Efficacy of Platelet-Rich Plasma as an Adjuvant Therapy to Endoscopic Sinus Surgery in Anosmia Patients with Sinonasal Polyposis: A Randomized Controlled Clinical Trial

Tabrizi, Ali; Asadi, Mahboobe; Mohammadi, Mehdi; Yekta, Abbasali; Sohrabi, Mohammad‐Reza

doi:10.47176/mjiri.35.156

Cited by 8 publications

(22 citation statements)

References 33 publications

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“…In this single‐blinded, randomized controlled study, PRP treatment resulted in a greater improvement in overall olfaction scores compared with placebo with a 12.5 times greater likelihood in achieving a treatment response at 3 months. Submucosal injections of PRP into the olfactory cleft were well tolerated without significant adverse effects and did not worsen smell function, as previously noted in our pilot study and other studies utilizing intranasal PRP 20–22,28,29 . These data suggest that PRP has the potential as a safe treatment option for patients with COVID‐19 smell loss.…”

Section: Discussionsupporting

confidence: 84%

“…Submucosal injections of PRP into the olfactory cleft were well tolerated without significant adverse effects and did not worsen smell function, as previously noted in our pilot study and other studies utilizing intranasal PRP. 20 , 21 , 22 , 28 , 29 These data suggest that PRP has the potential as a safe treatment option for patients with COVID‐19 smell loss.…”

Section: Discussionmentioning

confidence: 89%

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Use of platelet‐rich plasma for COVID‐19–related olfactory loss: a randomized controlled trial

Yan

Jang

Lin

et al. 2022

Int Forum Allergy Rhinol

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Introduction The current study evaluated the use of platelet‐rich plasma (PRP), an autologous blood product with supraphysiologic concentrations of growth factors, in the treatment of prolonged coronavirus disease 2019 (COVID‐19)–related smell loss. Methods This multi‐institutional, randomized controlled trial recruited patients with COVID‐19 who had objectively measured smell loss (University of Pennsylvania Smell Identification Test [UPSIT] ≤ 33) between 6 and 12 months. Patients were randomized to three intranasal injections of either PRP or sterile saline into their olfactory clefts. The primary outcome measure was change in Sniffin’ Sticks score (threshold, discrimination, and identification [TDI]) from baseline. The secondary end point measures included responder rate (achievement of a clinically significant improvement, ≥5.5 points TDI), change in individual TDI olfaction scores, and change in subjective olfaction via a visual analog scale. Results A total of 35 patients were recruited and 26 completed the study. PRP treatment resulted in a 3.67‐point (95% CI: 0.05–7.29, p = 0.047) greater improvement in olfaction compared with the placebo group at 3 months and a higher response rate (57.1% vs 8.3%, odds ratio 12.5 [95% exact bootstrap confidence interval, 2.2–116.7]). There was a greater improvement in smell discrimination following PRP treatment compared with placebo but no difference in smell identification or threshold. There was no difference in subjective scores between PRP and placebo. No adverse effects were reported. Conclusion Olfactory function following COVID‐19 can improve spontaneously after 6 months and can improve to a greater extent with PRP injection. These data build on the promise of PRP to be a safe potential treatment option for patients with COVID‐19–related smell loss, and larger‐powered studies will help further assess its efficacy.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 89%

Use of platelet‐rich plasma for COVID‐19–related olfactory loss: a randomized controlled trial

Yan

Jang

Lin

et al. 2022

Int Forum Allergy Rhinol

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“…24,25 To date, the injection of PRP into the olfactory clefts of patients with OD was attempted in a few small-cohort studies and reported safety 13 and promising findings. 12,[26][27][28] The primary finding of our study may suggest better significant improvements in both patient-reported outcome olfactory questionnaire and psychophysical evaluations in PRP patients compared with controls. In addition to the potential effectiveness of PRP in COVID-19 patients with OD, our preliminary 13 and current data supported that this procedure is safe and not associated with adverse events.…”

Section: Discussionmentioning

confidence: 68%

“…Precisely, in Otolaryngology–Head and Neck Surgery, PRP may be indicated in the management of vocal fold lesions, 22 neck fistula, 23 or tympanic membrane perforation 24,25 . To date, the injection of PRP into the olfactory clefts of patients with OD was attempted in a few small‐cohort studies and reported safety 13 and promising findings 12,26‐28 …”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Platelet‐Rich Plasma for COVID‐19‐Related Olfactory Dysfunction: A Controlled Study

Lechien

Saussez

Vaira

et al. 2023

Otolaryngol.--head neck surg.

