Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-23T23:53:33.890Z Has data issue: false hasContentIssue false

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

Published online by Cambridge University Press:  28 October 2008

E Erkilet
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, School of Medicine, Ondokuz Mayis University, Samsun, Turkey
M Koyuncu
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, School of Medicine, Ondokuz Mayis University, Samsun, Turkey
S Atmaca*
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, School of Medicine, Ondokuz Mayis University, Samsun, Turkey
M Yarim
Affiliation:
Department of Pathology, Faculty of Veterinary Medicine, Ondokuz Mayis University, Samsun, Turkey
*
Address for correspondence: Dr Sinan Atmaca, Assistant Professor of Otolaryngology, Ondokuz Mayis Universitesi, Tip Fak KBB Anabilim Dali, Kurupelit 55139, Samsun, Turkey. Fax: +90 362 4576041 E-mail: [email protected]

Abstract

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.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Guneri, EA, Tekin, S, Yilmaz, O, Ozkara, E, Erdag, TE, Ikiz, AO et al. The effects of hyaluronic acid, epidermal growth factor, and mitomycin in an experimental model of acute traumatic tympanic membrane perforation. Otol Neurotol 2003;24:371–6CrossRefGoogle Scholar
2 Kaftan, H, Herzog, M, Miehe, B, Hosemann, W. Topical application of transforming growth factor-beta 1 in acute traumatic tympanic membrane perforations: an experimental study in rats. Wound Repair Regen 2006;14:453–6CrossRefGoogle ScholarPubMed
3 Ozturk, K, Yaman, H, Cihat, AM, Arbag, H, Keles, B, Uyar, Y. Effectiveness of MeroGel hyaluronic acid on tympanic membrane perforations. Acta Otolaryngol 2006;126:1158–63CrossRefGoogle ScholarPubMed
4 Yeo, SW, Kim, SW, Suh, BD, Cho, SH. Effects of platelet-derived growth factor-AA on the healing process of tympanic membrane perforation. Am J Otolaryngol 2000;21:153–60CrossRefGoogle ScholarPubMed
5 Ramalho, JR, Bento, RF. Healing of subacute tympanic membrane perforations in chinchillas treated with epidermal growth factor and pentoxifylline. Otol Neurotol 2006;27:720–7CrossRefGoogle ScholarPubMed
6 Somers, T, Goovaerts, G, Schelfhout, L, Peeters, S, Govaerts, PJ, Offeciers, E. Growth factors in tympanic membrane perforations. Am J Otol 1998;19:428–34Google ScholarPubMed
7 Boyapati, L, Wang, HL. The role of platelet-rich plasma in sinus augmentation: a critical review. Implant Dent 2006;15:160–70CrossRefGoogle ScholarPubMed
8 Eppley, BL, Pietrzak, WS, Blanton, M. Platelet-rich plasma: a review of biology and applications in plastic surgery. Plast Reconstr Surg 2006;118:147–59CrossRefGoogle Scholar
9 Everts, PA, Mahoney, CB, Hoffmann, JJ, Schönberger, JP, Box, HA, Zundert, AV et al. Platelet-rich plasma preparation using three devices: implications for platelet activation and platelet growth factor release. Growth Factors 2006;24:165–71CrossRefGoogle ScholarPubMed
10 Floryan, KM, Berghoff, WJ. Intraoperative use of autologous platelet-rich and platelet-poor plasma for orthopedic surgery patients. AORN J 2004;80:668–74CrossRefGoogle ScholarPubMed
11 Grageda, E. Platelet-rich plasma and bone graft materials: a review and a standardized research protocol. Implant Dent 2004;13:301–9CrossRefGoogle Scholar
12 Pietrzak, WS, Eppley, BL. Platelet rich plasma: biology and new technology. J Craniofac Surg 2005;16:1043–54CrossRefGoogle ScholarPubMed
13 Lambert, PR, McElveen, JT. Tympanoplastic surgery for chronic ear disease. In: Cummings, CW, Fredrickson, JM, Harker, LA, Krause, CJ, Richardson, MA, Schuller, DE, eds. Otolaryngology Head and Neck Surgery, 3rd ed. St Louis: Mosby-Year Book, 1998;3108–17Google Scholar
14 Govaerts, PJ, Jacob, WA, Marquet, J. Histological study of the thin replacement membrane of human tympanic membrane perforations. Acta Otolaryngol 1988;105:297302CrossRefGoogle ScholarPubMed
15 Hellstrom, S, Laurent, C. Hyaluronan and healing of tympanic membrane perforations. An experimental study. Acta Otolaryngol 1987;442:5461CrossRefGoogle ScholarPubMed
16 Johnson, A, Hawke, M. An ultrastructural study of the skin of the tympanic membrane and external ear canal of the guinea pig. J Otolaryngol 1985;14:357–64Google ScholarPubMed
17 Ma, Y, Zhao, H, Zhou, X. Topical treatment with growth factors for tympanic membrane perforations: progress towards clinical application. Acta Otolaryngol 2002;122:586–99CrossRefGoogle ScholarPubMed
18 Gladstone, HB, Jackler, RK, Varav, K. Tympanic membrane wound healing. Otolaryngol Clin North Am 1995;28:913–32CrossRefGoogle ScholarPubMed
19 Hom, DB. Growth factors and wound healing in otolaryngology. Otolaryngol Head Neck Surg 1994;110:560–4CrossRefGoogle ScholarPubMed
20 Mondain, M, Ryan, A. Epidermal growth factor and basic fibroblast growth factor are induced in guinea-pig tympanic membrane following traumatic perforation. Acta Otolaryngol 1995;115:50–4CrossRefGoogle ScholarPubMed
21 O'Daniel, TG, Petitjean, M, Jones, SC. Epidermal growth factor binding and action on tympanic membranes. Ann Otol Rhinol Laryngol 1990;99:80–4Google ScholarPubMed
22 Marx, RE, Carlson, ER, Eichstaedt, RM, Schimmele, SR, Strauss, JE, Georgeff, KR. Platelet-rich plasma: growth factor enhancement for bone grafts. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998;85:638–46CrossRefGoogle ScholarPubMed
23 Anitua, E. Plasma rich in growth factors: preliminary results of use in the preparation of future sites for implants. Int J Oral Maxillofac Implants 1999;14:529–35Google Scholar
24 Kim, SG, Chung, CH, Kim, YK, Park, JC, Lim, SC. Use of particulate dentin-plaster of Paris combination with/without platelet-rich plasma in the treatment of bone defects around implants. Int J Oral Maxillofac Implants 2002;17:8694Google ScholarPubMed
25 Dere, H, Unal, A, Ozcan, I, Yrdimci, S, Ergul, G, Titiz, A et al. Histological evaluation of basic fibroblast growth factor effect on the healing of traumatic tympanic membrane perforation [in Turkish]. Turk Otolarengoloji Arsivi 1997;35:33–7Google Scholar
26 Mondain, M, Saffiedine, S, Uziel, A. Fibroblast growth factor improves the healing of experimental tympanic membrane perforations. Acta Otolaryngol 1991;111:337–41CrossRefGoogle ScholarPubMed
27 Fina, M, Baird, A, Ryan, A. Direct application of basic fibroblast growth factor improves tympanic membrane perforation healing. Laryngoscope 1993;103:804–9CrossRefGoogle ScholarPubMed