Platelet-rich plasma improves healing of tympanic membrane perforations: experimental study.

OBJECTIVE The aim of this study was to investigate the effect of local application of platelet-rich plasma to perforated rat tympanic membranes, in terms of healing time and histopathological outcome. METHODS Eighty-eight tympanic membranes of 44 rats were given a standard 3 mm perforation, and platelet-rich plasma was applied to the right tympanic membrane perforations. The left tympanic membranes were left to heal spontaneously, as controls. The 44 rats were divided into two groups. In group one, comprising 20 rats, daily otomicroscopic examination of the tympanic membrane perforations was performed. The 24 rats in group two were subdivided into four subgroups of six rats each; these subgroups were sacrificed sequentially on days three, seven, 14 and 28 for histopathological examination, regardless of tympanic membrane healing stage. RESULTS In group one, the mean tympanic membrane healing times for tympanic membrane perforations receiving platelet-rich plasma and controls were respectively 10.2 +/- 2.1 and 13.0 +/- 2.9 days (mean +/- standard deviation). This difference was statistically significant (p < 0.001). In group two, histopathological evaluation of tympanic membrane perforation healing at days three, seven, 14 and 28 did not reveal any statistically significant difference, individually or within the four groups as a whole. CONCLUSION These findings suggest that earlier healing of tympanic membrane perforations occurred in the platelet-rich plasma group compared with the control group. These findings suggest that platelet-rich plasma is effective in accelerating tympanic membrane perforation healing, and that it may be effective in human subjects, particularly as it is an autologous material.

[1]  B. Eppley,et al.  Platelet-Rich Plasma: A Review of Biology and Applications in Plastic Surgery , 2006, Plastic and reconstructive surgery.

[2]  J. Hochberg,et al.  P67: Reconstruction of the Nipple Sparing Total Mastectomy , 2006 .

[3]  R. Bento,et al.  Healing of Subacute Tympanic Membrane Perforations in Chinchillas Treated with Epidermal Growth Factor and Pentoxifylline , 2006, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[4]  M. Herzog,et al.  Topical application of transforming growth factor‐β1 in acute traumatic tympanic membrane perforations: an experimental study in rats , 2006, Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society.

[5]  Hom-lay Wang,et al.  The Role of Platelet-Rich Plasma in Sinus Augmentation: A Critical Review , 2006, Implant dentistry.

[6]  Peter A M Everts,et al.  Platelet-rich plasma preparation using three devices: Implications for platelet activation and platelet growth factor release , 2006, Growth factors.

[7]  Y. Uyar,et al.  Effectiveness of MeroGel hyaluronic acid on tympanic membrane perforations , 2006, Acta oto-laryngologica.

[8]  B. Eppley,et al.  Platelet Rich Plasma: Biology and New Technology , 2005, The Journal of craniofacial surgery.

[9]  Edgar Grageda Platelet-Rich Plasma and Bone Graft Materials: A Review and a Standardized Research Protocol , 2004, Implant dentistry.

[10]  W. Berghoff,et al.  Intraoperative use of autologous platelet-rich and platelet-poor plasma for orthopedic surgery patients. , 2004, AORN journal.

[11]  S. Sarıoğlu,et al.  The Effects of Hyaluronic Acid, Epidermal Growth Factor, and Mitomycin in an Experimental Model of Acute Traumatic Tympanic Membrane Perforation , 2003, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[12]  Yuanxui Ma,et al.  Topical Treatment with Growth Factors for Tympanic Membrane Perforations: Progress Towards Clinical Application , 2002, Acta oto-laryngologica.

[13]  Young-Kyun Kim,et al.  Use of particulate dentin-plaster of Paris combination with/without platelet-rich plasma in the treatment of bone defects around implants. , 2002, The International journal of oral & maxillofacial implants.

[14]  S. Yeo,et al.  Effects of platelet-derived growth factor-AA on the healing process of tympanic membrane perforation. , 2000, American journal of otolaryngology.

[15]  E. Anitua Plasma rich in growth factors: preliminary results of use in the preparation of future sites for implants. , 1999, The International journal of oral & maxillofacial implants.

[16]  P. Govaerts,et al.  Growth factors in tympanic membrane perforations. , 1998, The American journal of otology.

[17]  R. Marx,et al.  Platelet-rich plasma: Growth factor enhancement for bone grafts. , 1998, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[18]  H. Gladstone,et al.  Tympanic membrane wound healing. An overview. , 1995, Otolaryngologic clinics of North America.

[19]  M. Mondain,et al.  Epidermal growth factor and basic fibroblast growth factor are induced in guinea-pig tympanic membrane following traumatic perforation. , 1995, Acta oto-laryngologica.

[20]  D. Hom Growth Factors and Wound Healing in Otolaryngology , 1994, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[21]  A. Baird,et al.  Direct application of basic fibroblast growth factor improves tympanic membrane perforation healing , 1993, The Laryngoscope.

[22]  S. Saffiedine,et al.  Fibroblast growth factor improves the healing of experimental tympanic membrane perforations. , 1991, Acta oto-laryngologica.

[23]  G. Schultz,et al.  Epidermal Growth Factor Binding and Action on Tympanic Membranes , 1990, The Annals of otology, rhinology, and laryngology.

[24]  P. Govaerts,et al.  Histological study of the thin replacement membrane of human tympanic membrane perforations. , 1988, Acta oto-laryngologica.

[25]  S. Hellström,et al.  Hyaluronan and healing of tympanic membrane perforations. An experimental study. , 1987, Acta oto-laryngologica. Supplementum.

[26]  M. Hawke,et al.  An ultrastructural study of the skin of the tympanic membrane and external ear canal of the guinea pig. , 1985, The Journal of otolaryngology.