MYRINGOPLASTY OF CENTRAL TYMPANIC MEMBRANE PERFORATION WITH A FAT GRAFT FROM THE EAR LOBULE AND PLATELET RICH PLASMA.

Abstract

ABSTRACT Background: Fat myringoplasty had been described over 50 years to be a safe and simple option for myringoplasty. Platelet rich plasma [PRP] is a simple and minimally invasive method to obtain a high concentrate of autologous growth factors that can facilitate wound healing. Objectives: To assess the effectiveness of using fat and PRP in myringoplasty. Patients and methods: Twenty patients with small to medium sized tympanic membrane perforations were enrolled in this study. Under local anesthesia, the margin of the perforation was freshened, then a single piece of ear lobule fat graft, approximately double the size of the perforation, was placed through the perforation, then the PRP was applied over the fat graft. Results: Successful TM perforation repair was achieved in 36 ears [85.7%]. 100% success rate was obtained in small peroration and 79.3%in medium sized perforation. There was significant postoperative improvement in the mean air bone gap [p = 0.0016]. Conclusion: Adding PRP to fat myringoplasty is a safe, effective, cost saving and minimally invasive procedure. It is suitable to repair small as well as moderate sized TM perforations. Keywords: Myringoplasty, platelet rich plasma, tympanic membrane. Ear lobule fat Corresponding author; Ahmed Roshdy Ebrahim.