Efficacy and Safety of Fat Graft Myringoplasty Combined With Platelet-Rich Plasma for Managing Chronic Tympanic Membrane Perforations: A Systematic Review and Meta-Analysis

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Objectives Platelet-rich plasma (PRP) is an autologous product derived from whole blood through the process of gradient density centrifugation. Autologous PRP has been shown to be safe and effective in promoting natural wound healing processes. This study assessed the efficacy of fat graft myringoplasty combined with PRP in tympanic membrane (TM) healing in dry TM perforation due to chronic otitis media and compared it to that of fat graft myringoplasty. Methods A systematic review and meta-analysis of prospective or retrospective studies was conducted, with database searches (PubMed, Cochrane Library, Embase, Web of Science, Scopus, and Google Scholar) performed through April 2025. The outcomes included the success rate (complete closure of the TM postoperatively) and changes in air-bone conduction gap (ABG) (preoperatively and postoperatively) in the audiogram. Results Five studies (n=522) were included. Fat myringoplasty with PRP resulted in greater improvement in ABGs (standardized mean difference [SMD], 0.329; 95% CI, 0.132 to 0.527) and higher success rates (odds ratio [OR], 3.129; 95% CI, 1.882 to 5.203) compared to fat myringoplasty alone. In medium-sized perforations, combination therapy demonstrated superior outcomes in both success rate (OR, 3.179; 95% CI, 1.891 to 5.343) and ABG (SMD, 0.357; 95% CI, 0.128 to 0.586). However, no significant differences were observed

Evidence level

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

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