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[Fat graft and platelet-rich plasma versus fat alone myringoplasty]
Cristian Daniel Piñón-Hernández1, Miguel Ángel Rico-Maldonado1, Martha Alicia Hernández-González2
1Instituto Mexicano del Seguro Social, Centro Médico Nacional del Bajío, Hospital de Especialidades No. 1, Servicio de Otorrinolaringología y Cirugía de Cabeza y Cuello. León, Guanajuato, México.
Background:
Myringoplasty is the most effective method for the closure of chronic tympanic perforations, fat graft as support for epithelialization has a low success rate for perforations > 30%, the use of platelet-rich plasma promises an adjuvant role in the regeneration of the tympanic membrane in perforations > 25% and <50%.
Objective:
To demonstrate the rate of successful of myringoplasty with fat graft with platelet-rich plasma in tympanic membrane perforations less than 50% compared to fat graft alone.
Material And Methods:
Clinical, randomized, controlled study. 60 patients were included with perforation of less than 50%, both sexes, without active infection, suspicion of ossicular pathology or history of mastoidectomy. Divided into two groups: Group A, 30 patients who underwent myringoplasty with fat graft and Group B, 30 patients with the same technique and platelet-rich plasma. Groups were subdivided by perforation size: Subgroup 1 (0-25%) and Subgroup 2 (26-50%).
Results:
At one month of postsurgical follow up, the tympanic membrane perforation closure success rate was significantly higher in group B compared to group A, p = 0.047. Subgroup 1: closure of 56% and 66.6% for group A and B, subgroup 2: with 0 and 13%.
Conclusions:
Myringoplasty with fat graft with platelet-rich plasma enriched is recommended as a treatment option for first line of medium-sized tympanic perforations.
