Platelet-Rich Plasma for Patients with Olfactory Dysfunction: Myth or Reality? A Systematic Review

Abstract

Background: With promising outcomes, platelet-rich plasma (PRP) has recently been suggested as a treatment for olfactory dysfunction (OD). Methods: Clinical studies utilizing PRP in OD caused by COVID-19, trauma, anesthetic exposure, viral infection, and chronic rhinosinusitis were included in a systematic review. Results: Ten clinical studies were qualitatively analyzed. Six of these studies used the PRP for OD caused by COVID-19, one on OD after functional endoscopic sinus surgery, and three on post-infectious or post-trauma OD. The population included 531 patients, ranging in age from 15 to 63. Conclusion: The use of PRP may be a risk-free and efficient therapeutic option with very encouraging outcomes. Indeed, it enhances olfactory perception in patients who not only exhibit COVID-19 infection aftereffects, but also in those who have lost their sense of smell due to trauma, rhinosinusitis, rhinitis, or even surgery. To evaluate the PRP’s therapeutic benefits in OD patients and to compare the efficacy of different therapeutic protocols with regard to treatment schedules, there is an urgent need for focused controlled trials.

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

“…One of the notable sequelae of Long COVID-19 is olfactory dysfunction (OD), which can last for months after the initial SARS-CoV-2 infection [15][16][17]. The precise mechanisms underlying the development of OD in Long COVID are not yet fully understood, but several hypotheses have been proposed [18,41]. Persistent viral infection or reactivation within the olfactory system may lead to chronic inflammation and damage to the olfactory neurons or supporting cells [42,43].…”

“…Therapies that target the mechanisms of chronic viral infection, dysregulated immunological responses, and microvascular dysfunction that underlie OD in Long COVID may prove advantageous [37,50]. In various clinical contexts, platelet-rich plasma (PRP), a concentrated source of autologous growth factors and cytokines produced from the patient's own blood, has demonstrated promise in promoting tissue repair and regeneration [34,41]. PRP therapy may be beneficial in the context of OD linked to Long COVID through several ways.…”

“…The PRP that is utilized in various therapeutic interventions boasts a composition teeming with platelets, far exceeding the concentration found within normal blood. These platelets are not just components that respond swiftly to injury, but also factories of growth factors and cytokines crucial for healing [41]. In typical PRP preparations, the goal is to achieve a platelet concentration 3-5 times that of baseline blood levels, translating into a potent cocktail of biologically active proteins [34].…”

“…The efficacy of PRP therapy as a treatment for olfactory disorders associated with COVID-19 is influenced by an intricate interplay of factors [41,54,55]. The unique characteristics and demographics of each patient-including age, sex, overall health status, and the presence of underlying medical conditions-can significantly affect how one might respond to PRP therapy [56].…”

“…In clinical practice, PRP has been gaining traction within otolaryngology for its diverse applications, ranging from enhancing wound healing post-surgery to treating sensorineural hearing loss, and even as a treatment for qualitative OD [36][37][38][39][40]. While the literature contains systematic reviews on the use of PRP in the context of COVID-19-related OD [41], comprehensive reviews evaluating PRP's efficacy across other etiologies of OD are lacking. This comprehensive review aimed to fill this gap by revisiting the current literature on PRP use in olfactory dysfunction caused by CRS, trauma, anesthetic exposure, or viral infections, including COVID-19.…”