Graft Uptake Following Myringoplasty With Adjuvant Autologous Platelet-Rich Plasma: A Prospective, Non-randomized Comparative Cohort Study in Tiruvannamalai District, Tamil Nadu, South India

BackgroundTympanic membrane (TM) perforation may require surgical repair to restore anatomical integrity and hearing.Autologous platelet-rich plasma (PRP) has been used as an adjunct to myringoplasty to support tissue healing and graft uptake.This study was conducted to evaluate graft uptake following myringoplasty with adjunctive autologous PRP and to compare postoperative hearing outcomes between PRP and non-PRP cohorts. Materials and methodsA prospective, non-randomized comparative cohort study was conducted among 174 patients undergoing myringoplasty at a tertiary care teaching hospital and medical college in Tiruvannamalai district, Tamil Nadu, South India.Participants were classified into PRP and non-PRP cohorts according to participant willingness and operating surgeon preference, with 87 patients in each cohort.Successful graft uptake was defined as an intact TM without persistent, residual, or recurrent perforation at three months.Hearing outcome was assessed using pure-tone audiometry (PTA), and PTA gain was calculated from preoperative and postoperative values.Associations with graft uptake were examined using modified Poisson regression with robust variance.Postoperative PTA was additionally assessed using analysis of covariance (ANCOVA) to account for baseline differences.A p-value <0.05 was considered statistically significant. ResultsThe PRP cohort had a mean (± standard deviation (SD)) age of 34.64 (± 7.22) years, compared with 35.11 (± 8.51) years in the non-PRP cohort.At three months, graft uptake was achieved in 76 (87.4%) patients in the PRP cohort and 68 (78.2%) patients in the non-PRP cohort.After adjustment, PRP remained associated with higher graft uptake, but the association was not statistically significant (adjusted risk ratio (RR): 1.13; 95% confidence interval (CI): 0.98-1.26).Operated-ear PTA improved significantly after surgery, with a mean improvement of 8.81 dB (95% CI: 7.93-9.69;p < 0.001).PTA gain did not differ significantly between the PRP and non-PRP cohorts (9.47 vs 8.15 dB; p = 0.138).After adjustment for baseline PTA, postoperative hearing also showed no significant between-cohort difference (p = 0.662).Patients with successful graft uptake demonstrated greater PTA improvement than those with graft failure (10.42 vs 1.07 dB; p < 0.001). ConclusionAdjunctive autologous PRP was associated with a numerically higher three-month graft uptake rate, although the adjusted association was not statistically significant.Hearing improved significantly following myringoplasty in both cohorts.No statistically significant difference in postoperative hearing was observed between the PRP and non-PRP cohorts.Larger randomized clinical trials are needed to clarify the clinical value of PRP in myringoplasty.