Using leucocyte- and platelet-rich fibrin (L-PRF) concentrates as middle ear packing in type 1 tympanoplasty versus...

To compare the use of L-PRF versus absorbable gelatin sponge as middle ear packing in type I tympanoplasty, in terms of perforation closure and complication rates.

We retrospectively analyzed data from patients who underwent type 1 tympanoplasty for tympanic membrane perforation between January 2013 and Decembre 2022, performed by a single surgeon. After reviewing these 10 years, the two cohorts were highly asymmetrical in size, so we extended data collection to earlier cases for the smaller group (back to 1997), to achieve comparable cohort sizes (n = 115). Confounding factors including perforation type, middle ear mucosa status and graft type were compared between groups. Postoperative success and complication rates were also analyzed. A multivariable logistic regression model was used to adjust the results for relevant confounding factors.

Both groups exhibited similar confounding factors, except for graft type, with temporalis fascia being predominant in the Spongostan^® group and cartilage in the L-PRF group (p < 0.01). Success rates were high in both groups, with perforation closure rates of 91% in the L-PRF group and 95% in the Spongostan^® group. After adjustment for confounding factors, the chance of closure appeared, on average, higher with Spongostan^®; however, the 95% confidence interval was wide, and the difference was not statistically significant (p-value 0.094). The complication rate (otorrhea, granuloma) was low and comparable between groups.

L-PRF is an autologous material that can be successfully used as middle ear packing in type I tympanoplasty.