Uporaba avtologne plazme bogate s trombociti in zunajceličnimi vezikli pri kirurškem zdravljenju kroničnih vnetij srednjega ušesa : doktorska disertacija

Steiner, Nejc (avtor), Battelino, Saba (mentor), Kralj Iglič, Veronika (komentor)

V doktorski disertaciji smo raziskovali možnosti izboljšanja celjenja perforiranih bobničev z uporabo plazme, bogate s trombociti in zunajceličnimi vezikli (PBTZV). Želeli smo oceniti, kako dodatek PBTZV pri timpanoplastiki vpliva na celjenje bobničev, sluh in kakovost življenja, ter optimizirati in individualizirati postopek priprave PBTZV. Raziskavo smo razdelili na dva dela. V prvem delu smo opravili dvojno slepo kontrolirano randomizirano raziskavo. Bolnike smo randomizirali v dve skupini, vzeli natančno anamnezo in jih pregledali. Velikost perforacij smo izrazili kot delež v celotni perforaciji, ki smo jo izmerili na endoskopskih fotografijah perforiranih bobničev. Sledile so predoperativne avdiovestibuloške preiskave in operacija – timpanoplastika. Bolnikom v terapevtski skupini smo med timpanoplastiko dodali PBTZV. Rezultate smo ocenjevali tri mesece po operaciji, ponovno vzeli anamnezo ter opravili klinični pregled, fotografiranje bobniča in avdiovestibuloške preiskave. V drugem delu raziskave smo klinično implementirali poenostavljen protokol priprave gela, bogatega s trombociti in zunajceličnimi vezikli (GBTZV), izdelali matematični model za izračun volumna krvi, ki jo potrebujemo za pripravo želenega volumna GBTZV, in modelne enačbe vnesli v program Microsoft Excel. Rezultati raziskave, v katero je bilo vključenih 72 bolnikov, so pokazali, da je bilo v skupini PBTZV statistično značilno več popolnih zacelitev. Statistično značilnega izboljšanja sluha in kakovosti življenja nismo opažali. Prav tako bolniki z večjimi perforacijami bobniča niso imeli slabše kakovosti življenja. Presenetljivo smo ugotovili, da na kakovost življenja pomembno vpliva starost bolnikov. Razvili smo tudi optimiziran protokol za pripravo PBTZV in GBTZV ter izdelali matematični model za izračun volumna krvi, ki ga potrebujemo za pripravo želenega terapevtskega volumna GBTZV.

• Jezik: Slovenski jezik
• Ključne besede: plazma, trombociti, zunajcelični vezikli, timpanoplastika, miringoplastika, perforacija bobniča, kronično vnetje srednjega ušesa, regenerativna medicina
• Vrsta gradiva: Doktorsko delo/naloga
• Tipologija: 2.08 - Doktorska disertacija
• Organizacija: BF - Biotehniška fakulteta
• Leto izida: 2024
• PID: 20.500.12556/RUL-154498
• COBISS.SI-ID: 186244099
• Datum objave v RUL: 18.02.2024

STEINER, Nejc, 2024, Uporaba avtologne plazme bogate s trombociti in zunajceličnimi vezikli pri kirurškem zdravljenju kroničnih vnetij srednjega ušesa : doktorska disertacija [na spletu]. Doktorska disertacija. [Dostopano 3 maj 2025]. Pridobljeno s: https://repozitorij.uni-lj.si/IzpisGradiva.php?lang=slv&id=154498

Sekundarni jezik

• Jezik: Angleški jezik
• Naslov: Use of autologous plasma rich in platelets and extracellular vesicles in the surgical treatment of chronic otitis media : doctoral dissertation

Izvleček

We investigated effect of platelet- and extracellular vesicle-rich plasma (PVRP) on the success of tympanoplasty. In the doctoral dissertation, we wanted to assess whether the addition of PVRP in tympanoplasty affects the success of eardrum healing, hearing and quality of life; whether the size of the perforation affects the quality of life; and optimize and individualize the PVRP preparation process. Our research was divided into two parts. The first part included a double-blind randomized controlled study. The patients were randomized into two groups, a detailed medical history was taken and they were examined. The size of perforations was expressed as a proportion of the total perforation, which was measured from endoscopic photographs of perforated eardrums. This was followed by pre-operative audiovestibulological examinations and surgery - tympanoplasty. PVRP was used in the therapeutic group during tympanoplasty. The results were evaluated three months after the surgery by resuming the medical history, clinical examination, tympanic imaging, and audiovestibulological examinations. In the second part of the research, we clinically implemented a simplified protocol for the preparation of platelet- and extracellular vesicle-rich gel (PVRG), constructed a mathematical model for calculating the volume of blood needed to prepare the desired volume of GBTZV, and introduced the model equations into the Microsoft Excel program. The results of the study, which included 72 patients, showed that there were statistically significantly more complete tympanic membrane closures in the PVRP group. We did not observe a statistically significant improvement in hearing and quality of life. Also, patients with larger perforations did not have a worse quality of life. Surprisingly, we found that the age of the patients significantly affects the quality of life. In addition, we developed an optimized protocol for the preparation of PVRP and PVRG.

• Ključne besede: platelet rich plasma, extracellular vesicles, tympanoplasty, myringoplasty, eardrum perforation, chronic otitis media, regenerative medicine