Evaluation of therapeutic potential of platelet rich fibrin (PRF) in the healing process of traumatic tympanic membrane (TM) perforation.

Background: Traumatic tympanic membrane (TM) perforation is a common otologic injury, often resulting in hearing loss, discomfort, and a range of functional impairments. Traditional treatments, such as tympanoplasty, are invasive and may not be viable for all patients. Recent advancements in regenerative medicine suggest that autologous Platelet Rich Fibrin (PRF), a second-generation platelet concentrate, may accelerate TM healing through the sustained release of growth factors and cytokines. This study evaluates the therapeutic potential of PRF in promoting the healing process of traumatic TM perforations, comparing its effectiveness with conventional approaches. Methods: This prospective observational study involved 63 patients with acute traumatic TM perforations, aged 10 to 70 years, who met stringent inclusion criteria. Exclusion criteria included non-traumatic and large perforations and patients with severe hearing impairment. Baseline assessments included otoscopic examination, tuning fork tests, Visual Analog Scale (VAS) for pain, and the Hearing Handicap Inventory for Adults (HHIA). PRF was prepared by centrifuging each patient’s blood at 4000 rpm for 10 minutes, and the resulting PRF membrane was applied under endoscopic guidance. Patients were followed up after one month with repeat otoscopy, tuning fork tests, pure tone audiometry, impedance testing, VAS, and HHIA to assess outcomes. Statistical analysis was performed to evaluate the efficacy of PRF in TM healing. Results: PRF treatment yielded successful TM healing in 62 of 63 cases, with a 98.4% success rate. All patients, except one who developed otomycosis, exhibited complete closure of TM perforations with improved hearing thresholds on pure tone audiometry. Post-treatment evaluations showed a significant reduction in VAS pain scores (mean score: 0) and HHIA scores, with 50 patients reporting high satisfaction. Impedance testing revealed a Type A tympanometric curve in healed cases, further confirming TM integrity. Statistically significant improvements were observed in audiometric outcomes, with mean hearing thresholds returning to normal in all successfully treated patients. Conclusions: PRF demonstrates substantial therapeutic potential as a minimally invasive, effective treatment for traumatic TM perforations. The high healing success rate, rapid pain reduction, and enhanced patient satisfaction highlight PRF’s viability as a primary option for TM repair, offering a safe and autologous approach that could transform otologic practice. Further large-scale studies are recommended to confirm these findings and explore optimized protocols for PRF application.