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Published in: Indian Journal of Otolaryngology and Head & Neck Surgery 2/2019

01-11-2019 | Original Article

Application of Platelet Rich Fibrin Matrix to Repair Traumatic Tympanic Membrane Perforations: A Pilot Study

Author: Rajendran Dinesh Kumar

Published in: Indian Journal of Otolaryngology and Head & Neck Surgery | Special Issue 2/2019

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Abstract

Trauma in the form of instrumentation, slap, blast, accident, and sporting injury can result in tympanic membrane (TM) perforations which spontaneously recover in 53–94%. The closure rates of TM perforation due to above causes do not vary greatly; however, some otolaryngologists prefer to perform immediate microsurgical procedures to accelerate the recovery process. Our aim is to study the efficacy of Trichloroacetic acid (TCA) Chemical Cauterization (50%) and Platelet rich fibrin (PRF) Plug Myringoplasty technique in healing traumatic tympanic membrane perforations. To evaluate the preoperative and postoperative hearing outcome from the procedure and compare them. Study design is prospective study. A pilot study was carried out amongst selected 25 patients with central perforations in the Department of ENT, for duration of 2 years from July 13 to July 15. All 25 patients underwent PTA assessment & TCA (50%) and Autologous PRF Plug Myringoplasty technique done and follow up to 6 months postoperatively. The success rate traumatic tympanic membrane closure was found to be 92%. Pre- and post-operative hearing assessments of each patient were done & showed statistically significant air–bone gap closure with success rate of 88% (p < 0.05). From this study, the closure rate in traumatic tympanic membrane perforation by TCA (50%) and PRF Plug Myringoplasty technique was 92% with statistically significant hearing improvement (88%). This technique can be recommended as a time and cost effective office based procedure for treatment of traumatic tympanic membrane perforations.
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Literature
1.
go back to reference Orji FT, Agu CC (2008) Determinants of spontaneous healing in traumatic perforations of the tympanic membrane. Clin Otolaryngol 33:420–426CrossRef Orji FT, Agu CC (2008) Determinants of spontaneous healing in traumatic perforations of the tympanic membrane. Clin Otolaryngol 33:420–426CrossRef
2.
go back to reference Lou ZC, Lou ZH, Zhang QP (2012) Traumatic tympanic membrane: a study of etiology and factors affecting outcome. Am J Otolaryngol 33:549–555CrossRef Lou ZC, Lou ZH, Zhang QP (2012) Traumatic tympanic membrane: a study of etiology and factors affecting outcome. Am J Otolaryngol 33:549–555CrossRef
3.
go back to reference Hempel JM, Becker A, Muller J, Krause E, Berghaus A, Braun T (2012) Traumatic tympanic membrane perforations: clinical and audiometric findings in 198 patients. Otol Neurotol 33:1357–1362CrossRef Hempel JM, Becker A, Muller J, Krause E, Berghaus A, Braun T (2012) Traumatic tympanic membrane perforations: clinical and audiometric findings in 198 patients. Otol Neurotol 33:1357–1362CrossRef
4.
go back to reference Simsek G, Akin I (2014) Early paper patching versus observation in patients with traumatic eardrum perforations: comparisons. Of anatomical and functional outcomes. J Craniofac Surg 25:2030–2032CrossRef Simsek G, Akin I (2014) Early paper patching versus observation in patients with traumatic eardrum perforations: comparisons. Of anatomical and functional outcomes. J Craniofac Surg 25:2030–2032CrossRef
5.
go back to reference Lou ZC, He JG (2011) A randomised controlled trial comparing spontaneous healing, gelfoam patching and edge-approximation plus gelfoam patching in traumatic tympanic membrane perforation with inverted or everted edges. Clin Otolaryngol 36:221–226CrossRef Lou ZC, He JG (2011) A randomised controlled trial comparing spontaneous healing, gelfoam patching and edge-approximation plus gelfoam patching in traumatic tympanic membrane perforation with inverted or everted edges. Clin Otolaryngol 36:221–226CrossRef
