Efficacy of Treatment with Platelet-Rich Concentrate on Temporalis Fascia Myringoplasty for Managing Tympanic Membrane Perforation Due to Chronic Otitis Media: A Systemic Review and Meta-analysis

Vollständiger Abstract

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This meta-analysis assessed the efficacy of temporalis fascia myringoplasty (TFM) combined with platelet-rich concentrate (PRC) on tympanic membrane (TM) healing in TM perforation due to chronic otitis media (COM), compared to TFM alone. A comprehensive search was conducted across PubMed, SCOPUS, EMBASE, Web of Science, and the Cochrane Library. The intervention group underwent TFM with the addition of PRC, while the control group received TFM alone. Key outcomes measured included the success rate (complete TM healing), postoperative infection incidence, changes in air–bone gap (ABG) and air conduction (AC), and the proportion of patients experiencing postoperative auditory improvement of at least 10 decibels, as recorded in audiograms. Pooled effects were determined using standardized mean differences or odds ratios, with 95% CIs. Twenty-four studies (n=1669) were included. TFM combined with PRC led to greater improvements in ABG and AC. The intervention group showed a significant increase in postoperative auditory improvement, exceeding 10 decibels in audiograms, as well as a higher success rate. Subgroup analysis by perforation size revealed that the intervention group achieved superior outcomes in medium and large perforations. Additionally, PRC application significantly reduced the incidence of postoperative infection. Autologous PRC application during TFM enhances surgical success and hearing improvement, especially in medium and large perforations, while also lowering postoperative infection rates.