Effectiveness of topical phenytoin therapy versus platelet-rich plasma for tympanic perforations closure: Comparative study

Abstract

Background: The tympanic membrane perforation is generally caused by infection or trauma. It is a condition that can cause hearing loss; its incidence varies between 1 and 3% of the population in the United States, and even less than 1% in the world population. Objective: This study is to conduct a pilot test in which the effectiveness of conservative treatment was measured and compared by applying phenytoin or platelet-rich plasma to close tympanic perforations and the healing period of the same. Patients and methods: Ten patients were included and all of them fulfilled the selection criteria: Age over five years-old, indiscriminate sex with a diagnosis of perforated eardrum, eardrum perforation between 30 and 60% and presence of tympanic remnant; and no previous surgical treatment. Elimination criteria were those patients with marginal eardrum perforations, patients who were not on antiplatelet drugs or anticoagulants, poor response to platelet-rich plasma after 6 weeks, patients with known autoimmune, active neoplastic, atopic otic conditions and those currently under immunosuppressive treatments. Participants were randomized into two groups according to treatment: phenytoin (0.2 mg) or platelet-rich plasma (0.2-0.5 cc). Results: Ten patients with unilateral tympanic perforation were recorded whose average age was 26.9 ± 14.9 years; the sex distribution was 1.5:1 male predominance. In treatment A, the average closing time was 3.8 ± 0.836 weeks; meanwhile, in the treatment B the closure time was 5.2 ± 0.836 weeks.