6.
go back to reference Park MK, Kim KH, Lee JD, Lee BD (2011) Repair of large traumatic tympanic membrane perforation with a Steri-strips patch. Otolaryngol Head Neck Surg 145:581–585CrossRef Park MK, Kim KH, Lee JD, Lee BD (2011) Repair of large traumatic tympanic membrane perforation with a Steri-strips patch. Otolaryngol Head Neck Surg 145:581–585CrossRef
7.
go back to reference Choukroun J, Adda F, Schoeffler C, Vervelle A (2001) Une opportunite en paro-implantologie: le PRF. Implantodontie 42:55–62 Choukroun J, Adda F, Schoeffler C, Vervelle A (2001) Une opportunite en paro-implantologie: le PRF. Implantodontie 42:55–62
8.
go back to reference Dohan DM, Chouknoun J, Diss A, Dohan SL (2006) Platelet rich fibrin (PRF): a second-generation platelet concentrate. Part I: technological concepts and evoluation. Oral Surg Oral Med Oral Pathol Oral Radiol Oral Endod 101:37–44CrossRef Dohan DM, Chouknoun J, Diss A, Dohan SL (2006) Platelet rich fibrin (PRF): a second-generation platelet concentrate. Part I: technological concepts and evoluation. Oral Surg Oral Med Oral Pathol Oral Radiol Oral Endod 101:37–44CrossRef
9.
go back to reference Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J et al (2006) Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part II: platelet-related biologic features. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 101:e45–e50CrossRef Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J et al (2006) Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part II: platelet-related biologic features. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 101:e45–e50CrossRef
10.
go back to reference Erkilet E, Koyuncu M, Atmaca S, Yarım M (2009) Platelet-rich plasma improves healing of tympanic membrane perforations: experimental study. J Laryngol Otol 123:482–487CrossRef Erkilet E, Koyuncu M, Atmaca S, Yarım M (2009) Platelet-rich plasma improves healing of tympanic membrane perforations: experimental study. J Laryngol Otol 123:482–487CrossRef
11.
go back to reference Alvaro MLN, Ortiz N, Rodriguez L, Boemo R, Fuentes JF, Mateo A, Ortiz P (2011) Pilot study on the efficiency of the biostimulation with autologous plasma rich in platelet growth factors in otorhinolaryngology. Otol Surg (Tympanoplasty Type 1) ISRN Surg 2011:451020. https://doi.org/10.5402/2011/451020 CrossRef Alvaro MLN, Ortiz N, Rodriguez L, Boemo R, Fuentes JF, Mateo A, Ortiz P (2011) Pilot study on the efficiency of the biostimulation with autologous plasma rich in platelet growth factors in otorhinolaryngology. Otol Surg (Tympanoplasty Type 1) ISRN Surg 2011:451020. https://​doi.​org/​10.​5402/​2011/​451020 CrossRef
12.
go back to reference Banzer M (1640) Disputatio de auditione laesa. Dissertation on deafness Banzer M (1640) Disputatio de auditione laesa. Dissertation on deafness
13.
go back to reference Griffin WL Jr (1979) A retrospective study of traumatic tympanic membrane perforations in a clinical practice. Laryngoscope 89:261–282PubMed Griffin WL Jr (1979) A retrospective study of traumatic tympanic membrane perforations in a clinical practice. Laryngoscope 89:261–282PubMed
14.
go back to reference Yearsley J (1863) Deafness practically illustrated. Churchill & Sons, London Yearsley J (1863) Deafness practically illustrated. Churchill & Sons, London
15.
go back to reference Toynbee J (1853) On the use of an artificial membrana tympani in cases of deafness dependent upon perforations or destruction of the natural organ. J. Churchill & Sons, London Toynbee J (1853) On the use of an artificial membrana tympani in cases of deafness dependent upon perforations or destruction of the natural organ. J. Churchill & Sons, London
