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富血小板纤维蛋白凝胶脂肪移植鼓膜成形术与脂肪移植鼓膜成形术治疗不同大小鼓膜穿孔的比较。

A Comparison of the Autologous Platelet-Rich Plasma Gel Fat Graft Myringoplasty and the Fat Graft Myringoplasty for the Closure of Different Sizes of Tympanic Membrane Perforations.

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, Namık Kemal University, Tekirdağ, Turkey.

出版信息

Ear Nose Throat J. 2020 Jun;99(5):331-336. doi: 10.1177/0145561319900388. Epub 2020 Jan 13.

Abstract

OBJECTIVE

We aimed to evaluate the effect of autologous platelet-rich plasma gel (PRPG) on fat graft myringoplasty (FGM) in tympanic membrane perforations caused by chronic otitis media.

METHODS

This retrospective study involved 63 patients who underwent operations between 2015 and 2018. Fat graft myringoplasty was performed with the transcanal approach with and without the use of PRPG in the surgical field. The patients were classified into 2 groups: group A, which included 32 patients who underwent FGM with the use of autologous PRPG, and group B, which included 31 patients who underwent FGM alone. Tympanic membrane perforations were divided into 2 groups: small perforations (1-2 mm) in a single quadrant and large perforations (2-4 mm) in at least 2 quadrants.

RESULTS

Both groups were statistically matched regarding age and sex. The mean postoperative follow-up was 11.6 and 12.1 months for groups A and B, respectively. Four months postoperatively, the success rate of the graft in group A (100%) was significantly higher than that in group B (83.8%; = .03). The preoperative and postoperative median air-bone gaps of the groups were similar ( = .653 and = .198, respectively). No worsening of the air-bone gap was noted postoperatively in either group.

CONCLUSIONS

This study demonstrated that autologous PRPG application during FGM allows for a higher success rate than FGM alone. Furthermore, the use of PRPG with FGM for large perforations increases the success rate. Further studies are needed to investigate the PRPG healing effect on other tympanic membrane perforation closure techniques.

摘要

目的

我们旨在评估自体富血小板血浆凝胶(PRPG)对慢性中耳炎引起的鼓膜穿孔脂肪移植成形术(FGM)的影响。

方法

这是一项回顾性研究,共纳入 63 例于 2015 年至 2018 年间接受手术的患者。FGM 采用经耳道入路,术中部分患者术野应用 PRPG,部分患者未应用 PRPG。患者分为两组:A 组(n=32)行 FGM 并应用自体 PRPG,B 组(n=31)行 FGM 但未应用 PRPG。鼓膜穿孔分为两组:单象限小穿孔(1-2mm)和至少 2 个象限的大穿孔(2-4mm)。

结果

两组患者的年龄和性别均具有统计学可比性。A、B 两组患者的平均术后随访时间分别为 11.6 个月和 12.1 个月。术后 4 个月,A 组(100%)的移植物成功率显著高于 B 组(83.8%;=0.03)。两组患者术前和术后的气骨导间隙中位数相似(=0.653,=0.198)。两组患者术后气骨导间隙均无恶化。

结论

本研究表明,与单独行 FGM 相比,FGM 术中应用自体 PRPG 可提高成功率。此外,对于大穿孔,应用 PRPG 联合 FGM 可提高成功率。需要进一步的研究来探究 PRPG 对其他鼓膜穿孔闭合技术的愈合效果。

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