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ObjectiveTo investigate the effectiveness of platelet‐rich plasma (PRP) injection into the olfactory clefts of coronavirus disease 2019 (COVID‐19) patients with persistent olfactory dysfunction (OD).Study DesignControlled study.SettingMulticenter study.MethodsFrom March 2022 to November 2022, COVID‐19 patients with persistent OD were recruited from three European hospitals to undergo PRP injections into the olfactory clefts. Olfactory function was evaluated at baseline and 10 weeks postinjection with the Olfactory Disorder Questionnaire (ODQ) and threshold, discrimination, and identification (TDI) test. Data were compared with a control group of untreated patients.ResultsEighty‐one patients who underwent PRP injection and 78 controls were included. Sixty‐five PRP patients (80.3%) experienced subjective smell improvement after a mean duration of 3.4 ± 1.9 weeks. The parosmia, life quality statement, and ODQ sub‐ and total scores significantly decreased from pre‐ to 10‐week postinjection in the PRP group. The TDI sub‐ and total scores significantly increased 10 weeks postinjection. In controls, the ODQ score did not change over time, while the discrimination, identification, and total TDI scores significantly increase after 10 weeks of follow‐up. The 10‐week TDI and ODQ scores were significantly better in the PRP group compared with the controls.ConclusionPatients who underwent PRP injection reported better 10‐week subjective and objective smell outcomes than controls. Future randomized‐controlled studies using saline injection into the olfactory cleft of controls are needed to determine the superiority of PRP over placebo.

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“…At the 3-month follow-up, five patients with hyposmia exhibited improvement, with 60% achieving normosmia. Forty-eight anosmia patients with sinonasal polyposis participated in randomized controlled research by Goljanian Tabrizi et al [ 38 ] to evaluate the effectiveness of platelet-rich plasma as an adjuvant therapy to endoscopic sinus surgery. Their research found that PRP injection had no immediate impact on patients with sinonasal polyposis’ ability to regain their olfactory function.…”

Section: Discussionmentioning

confidence: 99%

The potential therapeutic effect of platelet-rich plasma in the treatment of post-COVID-19 parosmia

Naga

Zaiat

Hamdan

2022

Egypt J Otolaryngol

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Background COVID-19-related olfactory dysfunction is an emerging problem with a significant impact on the quality of life of affected individuals. Different lines of treatment have been used with varying results. This study aimed to assess the potential therapeutic effect of PRP in the treatment of post-COVID olfactory dysfunction. This work aimed to assess the potential therapeutic effect of platelet-rich plasma (PRP) in treating post-COVID-19 parosmia. A pilot study was conducted on 60 patients with post-COVID parosmia without responding to a 3-month course of olfactory training, topical corticosteroids, omega-three, vitamin B12, and zinc supplementation. The patients were distributed randomly and equally among 2 groups. The case group was subjected to three PRP injections in the olfactory cleft at 3 weeks intervals. The control group continued the pre-study treatment protocol for 6 weeks. The degree of parosmia was assessed before and after treatment subjectively using a visual analog scale (VAS) from 0 to 10. Reaching 0–1 on the visual analog scale was a complete improvement. The primary outcome was assessing the post-treatment score for parosmia 1 month after the third injection in the case group. The second outcome was the comparison between both groups regarding the degree of improvement 1 month after cessation of treatment. Results There was a highly significant improvement in VAS for parosmia (p < 0.00001) in the case group and a significant improvement in VAS for parosmia in the control group (p = P = 0.00148). There was a significant difference between both groups regarding the degree of improvement favoring the case group (p = 0.002). Conclusion Platelet-rich plasma injection in the olfactory cleft offers a therapeutic option for treating patients with post-COVID-19 olfactory parosmia who failed to respond to traditional conservative treatment.

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Efficacy of Platelet-Rich Plasma as an Adjuvant Therapy to Endoscopic Sinus Surgery in Anosmia Patients with Sinonasal Polyposis: A Randomized Controlled Clinical Trial

Cited by 8 publications

References 33 publications

Use of platelet‐rich plasma for COVID‐19–related olfactory loss: a randomized controlled trial

Use of platelet‐rich plasma for COVID‐19–related olfactory loss: a randomized controlled trial

Effectiveness of Platelet‐Rich Plasma for COVID‐19‐Related Olfactory Dysfunction: A Controlled Study

The potential therapeutic effect of platelet-rich plasma in the treatment of post-COVID-19 parosmia

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