Department of Otorhinolaryngology, Head and Neck Surgery, Usak Training and Research Hospital, Usak, Turkey.
Department of Otorhinolaryngology, Head and Neck Surgery, Karadeniz Technical University, School of Medicine, Trabzon, Turkey.
Niger J Clin Pract. 2023 Jul;26(7):921-927. doi: 10.4103/njcp.njcp_620_22.
Type 1 fascia graft tympanoplasty (T1FGT) is the mainstay surgical approach for the treatment of tympanic membrane perforations. The most widely used graft material is temporal muscle fascia, and graft take rates are reported differently. The methods to enhance graft take are still being investigated. Aim: The aim of our study was to investigate the effect of titanium-prepared platelet-rich fibrin (T-PRF) on graft take and hearing outcomes in T1FGT.
Fifty-seven ears eligible for T1FGT were involved in the study and prospectively evaluated. T-PRF was applied with T1FGT in 27 ears. Thirty ears in the other group underwent only T1FGT. The patients underwent an otomicroscopic and audiometric examination in preoperative and postoperative 2 week, 1 month, and 6 month. Both groups were evaluated in terms of hearing levels, infection, and graft take rates.
Two patients in the T1FGT + T-PRF group and seven patients in the T1FGT group had postoperative perforation (graft take rate: 92.6% versus 76.7%). The graft take rate was found to be increased in the T-PRF group although the difference was not statistically significant. In the T1FGT group, the percentage of infection was higher than in the T1FGT + T-PRF group. When the preoperative and postoperative 6-month audiometry was compared, a statistically significant hearing gain was obtained for both groups.
In the treatment of tympanic membrane perforations, T-PRF applied over the fascia graft was shown to increase graft take rates and decrease the probability of infection. Further studies with larger samples are needed to demonstrate the effects of PRF.
1 型筋膜移植物鼓室成形术（T1FGT）是治疗鼓膜穿孔的主要手术方法。最常用的移植物材料是颞肌筋膜，其移植物成活率报道不一。增强移植物成活率的方法仍在研究中。目的：本研究旨在探讨钛制备富血小板纤维蛋白（T-PRF）对 T1FGT 中移植物成活率和听力结果的影响。
本研究共纳入 57 例符合 T1FGT 条件的患者，并进行前瞻性评估。27 例患者在 T1FGT 中应用 T-PRF，另 30 例患者仅行 T1FGT。所有患者在术前和术后 2 周、1 个月和 6 个月进行耳镜检查和听力测试。比较两组患者的听力水平、感染和移植物成活率。
T1FGT+T-PRF 组有 2 例患者和 T1FGT 组有 7 例患者术后出现穿孔（移植物成活率：92.6%比 76.7%）。尽管差异无统计学意义，但 T-PRF 组的移植物成活率有所增加。T1FGT 组的感染率高于 T1FGT+T-PRF 组。当比较 T1FGT 组和 T1FGT+T-PRF 组术前和术后 6 个月的听力测试时，两组均获得了有统计学意义的听力增益。
在治疗鼓膜穿孔时，将 T-PRF 应用于筋膜移植物上可增加移植物成活率并降低感染概率。需要进一步开展更大样本量的研究来证实 PRF 的效果。
