HASIL GUNA KLINIS PLATELET RICH PLASMA DENGAN PAPER PATCH TERHADAP PENUTUPAN PERFORASI MEMBRAN TIMPANI PERMANEN

BENYAMIN FRANKLYN LUMBAN SITIO, Dr. dr. RM. Tedjo Oedono, Sp. THT-KL(K)

2012 | Tesis | S2 Ked.Klinik/MS-PPDS

Analisis statistik : Analisis data menggunakan uji X 2 (Chi Square), dan uji t tidak berpasangan. Latar belakang : Perforasi membran timpani (PMT) dapat mengakibatkan tejadinya infeksi berulang telinga tengah dan gangguan pendengaran. Pada perforasi berukuran ≤ 50 % pars tensa, tingkat keberhasilan metode myringo bridge tidak berbeda dengan pembedahan. Konsentrasi dan aktifitas maksimal growth factors terjadi pada hari ketiga setelah perforasi. Platelet Rich Plasma mengandung growth factors. Tujuan penelitian : Menentukan hasil guna kombinasi Platelet Rich Plasma dan salep Mupirocin 2 % dengan Paper Patch pada penutupan PMT permanen. Metode penelitian : Double Blind Randomized Controlled Trial Prosedur penelitian : Pemeriksaan tajam pendengaran, pembuatan PRP, pembuatan luka pada pinggir perforasi membran timpani, dan penutupan PMT. Hasil penelitian : Subyek penelitian berjumlah 62 subyek, dibagi dua kelompok, dengan 31 subyek pada tiap kelompok. Keberhasilan penutupan PMT pada kelompok kombinasi Platelet Rich Plasma dan salep Mupirocin 2 % dengan paper patch sebanyak 28 subyek (90,3 %) dan pada kelompok salep Mupirocin 2 % dengan paper patch sebanyak 20 subyek (64,5 %). Perbedaan ini secara statistik bermakna dengan nilai p = 0,0015; RR: 5,133 (IK 95%: 1,266-20,809). Kesimpulan : Kombinasi Platelet Rich Plasma dan salep Mupirocin 2 % dengan Paper Patch lebih berhasil guna dibandingkan salep Mupirocin 2 % dengan Paper Patch pada penutupan perforasi membran timpani permanen.

Background : Tympanic membrane perforation usually causes recurrent of middle ear infection and conductive hearing loss. The level successfulness of surgical myringotomy method and conservative method is not significancy different on size of perforation ≤ 50 % of pars tensa. The growth factors concentration and activation achieve maximally in third day after perforation. Platelet Rich Plasma containing growth factors. Objectives : This study to determined the clinical efficacy of Platelet Rich Plasma with 2 % Mupirocin ointment in tympanic membrane perforation closure in paper patch. Study design : Double Blind Randomized Controlled Trial (RCT). Procedure : Hearing level examination, making Platelet Rich Plasma and a new wound in the edge of perforation, closuring perforation. Statistical analysis : The outcome were sed analysis with X 2 (Chi Square), and unpaired t test. Result : All of 62 samples were randomly allocated into two groups and each group contain 31 samples. There were 90.3 % success rate (28 samples) on closure of TM using combination of Platelet Rich Plasma and 2 % Mupirocin ointment in paper patch as a bridge and the control group using 2 % Mupirocin ointment in paper patch as a bridge were 64.5 % success rate (20 samples). This difference was statistically significant (p value: 0.0015; RR: 5.133 with 95% CI: 1.266-20.809). Conclusion : Combination of Platelet Rich Plasma and 2 % Mupirocin ointment is more efficacy than 2 % Mupirocin ointment in tympanic membrane perforation closure in paper patch.

Kata Kunci : Hasil guna, Platelet Rich Plasma, Perforasi membran timpani permanen.