Outcome of temporalis fascia myringoplasty with and without use of platelet rich plasma: A randomized control trial

Objectives: To compare the efficacy of temporalis fascia myringoplasty using platelet rich plasma(PRP) {MP-PRP} and conventional temporalis fascia myringoplasty(MP-C) in treatment of moderate to large central tympanic membrane(TM) perforation . STUDY DESIGN: Randomized-Control-Trial SETTING: Tertiary-Health-Centre SUBJECTS AND METHODS:We randomly assigned eighty patients with COM-mucosal-type with medium to large central TM perforation and conductive hearing loss planned for primary myringoplasty to receive either MP-PRP orMP-C. Myringoplasty was performed through post-auricular approach underlay graft using temporalis fascia. Primary outcome was graft uptake (an intact TM) at 6 months postoperatively. Secondary outcome was the post-operative hearing improvement measured by pure-tone-audiometry (PTA). RESULTS: Eighty myringoplasties (MP-PRP group-40, MP-C group-40) done for 80 patients (male=41; female=39,age-group=18-45-years) were included in analysis. At 6months postoperatively graft uptake rate was 94.4% in MP-PRP and 92.1%% in MP-C group. There was no statistically significant difference in graft uptake between the two groups(p=0.358).Success in terms of hearing gain (≥10dB) was achived in 34 patients (89.5%) in MP-C and 37 patients (94.9%) in MP-PRP group.At 6months follow-up; mean-PTA-average improved from 35.10±5.401dB to 27.74±5.660dB and mean ABG improved from 24.00±5.204dB to17.42±5.559dB in MP-C group. At 6months follow-up; mean-PTA-average improved from 37.00±6.144dB to 26.65dB and mean air bone gap(ABG) improved from 25.98±5.736dB to 16.21±4.318dB in MP-PRPgroup. No statistically significant differences in improvement in PTA-values were observed between both groups. (p=0.336).Postoperative complications were similar in both groups. Conclusion: Graft uptake, hearing outcomes and complications of MP-PRP were similar to MP-C. MP-PRP offers no advantages over MP-C for treatment of TM perforation.