Efficacy of Autologous Intratympanic Platelet-Rich Plasma in the Management of Sensorineural Hearing Loss

BACKGROUND: Hearing loss is one of the major causes of disability. SNHL leads to communication difficulties, cognitive decline, social isolation and impaired quality of life. Hearing aids and cochlear implantation may not be suitable for all patients. Intratympanic or intravenous steroids have been used with variable efficacy. Recently PRP injections have shown some promising results in regeneration of hair cells and auditory nerve fibers. Hence PRP may pave way for novel approach for patients with SNHL. The present study was conducted to assess the to assess the effectiveness of intra tympanic PRP in improving the Pure Tone Average of hearing threshold. and to analyze the efficacy of intra tympanic PRP based on the duration of hearing loss. MATERIALS AND METHODS: This prospective cohort study was conducted at a tertiary care hospital in South India from August 2022 to July 2023 after obtaining ethical clearance. Thirty patients aged ≥7 years with sensorineural hearing loss (SNHL) confirmed by pure tone audiometry (PTA) and intact tympanic membranes were included by purposive sampling. Exclusion criteria were age <7 years, conductive/mixed hearing loss, tympanic membrane perforation, ear pain/discharge, and prior ear surgery. After informed consent, 5 ml venous blood was collected, and platelet-rich plasma (PRP) was prepared by double centrifugation. Baseline PTA was done before treatment. Following topical lignocaine spray, 0.5 ml autologous PRP was injected intratympanically weekly for 3 weeks. PTA was repeated 6 months after the first injection. Data were analyzed using SPSS Version 17. RESULTS : Most of the patients were males (n=18) than females (n=12) and belonging to 71-80 age group (n=7) and 41-50 age group (n=6). Majority of patients presented within 6-24 months of onset of hearing loss (n=9). 15 patients had unilateral hearing loss (right>left) and 15 patients had bilateral hearing loss. Mean pure tone audiogram showed significant improvement after PRP injections with p value of <0.001. On comparing degree of hearing loss with recovery, 91.11% of patients had recovery and 8.89 % did not have any recovery. On comparing duration of hearing loss with recovery, patients presented with less than 5 years duration had significant recovery. CONCLUSION: Sensorineural hearing loss is an emerging problem in the younger age groups due to changes in lifestyle. PRP being safe, minimally invasive and feasible on an outpatient basis has shown promising results in this domain. In conclusion, our study shows that PRP can be used as a viable treatment modality for the management of SNHL especially in younger age group patients and patients with mild to moderate hearing loss with minimal complications.