16.
go back to reference Roosa DB (1876) Diseases of the ear. William Wood, New York Roosa DB (1876) Diseases of the ear. William Wood, New York
17.
go back to reference Goldman NC (2007) Chemical closure of chronic tympanic membrane perforations. ANZ J Surg 77:850–851CrossRef Goldman NC (2007) Chemical closure of chronic tympanic membrane perforations. ANZ J Surg 77:850–851CrossRef
18.
go back to reference Joynt JA (1919) Repair of drum. Iowa Med Soc 9:51 Joynt JA (1919) Repair of drum. Iowa Med Soc 9:51
19.
go back to reference Derlacki EL (1953) Repair of central perforations of tympanic membrane. Arch Otolaryngol 58:405CrossRef Derlacki EL (1953) Repair of central perforations of tympanic membrane. Arch Otolaryngol 58:405CrossRef
20.
go back to reference Gun T, Sozen T, Boztepe OF, Gur OE, Muluk NB, Cingi C (2014) Influence of size and site of perforation on fat graft myringoplasty. Auris Nasus Larynx 41:507–512CrossRef Gun T, Sozen T, Boztepe OF, Gur OE, Muluk NB, Cingi C (2014) Influence of size and site of perforation on fat graft myringoplasty. Auris Nasus Larynx 41:507–512CrossRef
21.
go back to reference Lou Z, Wang Y (2015) Evaluation of the optimum time for direct application of fibroblast growth factor to human traumatic tympanic membrane perforations. Growth Factors 33:65–70CrossRef Lou Z, Wang Y (2015) Evaluation of the optimum time for direct application of fibroblast growth factor to human traumatic tympanic membrane perforations. Growth Factors 33:65–70CrossRef
22.
go back to reference Guneri EA, Tekin S, Yılmaz O, Ozkara E, Erdag TK, Ikiz AO et al (2003) The effects of hyaluronic acid, epidermal growth factor and mitomycin in an experimental model of acute traumatic tympanic membrane perforation. Otol Neurotol 24:371–376CrossRef Guneri EA, Tekin S, Yılmaz O, Ozkara E, Erdag TK, Ikiz AO et al (2003) The effects of hyaluronic acid, epidermal growth factor and mitomycin in an experimental model of acute traumatic tympanic membrane perforation. Otol Neurotol 24:371–376CrossRef
23.
go back to reference El-Anwar MW, El-Ahl MA, Zidan AA, Yacoup MA (2015) Topical use of autologous platelet rich plasma in myringoplasty. Auris Nasus Larynx 42:365–368CrossRef El-Anwar MW, El-Ahl MA, Zidan AA, Yacoup MA (2015) Topical use of autologous platelet rich plasma in myringoplasty. Auris Nasus Larynx 42:365–368CrossRef
24.
go back to reference Habesoglu M, Oysu C, Sahin S, Sahin-Yilmaz A, Korkmaz D, Tosun A et al (2014) Platelet-rich fibrin plays a role on healing of acute-traumatic ear drum perforation. J Craniofac Surg 25:2056–2058CrossRef Habesoglu M, Oysu C, Sahin S, Sahin-Yilmaz A, Korkmaz D, Tosun A et al (2014) Platelet-rich fibrin plays a role on healing of acute-traumatic ear drum perforation. J Craniofac Surg 25:2056–2058CrossRef
25.
go back to reference Yamazaki KIK, Sato H (2010) A clinical study of traumatic tympanic membrane perforation. Nippon Jibiinkoka Gakkai Kaiho 113:679–686CrossRef Yamazaki KIK, Sato H (2010) A clinical study of traumatic tympanic membrane perforation. Nippon Jibiinkoka Gakkai Kaiho 113:679–686CrossRef
26.
go back to reference Berger G, Finkelstein Y, Harell M (1994) Non-explosive blast injury of the ear. J Laryngol Otol 108:395–398CrossRef Berger G, Finkelstein Y, Harell M (1994) Non-explosive blast injury of the ear. J Laryngol Otol 108:395–398CrossRef
Metadata
Title
Application of Platelet Rich Fibrin Matrix to Repair Traumatic Tympanic Membrane Perforations: A Pilot Study
Author
Rajendran Dinesh Kumar
Publication date
01-11-2019
Publisher
Springer India
Published in
Indian Journal of Otolaryngology and Head & Neck Surgery / Issue Special Issue 2/2019
Print ISSN: 2231-3796
Electronic ISSN: 0973-7707
DOI
https://doi.org/10.1007/s12070-017-1239-6

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