Efficacy and safety of fat graft myringoplasty combined with platelet-rich plasma for managing chronic tympanic membrane perforations: A systemic review and meta-analysis.

IF 3.4 3区医学 Q1 OTORHINOLARYNGOLOGY

Clinical and Experimental Otorhinolaryngology Pub Date : 2025-08-13 DOI:10.21053/ceo.2025-00157

Yun Jin Kang, Gulnaz Stybayeva, Se Hwan Hwang

{"title":"Efficacy and safety of fat graft myringoplasty combined with platelet-rich plasma for managing chronic tympanic membrane perforations: A systemic review and meta-analysis.","authors":"Yun Jin Kang, Gulnaz Stybayeva, Se Hwan Hwang","doi":"10.21053/ceo.2025-00157","DOIUrl":null,"url":null,"abstract":"Objectives: Platelet-rich plasma (PRP) is an autologous product derived from whole blood through the process of gradient density centrifugation. Autologous PRP has been shown to be safe and effective in promoting natural wound healing processes. This study assessed the efficacy of fat graft myringoplasty combined with PRP in tympanic membrane (TM) healing in dry TM perforation due to chronic otitis media and compared it to that of fat graft myringoplasty.Methods: A systematic review and meta-analysis of prospective or retrospective studies was conducted, with database searches performed through April 2025. The outcomes included the success rate (complete closure of the TM postoperatively) and changes in air-bone conduction gap (ABG) (preoperatively and postoperatively) in the audiogram.Results: Five studies (n = 522) were included. Fat myringoplasty with PRP resulted in greater improvement in ABGs (SMD 0.3292, 95% confidence interval (CI) [0.1317; 0.5266]) and higher success rates (odds ratio (OR) 3.1289, 95% CI [1.8816; 5.2028]) compared to fat myringoplasty alone. In medium-sized perforations, combination therapy demonstrated superior outcomes in both success rate (success rate (OR 3.1790, 95% CI [1.8914; 5.3432]) and ABG (SMD 0.3569, 95% CI [0.1278; 0.5860]). However, no significant differences were observed in cases involving small perforations (success rate (OR 2.1538, 95% CI [0.1739; 26.6721]) and changes in ABG (SMD 0.2490, 95% CI [-0.1405; 0.6384])). Both liquid and gel PRP significantly improved ABGs and TM closure rates, with no significant difference between types.Conclusion: This study demonstrated a higher success rate and greater hearing improvement with PRP-assisted fat myringoplasty, especially in medium-sized perforations. Both liquid and gel PRP forms were effective, with no significant difference between them.","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical and Experimental Otorhinolaryngology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21053/ceo.2025-00157","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives: Platelet-rich plasma (PRP) is an autologous product derived from whole blood through the process of gradient density centrifugation. Autologous PRP has been shown to be safe and effective in promoting natural wound healing processes. This study assessed the efficacy of fat graft myringoplasty combined with PRP in tympanic membrane (TM) healing in dry TM perforation due to chronic otitis media and compared it to that of fat graft myringoplasty.

Methods: A systematic review and meta-analysis of prospective or retrospective studies was conducted, with database searches performed through April 2025. The outcomes included the success rate (complete closure of the TM postoperatively) and changes in air-bone conduction gap (ABG) (preoperatively and postoperatively) in the audiogram.

Results: Five studies (n = 522) were included. Fat myringoplasty with PRP resulted in greater improvement in ABGs (SMD 0.3292, 95% confidence interval (CI) [0.1317; 0.5266]) and higher success rates (odds ratio (OR) 3.1289, 95% CI [1.8816; 5.2028]) compared to fat myringoplasty alone. In medium-sized perforations, combination therapy demonstrated superior outcomes in both success rate (success rate (OR 3.1790, 95% CI [1.8914; 5.3432]) and ABG (SMD 0.3569, 95% CI [0.1278; 0.5860]). However, no significant differences were observed in cases involving small perforations (success rate (OR 2.1538, 95% CI [0.1739; 26.6721]) and changes in ABG (SMD 0.2490, 95% CI [-0.1405; 0.6384])). Both liquid and gel PRP significantly improved ABGs and TM closure rates, with no significant difference between types.

Conclusion: This study demonstrated a higher success rate and greater hearing improvement with PRP-assisted fat myringoplasty, especially in medium-sized perforations. Both liquid and gel PRP forms were effective, with no significant difference between them.

查看原文本刊更多论文

脂肪移植鼓膜成形术联合富血小板血浆治疗慢性鼓膜穿孔的有效性和安全性：一项系统回顾和荟萃分析。

目的：富血小板血浆（PRP）是通过梯度密度离心从全血中提取的自体产物。自体PRP已被证明是安全有效的促进自然伤口愈合过程。本研究评估脂肪鼓膜成形术联合PRP在慢性中耳炎干性鼓膜穿孔鼓膜愈合中的疗效，并与脂肪鼓膜成形术进行比较。方法：对前瞻性或回顾性研究进行系统回顾和荟萃分析，并在2025年4月之前进行数据库检索。结果包括成功率（术后TM完全闭合）和听图中气骨传导间隙（ABG）的变化（术前和术后）。结果：纳入5项研究（n = 522）。PRP脂肪鼓膜成形术对ABGs的改善更大(SMD 0.3292, 95%可信区间（CI） [0.1317；0.5266])和更高的成功率(优势比（OR） 3.1289, 95% CI [1.8816；[5.2028])与单纯的脂肪鼓膜成形术相比。在中等穿孔中，联合治疗在成功率(OR 3.1790, 95% CI [1.8914；5.3432])和ABG (SMD 0.3569, 95% CI [0.1278；0.5860])。然而，在涉及小穿孔的病例中，没有观察到显着差异(成功率（OR） 2.1538, 95% CI [0.1739；26.6721])和ABG变化(SMD 0.2490, 95% CI [-0.1405；0.6384]))。液体PRP和凝胶PRP均能显著提高ABGs和TM的闭合率，两种类型间无显著差异。结论：本研究表明prp辅助脂肪鼓膜成形术成功率高，听力改善效果好，尤其是中等穿孔。液体和凝胶形式的PRP均有效，两者之间无显著差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Clinical and Experimental Otorhinolaryngology 医学-耳鼻喉科学

CiteScore

4.90

自引率

6.70%

发文量

审稿时长

6-12 weeks

期刊介绍： Clinical and Experimental Otorhinolaryngology (Clin Exp Otorhinolaryngol, CEO) is an international peer-reviewed journal on recent developments in diagnosis and treatment of otorhinolaryngology-head and neck surgery and dedicated to the advancement of patient care in ear, nose, throat, head, and neck disorders. This journal publishes original articles relating to both clinical and basic researches, reviews, and clinical trials, encompassing the whole topics of otorhinolaryngology-head and neck surgery. CEO was first issued in 2008 and this journal is published in English four times (the last day of February, May, August, and November) per year by the Korean Society of Otorhinolaryngology-Head and Neck Surgery. The Journal aims at publishing evidence-based, scientifically written articles from different disciplines of otorhinolaryngology field. The readership contains clinical/basic research into current practice in otorhinolaryngology, audiology, speech pathology, head and neck oncology, plastic and reconstructive surgery. The readers are otolaryngologists, head and neck surgeons and oncologists, audiologists, and speech pathologists.