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Adding a patient's own platelet-rich plasma during eardrum repair surgery may offer surgeons a simple biologic strategy to improve long-term healing and hearing restoration.
Repairing a perforated eardrum is generally a successful procedure, but not every graft survives the healing process. Even with modern surgical techniques, a proportion of patients experience incomplete graft integration or persistent perforation, often requiring additional interventions. In recent years, regenerative treatment approaches aimed at enhancing tissue healing at surgical sites have gained considerable research interest.
Among these, platelet-rich plasma (PRP)—an autologous blood-derived concentrate containing a high concentration of growth factors and bioactive proteins—has emerged as a promising adjunct in a wide range of surgical specialties. The authors therefore explored whether this biological enhancer could improve outcomes following myringoplasty (ear surgery). The prospective, randomized study enrolled 252 individuals undergoing tympanic membrane reconstruction and randomly allocated them to either conventional myringoplasty or myringoplasty supplemented with autologous PRP.
In the intervention arm, PRP was applied directly over the fascia graft during surgery. Participants were monitored for one year to assess graft integrity, hearing recovery, and postoperative events. The regenerative approach appeared to provide a measurable advantage during postoperative healing. Patients receiving topical PRP experienced higher rates of successful graft incorporation throughout follow-up (Table 1)
Functional hearing outcomes also favored PRP. Patients treated with PRP achieved a mean air-bone gap closure of 18.5 dB, indicating better postoperative hearing improvement than the control group (P = 0.042). Although the statistical margins were relatively modest, the findings suggest that biological enhancement of tissue repair may contribute to more durable surgical outcomes.
The study adds to growing evidence that regenerative medicine approaches are beginning to influence routine otologic surgery. By harnessing naturally occurring growth factors from the patient's own blood, PRP-assisted myringoplasty may represent a low-risk strategy to optimize healing while improving postoperative hearing outcomes.
Indian Journal of Otolaryngology and Head & Neck Surgery
Efficacy of Autologous Platelet-Rich Plasma (PRP) on Graft Uptake in Myringoplasty
Neelakshi Choudhury et al.
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