Anatomical success of myringoplasty using platelet-rich fibrin membrane in pediatric patients: A prospective study

Objectives: Recent studies on adults showed promising results of alternative tympanic membrane (TM) perforation closure methods by platelet-rich fibrin (PRF) membrane, but data on the pediatric population are limited. This study evaluated postoperative recovery and TM closure over 12 months after PRF myringoplasty in children with dry mesotympanal perforations and clinical factors affecting the outcome of TM closure.

Methods: The study involved 47 patients (2-16 years) and 59 procedures. Group A included 20 patients with dry mesotympanal perforations for more than 12 weeks, while Group B included 27 patients with additional clinical factors. The autologous PRF membrane was used as the only graft for the perforation closure. TM closure was assessed otomicroscopically and confirmed by tympanometry.
Results: The median surgery time was 10 min, and the median time until discharge from the hospital was 3.5 h. In Group A, TM closure rates increased from 26 % after 1 month to 52 %, 67 %, and 70 % after 3, 6, and 12 months, respectively. In Group B, TM closure rates were 16 %, 25 %, 25 %, and 28 %. The anatomical success at 12 months was not associated with the patient's age, sex, previous adenoidectomy, contralateral ear disease, or the size and side of the perforation. In Group B, additional clinical factors, except for previous corrective surgery for cleft palate (4 closures of 6), demonstrated no difference in TM closure rate.
Conclusion: Myringoplasty by PRF membrane demonstrated relatively good efficacy in children with dry TM perforations in size up to 50 %, with a complete TM closure in 70 % of cases at 12 months. Considering the procedure duration and perioperative course, this method could be viable for TM perforation closure - particularly important for children under 12 without additional clinical factors.