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.
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