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.
Similar content being viewed by others
References
Orji FT, Agu CC (2008) Determinants of spontaneous healing in traumatic perforations of the tympanic membrane. Clin Otolaryngol 33:420–426
Lou ZC, Lou ZH, Zhang QP (2012) Traumatic tympanic membrane: a study of etiology and factors affecting outcome. Am J Otolaryngol 33:549–555
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 33:1357–1362
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 25:2030–2032
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 36:221–226
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 145:581–585
Choukroun J, Adda F, Schoeffler C, Vervelle A (2001) Une opportunite en paro-implantologie: le PRF. Implantodontie 42:55–62
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 101:37–44
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–e50
Erkilet E, Koyuncu M, Atmaca S, Yarım M (2009) Platelet-rich plasma improves healing of tympanic membrane perforations: experimental study. J Laryngol Otol 123:482–487
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
Banzer M (1640) Disputatio de auditione laesa. Dissertation on deafness
Griffin WL Jr (1979) A retrospective study of traumatic tympanic membrane perforations in a clinical practice. Laryngoscope 89:261–282
Yearsley J (1863) Deafness practically illustrated. 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
Roosa DB (1876) Diseases of the ear. William Wood, New York
Goldman NC (2007) Chemical closure of chronic tympanic membrane perforations. ANZ J Surg 77:850–851
Joynt JA (1919) Repair of drum. Iowa Med Soc 9:51
Derlacki EL (1953) Repair of central perforations of tympanic membrane. Arch Otolaryngol 58:405
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 41:507–512
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 33:65–70
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 24:371–376
El-Anwar MW, El-Ahl MA, Zidan AA, Yacoup MA (2015) Topical use of autologous platelet rich plasma in myringoplasty. Auris Nasus Larynx 42:365–368
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 25:2056–2058
Yamazaki KIK, Sato H (2010) A clinical study of traumatic tympanic membrane perforation. Nippon Jibiinkoka Gakkai Kaiho 113:679–686
Berger G, Finkelstein Y, Harell M (1994) Non-explosive blast injury of the ear. J Laryngol Otol 108:395–398
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
None declared.
Informed Consent
Informed consent was obtained from all individual participants included in the study.
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Supplementary material 1 (WMV 6204 kb)
Supplementary material 2 (WMV 21221 kb)
Rights and permissions
About this article
Cite this article
Kumar, R.D. Application of Platelet Rich Fibrin Matrix to Repair Traumatic Tympanic Membrane Perforations: A Pilot Study. Indian J Otolaryngol Head Neck Surg 71 (Suppl 2), 1126–1134 (2019). https://doi.org/10.1007/s12070-017-1239-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12070-017-1239-6