Platelet rich plasma: a novel solution for post-canal wall down mastoidectomy complications

Background: A canal wall down mastoidectomy is a very effective technique forthe eradication of advanced chronic otitis media or cholesteatomas. The advantages of canal wall down mastoidec¬tomy include excellent exposure and low rates of residual and recur¬rent disease. However, this widely practiced technique of open cavity mastoidectomy carries the potential of unhealedcavity. Wound healing is a complex process and healing of acute and chronic wounds can become impaired by different factors. Platelet rich plasma (PRP) is considered to be an advanced wound therapy for acute and chronic wounds.
Patients and Methods: This is a prospective non randomized study which enrolled unsafe chronic suppurative otitis media patients attending the ENT outpatient clinics of the Fayoum University Hospital. Fifty patients were scheduled for one canal wall down mastoidectomy and were divided into two equal groups: Group A, the radical cavity, at the end of the operation, was filled with gel foam soaked with PRP. Group B, the radical cavity, at the end of the operation, was filled with only gel foam without PRP. Pre-operatively, every patient was asked to rate and complete the Chronic Otitis Media Questionnaire-12 (COMQ-12). Patients were followed up to evaluate the mastoid cavity healing one month post-operatively through: clinical examination, Bates-Jensen wound assessment tool, and (COMQ-12).
Results: according to COMQ-12, PRP group demonstrated a statistically significant difference as regards discharging from ear, having smelly ear and discomfort in ear in comparison to NON-PRP group (P-value <0.0001). According to the wound assessment tool, PRP group demonstrated a statistically significant difference as regards exudate amount, epithelialization, granulations and skin color surrounding the wound with rapid healing in comparison to NON –PRP group (P-value <0.0001).
Conclusion: Platelet rich plasma is a cheap and cost effective platelet concentrate with enriched growth factors. It accelerates wound healing following canal wall down radical mastoidectomy.