Comparative Study of Outcome of Platelet-Rich Plasma (PRP) and Temporalis Fascia in Myringoplasty

Abstract

Aim: this study aims to evaluate the efficacy of a PRP hourglass graft compared with the conventional method
employing a temporalis fascia underlay graft in treating tympanic membrane perforation.
Materials and methods: this randomized controlled trial randomized was conducted in the period from
October 2018 to December 2020 on forty patients with chronic otitis media safe dry mucosal disease presented to
department of otorhinolaryngology, Beni Suef University. They were randomly assigned into two groups (the first
group underwent myringoplasty using autologous PRP graft and the 2nd group underwent myringoplasty using
autologous temporalis fascia graft only (20 in each)).
Results: Though all post-operative A-B gaps at 500, 1000 and 2000 Hz seemed to be to be lower with temporalis
fascia graft, yet not significant. However, the average A-B gap was statistically higher in PRP group than temporalis
fascia, P-value = 0.035. Myringoplasty with temporalis fascia graft showed significant reduction in A-B gaps at
500, 1000 and 2000 Hz. While PRP showed no significant improvement was shown at low frequencies (500 Hz),
with significant improvement at higher frequencies (1000 & 2000 Hz). Both methods showed an improvement in
average A-B gaps, P-value =0.001 in temporalis fascia group and 0.034 in PRP group. Post-operative full healing
after 3 months, complications, graft lateralization, and displacement into the middle didn’t differ significantly in
both groups.
Conclusion: After a successful myringoplasty treatment, patients with PRP grafts had comparable hearing results
to those with fascial grafts, as shown by significant reductions in the mean air-bone gap from pre-operative to
post-operative.