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

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.