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Effect of topical use of platelet-rich fibrin in repairing central tympanic membrane perforation using the endoscopic inlay butterfly cartilage myringoplasty technique



The aim of this study was to determine the effectiveness of inlay butterfly cartilage myringoplasty and to assess the importance of topical use of autologous platelet-rich fibrin (PRF) in this technique.

Patients and methods

Fifty patients with dry central perforation were classified into two groups: group A included 25 patients who had undergone endoscopic inlay butterfly myringoplasty with the use of autologous PRF, and group B consisted of 25 patients who had undergone the same technique but without the use of autologous PRF. The study was performed during the period between 2013 and 2016. The follow-up period ranged from 1 to 14 months. All patients were assessed clinically to evaluate healing of tympanic membrane, postoperative air-bone gap, and complications.


The overall graft take rate was 96% (24 cases) in group A, whereas the graft take rate in group B was 76% (19 cases) with a statistically significant difference between the two groups. The hearing results were satisfactory and compatible with previous studies in the literature. No postoperative complications were reported.


Inlay butterfly cartilage myringoplasty is a simple technique for repairing small-to-medium-sized tympanic membrane perforation. The success rate of this technique has improved with topical application of PRF. The autologous PRF not only enhances healing of the graft but also protects it from infection.


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Correspondence to Mohamed Hosam.

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Hosam, M., Shaker, M. & Aboulwafa, A. Effect of topical use of platelet-rich fibrin in repairing central tympanic membrane perforation using the endoscopic inlay butterfly cartilage myringoplasty technique. Egypt J Otolaryngol 33, 557–563 (2017).

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  • cartilage
  • inlay butterfly
  • myringoplasty
  • platelet-rich fibrin