Platelets-derived growth factor enriched fat graft versus cartilage perichondrium for repair of medium size tympanic membrane perforations

Abstract

Abstract Background Tympanic membrane perforations (TMPs) are a common clinical issue that can lead to hearing loss and middle ear infections. Although many small perforations heal spontaneously, larger or recurrent ones may require surgical intervention. Objectives This study compared the clinical and audiological outcomes of two myringoplasty techniques: fat graft myringoplasty (FGM) enriched with lyophilized platelets derived growth factors (L-GFs) and cartilage perichondrium myringoplasty. Methods This prospective randomized controlled study included 50 patients aged 18 to 70 years, of both sexes, with medium-sized TMPs (25–50% of the membrane surface area) according to Saliba's TMP classification, present for at least 6 months, and with functional hearing in the contralateral ear. The participants were randomized into two groups underwent myringoplasty (1:1 ratio) using fat plug enriched with L-GFs in Group I and cartilage perichondrium in Group II. Results Both groups showed high rates of graft uptake, with no substantial difference observed between them at both one and three months postoperatively (P = 0.384, 0.552). Hearing was substantially improved postoperatively compared to preoperatively in both groups (P < 0.001). Hearing gain was similar between the two groups (P = 0.769). Conclusions Adopting L-GFs enriched FGM can be recommended as an effective method for closing medium-sized central TMPs, offering closure rates comparable to cartilage perichondrium myringoplasty.