Injection of Platelet Rich Plasma in the Olfactory Cleft for COVID-19 Patients With Persistent Olfactory Dysfunction: Description of the Technique

Abstract

In this paper, we described technique of platelet rich plasma injection into the olfactory cleft in a 22-year-old female with 24-month post–COVID-19 anosmia. The technique starts with the blood extraction and the isolation of PRP through a 10-min centrifugation. The supernatant was injected in nasal regions after a local anesthesia through a 0° rigid optic. Several points of .2–.5 mL were performed in the nasal septum in regard of the head of the middle turbine and in the head of the middle turbine in both sides. The baseline threshold, discrimination, and identification scores were 1, 8, and 0, and the Olfactory Disorder Questionnaire score was 51, respectively. The injection of PRP in olfactory cleft was done without complication and mild pain. The patient perception of recovery of smell sense occurred at 3-week post-injection. From this time, the smell sense progressively improved to the 2-month consultation. At 2-month post-injection, the TDI scores reached 16, 16, and 16 (48), while the Olfactory Disorder Questionnaire was 73. The injection of PRP into the olfactory cleft appears to be a safe and easiness new approach that may improve the recovery of smell sense. Future controlled studies are needed.

Platelet-Rich Plasma (PRP) in the Treatment of Long COVID Olfactory Disorders: A Comprehensive Review

“…TGF-β oversees the remodeling phase, where collagen synthesis by fibroblasts fortifies tissue strength and integrity. These growth factors also serve as chemotactic signals, recruiting macrophages and stem cells to the injury site and emphasizing PRP's role in tissue repair and regeneration [53][54][55]. The fibrin matrix's scaffolding effect and the modulation of inflammation by PRP contribute to reduced healing time and improved recovery outcomes [56].…”

“…Different PRP injection techniques are described in the research; some use a single injection, while others use repeated injections spaced out over a shorter period of time [54][55][56][57][58][59]. Most injections were administered at outpatient facilities or hospital based setting, and the frequency of treatment sessions ranged from a single application to multiple injections over a period of up to six weeks.…”

“…Yan and colleagues specifically used three PRP intranasal injections spaced two weeks apart into the olfactory cleft [55]. In comparison, one PRP injection into the olfactory cleft was used by Steffens et al [56] and Lechien et al [54,58]. In order to achieve a compromise, Abo El Naga et al gave the olfactory cleft three PRP injections spaced three weeks apart [59].…”

Autologous Platelet and Extracellular Vesicle-Rich Plasma as Therapeutic Fluid: A Review

“…The anti-inflammatory and regenerative potential of PVRP offered an option of treat persistent viral inflammation of neuroepithelium. Injections of PVRP into the olfactory area for COVID-19 patients with persistent olfactory dysfunction were administered by Lechien et al and Steffens et al [ 246 , 247 ]. Both studies showed encouraging results, with most patients reacquiring the sensation of smell.…”

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

“…There was only 1 practitioner that carried out the injection for European patients. The procedure was described in 2 recent papers, 13,20 and is reported in Supplemental Appendix 3, available online. In sum, the blood extraction was performed into a 20 mL tube with sodium citrate anticoagulant.…”