A Study of Efficiency of Autologous Platelet Rich Plasma in Myringoplasty

Abstract

Background: Chronic suppurative otitis media is defined as chronic inflammation of the mucoperiosteal lining of the middle ear cleft. It is associated with a persistent or intermittent infected discharge through a non-intact tympanic membrane. PRP is proven to be effective in aiding the graft uptake in myringoplasty in various studies. Platelet rich plasma is also effective in preventing the recurrence of perforation, thus avoiding repeated surgeries. It can also aid in hearing improvement. Hence the patients show greater degree of satisfaction with the surgery.

Methodology:  Hospital based Cross sectional study was conducted on the patients attending the out-patient department of ENT department at SMVMCH, who have undergone Myringoplasty within the duration of 18 months. The data collection was done for a period of 18 months after obtaining approval from the Institutional Ethics Committee. For all the selected patients, a thorough history and examination was conducted. The patients with PRP application were grouped under study group and those with conventional surgery were grouped under control group until the required sample size is attained. Both the groups had undergone PTA and otoendoscopy preoperatively. And 8 weeks post-operatively patient was subjected to PTA and otoendoscopy. results were collected and analysed. 

Results: The average PTA value was 24 in control group and 30 in control group. And the hearing improvement is better in the group with PRP application which was statistically significant. It was found in PRP group 96.9% of patients had healthy graft and 3.1% had recurrent perforation whereas in control group 78.1% had healthy graft and 21.9% had recurrent perforation.

Conclusions: The platelet rich plasma in Myringoplasty was found to be highly efficient. It was found to improve graft uptake and PTA value. It was also found to improve the hearing in patients when compared to patients who had not undergone PRP application. Platelet Rich Plasma, being safe, autologous and easily prepared can be applied over graft in “Myringoplasty for better outcomes and reduced failure rates.