Tags

Type your tag names separated by a space and hit enter

Surgical outcomes of myringoplasty using platelet-rich plasma and evaluation of the outcome-associated factors.

Abstract

OBJECTIVE

Tympanic membrane perforations must be closed with surgery; however, most surgical procedures are considerably invasive in nature. The aim of this study was to evaluate the outcomes of minimally invasive myringoplasty using platelet-rich plasma (PRP) and an atelocollagen sponge for closure of chronic tympanic membrane perforations, as well as to identify the factors affecting the surgical outcome.

METHODS

The records of 118 patients who underwent surgical closure of chronic tympanic membrane perforation at an ear-nose-throat clinic were reviewed retrospectively. After removing the margin of the perforation via a transcanal approach under local anesthesia, an atelocollagen sponge injected with PRP was inserted into the perforation as a scaffold. If the size of the perforation decreased after the surgery, the same surgical procedure was repeated. The success rate of closure after the last surgery was evaluated in terms of the size of the perforation. In addition, the relationships of the success rate with the cause and duration of perforation and patient age were also examined.

RESULTS

The perforation was closed after initial or repeat surgeries in 95.8% (68/71) of cases with small-sized perforations, 80.0% (32/40) of cases with middle-sized perforations, and 85.7% (6/7) of cases with large-sized perforations. Multiple surgeries (up to four times) were required for middle- and large-sized perforations, and even for some small-sized perforations. The number of re-operations required for closure significantly increased with increase in the size of the perforation (Kruskal-Wallis test, p<0.01). The cause and duration of perforation were not predictors of the surgical outcome. However, patient age was a significant predictor of the surgical outcome; patients older than 80years had a significantly worse success rate than younger patients (Fisher's exact test, p<0.01).

CONCLUSION

Minimally invasive myringoplasty using PRP has a satisfactory success rate even for large-sized tympanic membrane perforations. PRP is autologous and its use is non-toxic and safe. Although informed consent from the patient is necessary for the repetition of the surgery and for patients older than 80years, this technique appears to be a promising office-based procedure for closure of chronic tympanic membrane perforations.

Authors+Show Affiliations

Shiomi ENT Clinic, 8-15 Yakushi-cho, Nishinomiya, Hyogo, Japan. Electronic address: info@shiomi-clinic.com.Shiomi ENT Clinic, 8-15 Yakushi-cho, Nishinomiya, Hyogo, Japan. Electronic address: yshowme@yb3.so-net.ne.jp.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31320230

Citation

Shiomi, Yousaku, and Yoshiko Shiomi. "Surgical Outcomes of Myringoplasty Using Platelet-rich Plasma and Evaluation of the Outcome-associated Factors." Auris, Nasus, Larynx, 2019.
Shiomi Y, Shiomi Y. Surgical outcomes of myringoplasty using platelet-rich plasma and evaluation of the outcome-associated factors. Auris Nasus Larynx. 2019.
Shiomi, Y., & Shiomi, Y. (2019). Surgical outcomes of myringoplasty using platelet-rich plasma and evaluation of the outcome-associated factors. Auris, Nasus, Larynx, doi:10.1016/j.anl.2019.06.005.
Shiomi Y, Shiomi Y. Surgical Outcomes of Myringoplasty Using Platelet-rich Plasma and Evaluation of the Outcome-associated Factors. Auris Nasus Larynx. 2019 Jul 15; PubMed PMID: 31320230.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Surgical outcomes of myringoplasty using platelet-rich plasma and evaluation of the outcome-associated factors. AU - Shiomi,Yousaku, AU - Shiomi,Yoshiko, Y1 - 2019/07/15/ PY - 2019/02/03/received PY - 2019/06/06/revised PY - 2019/06/20/accepted PY - 2019/7/20/entrez KW - Closure surgery KW - Myringoplasty KW - Platelet-rich plasma KW - Tympanic membrane perforation KW - Tympanoplasty JF - Auris, nasus, larynx JO - Auris Nasus Larynx N2 - OBJECTIVE: Tympanic membrane perforations must be closed with surgery; however, most surgical procedures are considerably invasive in nature. The aim of this study was to evaluate the outcomes of minimally invasive myringoplasty using platelet-rich plasma (PRP) and an atelocollagen sponge for closure of chronic tympanic membrane perforations, as well as to identify the factors affecting the surgical outcome. METHODS: The records of 118 patients who underwent surgical closure of chronic tympanic membrane perforation at an ear-nose-throat clinic were reviewed retrospectively. After removing the margin of the perforation via a transcanal approach under local anesthesia, an atelocollagen sponge injected with PRP was inserted into the perforation as a scaffold. If the size of the perforation decreased after the surgery, the same surgical procedure was repeated. The success rate of closure after the last surgery was evaluated in terms of the size of the perforation. In addition, the relationships of the success rate with the cause and duration of perforation and patient age were also examined. RESULTS: The perforation was closed after initial or repeat surgeries in 95.8% (68/71) of cases with small-sized perforations, 80.0% (32/40) of cases with middle-sized perforations, and 85.7% (6/7) of cases with large-sized perforations. Multiple surgeries (up to four times) were required for middle- and large-sized perforations, and even for some small-sized perforations. The number of re-operations required for closure significantly increased with increase in the size of the perforation (Kruskal-Wallis test, p<0.01). The cause and duration of perforation were not predictors of the surgical outcome. However, patient age was a significant predictor of the surgical outcome; patients older than 80years had a significantly worse success rate than younger patients (Fisher's exact test, p<0.01). CONCLUSION: Minimally invasive myringoplasty using PRP has a satisfactory success rate even for large-sized tympanic membrane perforations. PRP is autologous and its use is non-toxic and safe. Although informed consent from the patient is necessary for the repetition of the surgery and for patients older than 80years, this technique appears to be a promising office-based procedure for closure of chronic tympanic membrane perforations. SN - 1879-1476 UR - https://www.unboundmedicine.com/medline/citation/31320230/Surgical_outcomes_of_myringoplasty_using_platelet-rich_plasma_and_evaluation_of_the_outcome-associated_factors L2 - https://linkinghub.elsevier.com/retrieve/pii/S0385-8146(19)30116-6 DB - PRIME DP - Unbound Medicine ER -