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Albazee E, Alsubaie HM, Alkanderi R, Althaidy M, Alsafar H, Alsaleh S, Abdulrahman S. Platelet-rich plasma following endoscopic sinus surgery in patients with chronic sinusitis: A systematic review and meta-analysis of randomised controlled trials. Clin Otolaryngol 2024; 49:567-577. [PMID: 38816910 DOI: 10.1111/coa.14186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 04/08/2024] [Accepted: 05/12/2024] [Indexed: 06/01/2024]
Abstract
INTRODUCTION To comprehensively evaluate the reported clinical effectiveness of platelet-rich plasma (PRP) in patients with chronic sinusitis undergoing endoscopic sinus surgery (ESS). METHODS We performed a systematic review and meta-analysis of randomised controlled trials (RCTs). Five digital online databases (PubMed, Scopus, Web of Science, Google Scholar and Cochrane CENTRAL) were searched from inception up to 1st May 2023. Our specific outcomes involved postoperative nasal endoscopy scores measured via Lund-Kennedy score or Meltzer score, olfactory sensation scores and pre-operative anosmia duration. All data were pooled as standardised mean difference (SMD) with a 95% confidence interval (CI), using the RevMan software. RESULTS Six RCTs were included in this systematic review and meta-analysis, with a total of 169 patients. The risk of bias in the included RCTs was low in three RCTs, some concerns in one RCT and high risk in two RCTs. The overall analysis of the postoperative nasal endoscopy scores showed that the PRP group had lower scores compared to the control group (n = 3 RCTs, SMD = -1.19; 95% CI [-1.94, -0.44], p = .002). There was no significant difference between the PRP and control groups regarding anosmia duration (n = 2 RCTs, SMD = 0.21; 95% CI [-0.17, 0.59], p = 0.28) or olfactory sensation scores, despite the PRP group having higher scores (n = 2 RCTs, SMD = 0.53; 95% CI [-0.32, 1.39], p = 0.22). CONCLUSION This study highlights the potential advantages of using PRP as an additional treatment for individuals with chronic sinusitis undergoing ESS. The improvements associated with PRP include facilitating wound healing, reducing inflammation and enhancing surgical outcomes. To optimise the use of PRP in clinical settings, future research should focus on conducting larger trials with standardised protocols.
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Affiliation(s)
- Ebraheem Albazee
- Kuwait Institute for Medical Specializations (KIMS), Kuwait City, Kuwait
| | - Hemail M Alsubaie
- Otorhinolaryngology-Head and Neck Surgery and Communication Sciences Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Roaa Alkanderi
- Kuwait Institute for Medical Specializations (KIMS), Kuwait City, Kuwait
| | - Mubarak Althaidy
- Kuwait Institute for Medical Specializations (KIMS), Kuwait City, Kuwait
| | - Husain Alsafar
- Kuwait Institute for Medical Specializations (KIMS), Kuwait City, Kuwait
| | - Saad Alsaleh
- Department of Otolaryngology-Head & Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Shawkat Abdulrahman
- Department of Otolaryngology-Head & Neck Surgery, Tallaght University Hospital, Dublin, Ireland
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Erçelik O, Karadaş H, Kaptan Z, Bilgen AS, Samaraz Olgun P, Çaydere M, Hücümenoğlu S. The effect of adipose tissue-derived stromal vascular fraction/gel material on wound healing in a rat model of nasal mucosa injury. Acta Otolaryngol 2024:1-8. [PMID: 39141586 DOI: 10.1080/00016489.2024.2385594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 07/16/2024] [Accepted: 07/17/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND Stromal Vascular fraction/gel (SVF/gel) is prepared mechanically from autologous adipose tissue, and it is known for its regenerative and anti-inflammatory properties. AIMS To assess histopathological effects of adipose tissue-derived SVF/gel and nasal steroids on nasal mucosal healing. MATERIAL AND METHODS Forty-two Wistar Albino rats with right nasal mucosal injury were randomly divided into three groups: control (saline), Mometasone Furoate (MF), and SVF/gel. Control group (n = 14) received saline for 7 days, while MF group (n = 14) was administered MF to the right nasal cavity for 7 days. SVF/gel group (n = 14) was treated once with SVF/gel in the right nasal cavity. Histological analysis on days 14 and 28 post-injury focused on evaluating epithelial thickness, inflammation, disarray, subepithelial thickness, goblet cell count, subepithelial fibrosis, presence of ciliated cells, lacunae, adhesion, and neo-osteogenesis. RESULTS When comparing the MF and SVF/gel groups, statistically significant differences were found on day 14 in indices of epithelial thickness, subepithelial thickness, goblet cells, subepithelial fibrosis, and ciliated cells. On day 28, SVF/gel group exhibited higher ciliated cell counts and lower subepithelial fibrosis values (p = .027; p = .016). Additionally, epithelial disarray, adhesions, lacunae, and neo-osteogenesis were not observed in the SVF/gel group. CONCLUSIONS AND SIGNIFICANCE SVF/gel accelerates re-epithelialization, reduces fibrosis and adhesions, and enhances cilia formation compared to nasal steroids. These findings suggest that SVF/gel is an autologous and cost-effective treatment for improving nasal mucosal healing post-injury.
