789146 ◽

2018 ◽

Vol 160 (1) ◽

pp. 116-121 ◽

Cited By ~ 3

Author(s):

Mahmoud Fawzy Mandour ◽

Mohamed Nasser Elsheikh ◽

Mohamed Fathy Khalil

Keyword(s):

Tympanic Membrane ◽

Platelet Rich Plasma ◽

Neck Surgery ◽

Tympanic Membrane Perforation ◽

Fat Graft ◽

Controlled Study ◽

Medium Size ◽

Tympanic Membrane Perforations ◽

Group 2 ◽

Group 1

Objectives To compare clinical and audiologic outcomes among patients who underwent myringoplasty with fat graft enriched with platelet-rich plasma and cartilage perichondrium graft. Study Design Prospective randomized controlled study. Setting Department of Otolaryngology–Head and Neck Surgery, Tanta University, Egypt. Subjects and Methods The study comprised 50 patients who had tympanic membrane perforation of medium size (25%-50% of its surface area) without evidence of active otitis media or ossicular abnormalities and who had surgery between December 2016 and December 2017. Patients randomly underwent myringoplasty with fat graft enriched with platelet-rich plasma (group 1) or cartilage perichondrium graft (group 2). Results Twenty-five patients were included in each group. Rates of successful closure at 3-month follow-up were 88% (group 1) and 92% (group 2). The mean overall improvement in pure tone average was 18.08 dB (95% CI, 16.9-19.25) for group 1 and 18.24 dB (95% CI, 16.94-19.53) for group 2. Conclusion Fat graft enriched with platelet-rich plasma can be recommended as an alternative choice for first-line treatment of medium-size central perforations of the tympanic membrane, with healing and hearing results comparable to those of conventional cartilage perichondrium myringoplasty.

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Bacterial cellulose graft versus fat graft in closure of tympanic membrane perforation

American Journal of Otolaryngology ◽

10.1016/j.amjoto.2018.12.008 ◽

2019 ◽

Vol 40 (2) ◽

pp. 168-172 ◽

Cited By ~ 7

Author(s):

Yasser Mohammad Hassan Mandour ◽

Samira Mohammed ◽

M.o.Abdel Menem

Keyword(s):

Tympanic Membrane ◽

Bacterial Cellulose ◽

Tympanic Membrane Perforation ◽

Fat Graft ◽

Membrane Perforation

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Fat graft myringoplasty in children – a safe and successful day-stay procedure

The Journal of Laryngology & Otology ◽

10.1017/s002221510013659x ◽

1997 ◽

Vol 111 (2) ◽

pp. 106-108 ◽

Cited By ~ 39

Author(s):

R. B. Mitchell ◽

Kevin D. Pereira ◽

Rande H. Lazar

Keyword(s):

Tympanic Membrane ◽

Otitis Media With Effusion ◽

Tympanic Membrane Perforation ◽

Successful Outcome ◽

Fat Graft ◽

Graft Material ◽

Surgical Closure ◽

Tympanic Membrane Perforations ◽

Membrane Perforation ◽

Ventilation Tubes

AbstractThe surgical closure of dry tympanic membrane perforations in children remains a controversial issue due to conflicting opinions on the appropriate technique, graft material and success rate. We present a review of 342 children who underwent fat graft myringoplasty as a day-stay procedure over a six-year period. Successful closure of the tympanic membrane perforation was achieved in 92 per cent of ears. Subsequent recurrent otitis media with effusion required insertion of ventilation tubes in 12 per cent. No relationship was observed between the age of the child and a successful outcome. We conclude that day-stay fat graft myringoplasty is a safe and successful procedure which results in a dry and safe ear in the majority of children.

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