Steiner Nejc, Vozel Domen, Bozanic Urbancic Nina, Troha Kaja, Lazar Andraz, Kralj-Iglic Veronika, Battelino Saba
Otorhinolaryngology Department, UMC Ljubljana, Zaloska cesta 2, 1000 Ljubljana, Slovenia.
Medical Faculty, University of Ljubljana, Vrazov Trg 2, 1000 Ljubljana, Slovenia.
J Pers Med. 2025 Jun 4;15(6):233. doi: 10.3390/jpm15060233.
This study aimed to investigate the impact of platelet-rich plasma (PRP) and platelet-rich gel (PRG) on tympanic membrane closure rates, hearing improvement, and quality of life following tympanoplasty. Seventy-two patients with chronic tympanic membrane perforations were enrolled in a double-blinded, randomized controlled trial at a single tertiary referral center. All patients underwent tympanoplasty using a temporalis fascia graft and were randomly assigned to one of two groups: one group received standard tympanoplasty alone, while the other received intraoperative application of autologous PRP and PRG, in addition to the standard procedure. The PRP group demonstrated a significantly higher rate of complete tympanic membrane closure compared to the control group (32/36; 88.9% vs. 24/36; 66.7%; < 0.05). Bone conduction hearing remained unchanged in both groups, while air conduction hearing improved significantly from pre- to post-treatment in each group. However, the difference in air conduction improvement between the PRP group and the control group was not statistically significant (PRP group: Mdn = -8.25; control group: Mdn = -12.20; U = 618; z = -0.54; = 0.30). Quality of life improved in both the PRP and control groups; however, the difference between the groups was not statistically significant (PRP group: 10.44 ± 10.46; control group: 10.47 ± 8.22; 95% CI [-4.45; 4.40]; (66) = -0.01; = 0.16). Our findings suggest that intraoperative application of autologous PRP and PRG may improve tympanoplasty outcomes, particularly in cases with lower expected success rates or when performing minimally invasive transcanal procedures under local anesthesia. However, variability in PRP preparation, application methods, and graft materials across studies limits direct comparisons. Standardized protocols and further controlled studies are necessary to clarify PRP's clinical value in tympanoplasty.
本研究旨在探讨富血小板血浆（PRP）和富血小板凝胶（PRG）对鼓室成形术后鼓膜闭合率、听力改善及生活质量的影响。72例慢性鼓膜穿孔患者在一家三级转诊中心参与了一项双盲随机对照试验。所有患者均采用颞肌筋膜移植进行鼓室成形术，并随机分为两组：一组仅接受标准鼓室成形术，另一组除标准手术外，术中还应用自体PRP和PRG。与对照组相比，PRP组鼓膜完全闭合率显著更高（32/36；88.9%对24/36；66.7%；<0.05）。两组骨导听力均未改变，而每组气导听力从治疗前到治疗后均有显著改善。然而，PRP组与对照组气导改善的差异无统计学意义（PRP组：中位数=-8.25；对照组：中位数=-12.20；U=618；z=-0.54；P=0.30）。PRP组和对照组的生活质量均有所改善；然而，两组之间的差异无统计学意义（PRP组：10.44±10.46；对照组：10.47±8.22；95%可信区间[-4.45；4.4]；t(66)=-0.01；P=0.16）。我们的研究结果表明，术中应用自体PRP和PRG可能改善鼓室成形术的效果，特别是在预期成功率较低的病例或在局部麻醉下进行微创经耳道手术时。然而，不同研究中PRP的制备、应用方法和移植材料的差异限制了直接比较。需要标准化方案和进一步的对照研究来阐明PRP在鼓室成形术中的临床价值。
