Comparison of outcomes of myringoplasty using Temporalis fascia alone and Temporalis fascia with Platelet Rich Fibrin sheet - an Academic trial

Myringoplasty is defined as surgical closure of tympanic membrane perforation, without reconstruction of ossicular chain. It is used in the treatment of chronic otitis media. Chronic suppurative otitis media (CSOM) is a long-standing infection of a part or whole of the middle ear cleft characterized by ear discharge and a permanent perforation. It is also the single most important cause of hearing impairment in rural population. Platelet-rich fibrin (PRF) is an autogenous material that is derived from a person’s own platelets and is used to enhance wound healing and tissue regeneration. PRF is proposed to have a direct effect on enhancing a patient’s wound healing by suprasaturating the wound with growth factors that promote tissue healing. Clinically, PRF is easily produced bedside from the patient’s own blood. Platelet rich fibrin is composed of an assembly of a cytokines, glycaemic chains, and structural glycoproteins enmeshed within a slowly polymerised fibrin network. These biochemical components help in healing through synergistic mechanisms. PRF hastens the cell proliferation and also offers inflammatory protection to grafts. As PRF membrane has a strong, elastic fibrin structure containing growth factors, it may improve graft uptake and healing.

Data regarding effect of PRF sheet in repair of chronic tympanic membrane perforations is limited and therefore the present study is being conducted to evaluate graft uptake and hearing improvement with the usage of PRF sheet in repair of chronic tympanic membrane perforation along with temporalis fascia and comparing the outcomes with conventional myringoplasty.