Alahmadi Rana A, Lajdam Ghassan Bin, Aghashami Afnan, Hamdan Dalia, Almalki Abdulaziz H, Altalhi Atheer A, Amoodi Hosam A
College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.
Otolaryngol Head Neck Surg. 2025 Jan;172(1):25-35. doi: 10.1002/ohn.988. Epub 2024 Sep 29.
We aimed to perform a systematic review and meta-analysis of myringoplasty outcomes following platelet concentrates application in patients with chronic otitis media (COM).
We searched MEDLINE, Embase, and Cochrane Central register of Controlled Clinical Trials (CENTRAL). We also performed a manual search in Google Scholar and reference lists.
Eligible for inclusion were randomized controlled trials on COM patients undergoing myringoplasty with platelet concentrates (platelet-rich plasma or platelet-rich fibrin) compared to myringoplasty alone. The primary outcomes were graft uptake and air-bone gap (ABG) gain, while the secondary outcome was complication rate. We used odds ratio (OR) and standardized mean difference (SMD) to represent dichotomous and continuous outcomes, respectively.
Thirteen trials (n = 1179) were deemed eligible. Platelet concentrates significantly improved graft uptake after 6 months (OR: 2.45, 95% confidence interval [CI]: 1.34-4.47, P = .004, I = 0%, high certainty), ABG gain (SMD: 0.36, 95% CI: 0.17-0.55, P = .0002, I = 0%, moderate certainty), and complication rate (OR: 0.38, 95% CI: 0.18-0.82, P = .01, I = 0%, low certainty).
Our results showed that platelet concentrates may improve graft uptake and ABG gain and reduce complications in COM patients undergoing myringoplasty. Caution is warranted given to the relatively small sample size, as well as inconsistent reporting across included trials.
我们旨在对慢性中耳炎（COM）患者应用血小板浓缩物后的鼓膜成形术结果进行系统评价和荟萃分析。
我们检索了MEDLINE、Embase和Cochrane对照临床试验中心注册库（CENTRAL）。我们还在谷歌学术和参考文献列表中进行了手动检索。
纳入的研究为关于COM患者接受血小板浓缩物（富血小板血浆或富血小板纤维蛋白）鼓膜成形术与单纯鼓膜成形术对比的随机对照试验。主要结局为移植物摄取和气骨导差（ABG）改善，次要结局为并发症发生率。我们分别用比值比（OR）和标准化均数差（SMD）来表示二分法和连续性结局。
13项试验（n = 1179）被认为符合纳入标准。血小板浓缩物显著改善了6个月后的移植物摄取（OR：2.45，95%置信区间[CI]：1.34 - 4.47，P = .004，I² = 0%，高确定性）、ABG改善（SMD：0.36，95%CI：0.17 - 0.55，P = .0002，I² = 0%，中等确定性）以及并发症发生率（OR：0.38，95%CI：0.18 - 0.82，P = .01，I² = 0%，低确定性）。
我们的结果表明，血小板浓缩物可能改善COM患者鼓膜成形术后的移植物摄取和ABG改善，并减少并发症。鉴于样本量相对较小以及纳入试验报告的不一致性，需谨慎对待。
