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Tympanic membrane regeneration using platelet-rich fibrin: a systematic review and meta-analysis

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European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Platelet-rich fibrin (PRF) results in satisfactory wound healing. This analysis focuses on assessing the effectiveness of PRF in the treatment of tympanic membrane (TM) perforations.

Materials and methods

The literature was searched using PubMed, Embase, Cochrane Library and Web of Science databases from inception to February 28th, 2021. The following healing and hearing outcomes were measured: closure rate, pre-and postoperative auditory results, and incidence of postoperative infections. Data were pooled and expressed as the odds ratio (OR).

Results

Ten studies were eligible for qualitative review, and seven of them were included for the final quantitative comparison. The OR for the closure rate of acute perforations was 4.30 (95% CI 1.35–13.70, I2 = 0%), and the OR in the chronic subgroup was 5.42 (95% CI 2.57–11.43, I2 = 0%). The total OR value for the completed closure rate was 5.10 (95% CI 2.72–9.54, I2 = 0%), indicating that the utilization of PRF can enhance the closure of both acute and chronic perforations. The qualitative review did not find improved hearing results with the use of PRF. In addition to promoting closure, PRF can reduce the incidence of infections (OR = 0.14). The sensitivity analysis did not change the final results, and there was no publication bias in this analysis.

Conclusion

PRF can increase the closure rate of acute perforations, enhance the survival rate of autografts in TM surgeries and reduce the incidence of infections. However, the literature indicates that PRF does not influence the hearing outcomes. This study shows that PRF is an effective agent for TM regeneration.

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Funding

This study was supported by the National Natural Science Foundation of China (No.81670920), Zhejiang Provincial Natural Science Foundation (No.LY15H130003), Zhejiang Provincial Medical and Health Science Research Foundation (No.2020RC107 and No.2020KY274), Ningbo Natural Science Foundation (No.2018A610363), and Ningbo Huimin Technology Research and Development Project Fund (No.2015C50026).

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Authors and Affiliations

  1. Department of Otolaryngology Head and Neck Surgery, Ningbo Medical Center (Ningbo Lihuili Hospital), The Affiliated Lihuili Hospital of Ningbo University, Ningbo, 315040, Zhejiang, China

    Juntao Huang, Chongchang Zhou, Yunbin Shi & Yi Shen

  2. School of Medicine, Ningbo University, Ningbo, Zhejiang, China

    Juntao Huang, Chongchang Zhou, Yunbin Shi & Yi Shen

  3. Department of Ear Nose and Throat, Head and Neck Surgery, Eastern Health, Box Hill, VIC, Australia

    Bing Mei Teh

  4. Department of Otolaryngology, Head and Neck Surgery, Monash Health, Clayton, VIC, Australia

    Bing Mei Teh

  5. Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia

    Bing Mei Teh

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  1. Juntao Huang
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Correspondence to Yi Shen.

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Huang, J., Teh, B.M., Zhou, C. et al. Tympanic membrane regeneration using platelet-rich fibrin: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol 279, 557–565 (2022). https://doi.org/10.1007/s00405-021-06915-1

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