Garin P, Peerbaccus Y, Mullier F, Gheldof D, Dogne Jean-Michel, Putz L, Van Damme J P
B-ENT. 2014;10(1):27-34.
To assess the use of PRF prepared using an optimised protocol in middle ear surgery as a substitute for conventional packing products of animal origin such as collagen derived from porcine skin.
A retrospective study of 108 patients in whom optimised PRF was used exclusively to pack the external auditory canal or middle ear. The effectiveness or harmlessness of the PRF was evaluated by assessing a range of parameters. A morphological comparison was also made of PRF produced using the Choukroun procedure and our procedure.
The success rate of the repair of the tympanic membrane one year after the surgery was 45/48 patients. In 5 of 63 patients in whom a retro-auricular approach and wall-up technique were used, granuloma was observed along the incision in the ear canal. Granuloma was not seen in any of the 23 patients undergoing a procedure with an endaural approach.
The use of a material prepared from patients themselves and not of animal origin has numerous advantages in terms of biocompatibility and safety, without any adverse effect on the success rate for general middle ear procedures. The protocol is simple and does not prolong the time spent by the patient in the operating theatre. The Choukroun technique should be modified to prevent excessive failure rates in PRF processing.
评估采用优化方案制备的富血小板纤维蛋白（PRF）在中耳手术中替代传统动物源性填充产品（如猪皮来源的胶原蛋白）的应用情况。
对108例仅使用优化后的PRF填充外耳道或中耳的患者进行回顾性研究。通过评估一系列参数来评价PRF的有效性或无害性。还对采用舒克鲁恩法和我们的方法制备的PRF进行了形态学比较。
术后一年鼓膜修复成功率为45/48例患者。在63例采用耳后入路和鼓室成形术的患者中，有5例在耳道切口处观察到肉芽肿。在23例采用耳内入路手术的患者中均未见到肉芽肿。
使用由患者自身制备而非动物源性的材料，在生物相容性和安全性方面具有诸多优势，对一般中耳手术的成功率没有任何不利影响。该方案简单，不会延长患者在手术室的时间。应改进舒克鲁恩技术以防止PRF制备过程中的过高失败率。