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Affiliation(s)
- Onur Erçelik
- Department of Otolaryngology-Head and Neck Surgery, Bandırma State Hospital, Bandırma, Balıkesir, Turkey
| | - Hatice Karadaş
- Department of Otolaryngology-Head and Neck Surgery, Ankara Research and Training Hospital, Ankara, Turkey
| | - Zeynep Kaptan
- Department of Otolaryngology-Head and Neck Surgery, Ankara Research and Training Hospital, Ankara, Turkey
| | - Akif Sinan Bilgen
- Department of Otolaryngology-Head and Neck Surgery, Ankara Research and Training Hospital, Ankara, Turkey
| | - Pelin Samaraz Olgun
- Department of Otolaryngology-Head and Neck Surgery, Kırşehir Research and Training Hospital, Kırşehir, Turkey
| | - Muzaffer Çaydere
- Department of Pathology, Ankara Research and Training Hospital, Ankara, Turkey
| | - Sema Hücümenoğlu
- Department of Pathology, Ankara Research and Training Hospital, Ankara, Turkey
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Dinaki K, Grigoriadis N, Vizirianakis IS, Constantinidis J, Triaridis S, Karkos P. The impact of submucosal PRP injection on wound healing after endoscopic sinus surgery: a randomized clinical trial. Eur Arch Otorhinolaryngol 2024; 281:3587-3599. [PMID: 38334783 PMCID: PMC11211195 DOI: 10.1007/s00405-024-08483-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 01/13/2024] [Indexed: 02/10/2024]
Abstract
PURPOSE Chronic rhinosinusitis (CRS) is a prevalent chronic disease observed on a global scale. The utilization of endoscopic sinus surgery (ESS) has gained significant recognition as an effective intervention for individuals with CRS and nasal polyps who have not responded to conventional treatments. The need (or not) for revision surgery frequently relies on the promotion of optimal wound healing. The impact of platelet-rich plasma (PRP) on tissue healing has been extensively examined in various surgical fields. METHODS The present prospective study involved 30 patients suffering with nasal polyposis who underwent endoscopic sinus surgery. 15 patients were assigned to the PRP group, and 15 patients to the control group. The clinical follow-up of the patients took place at specific intervals, at weeks 1, 2, 3, 4, 8, and 12 after the surgical procedure. The evaluator identified the existence of adhesions, crusting, bleeding, granulation and infection using a visual analogue scale score. The patients also completed the SNOT 22 questionnaire prior to surgery and at each postoperative visit. RESULTS The present study observed a lower incidence of adhesion, infection, hemorrhage and granulation in the PRP group. Furthermore, a statistically significant difference was detected between the groups. CONCLUSION Based on the findings of the present investigation, it seems that platelet-rich plasma (PRP) is beneficial on wound healing during the early stages following the surgical procedure. The technique is characterized by its limited invasiveness, which contributes to its low risk profile and the achievement of clinically good outcomes.
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Affiliation(s)
- Konstantina Dinaki
- 1st Academic ORL Department, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Nikolaos Grigoriadis
- Laboratory of Pharmacology, School of Pharmacy, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis S Vizirianakis
- Laboratory of Pharmacology, School of Pharmacy, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Department of Health Sciences, School of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
| | - Jannis Constantinidis
- 1st Academic ORL Department, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stefanos Triaridis
- 1st Academic ORL Department, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Petros Karkos
- 1st Academic ORL Department, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Javid K, Mourão CF, Mello-Machado RC, Sartoretto SC, Torres M, Stellet Lourenço E, Leite PEC, Granjeiro JM, Alves GG, Calasans-Maia MD. Clinical and Biochemical Evaluation of the Use of Alb-PRF versus L-PRF in Mandibular Third Molar Extractions: A Split-Mouth Randomized Clinical Trial. J Funct Biomater 2023; 14:505. [PMID: 37888172 PMCID: PMC10607814 DOI: 10.3390/jfb14100505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 09/29/2023] [Accepted: 10/08/2023] [Indexed: 10/28/2023] Open
Abstract
Bone tissue engineering seeks biomaterials that enable cell migration, angiogenesis, matrix deposition, and tissue regeneration. Blood concentrates like platelet-rich fibrin (L-PRF) offer a cost-effective source of cells and growth factors to enhance healing. The present study aimed to evaluate heated serum albumin with liquid PRF (Alb-PRF) and L-PRF clinically and biochemically after placement in dental sockets following mandibular third molar extraction. In a controlled, split-mouth study involving 10 volunteers, 20 extracted molars were treated with either Alb-PRF or L-PRF. Post-extraction, pain, trismus, infection presence, and swelling were measured. The concentrations of different analytes in the surgical sites were also examined. The data were statistically analyzed, with significance defined at p < 0.05 (t-test). No significant difference was noted between the groups for pain and trismus, but Alb-PRF showed a significant reduction in swelling on day seven. The Alb-PRF group showed lower levels of pro-inflammatory cytokines (GM-CSF, IL-1b, IL-6, IFNy, IL-8, IL-15, RANTES, and MIP-1a) after seven days, with only higher expressions of MIP-1b, IL-1b, and MCP-1 found in the L-PRF group. Differences were observed in the release of analytes between L-PRF and Alb-PRF, with Alb-PRF significantly reducing edema after seven days. Alb-PRF reduced edema, while L-PRF increased inflammatory cytokines. When compared to L-PRF, Alb-PRF reduced edema and the release of inflammatory cytokines, suggesting promising effects in socket healing while underscoring the role of growth factors and cytokines in potential applications of blood concentrates.
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Affiliation(s)
- Kayvon Javid
- Graduate Program in Dentistry, Fluminense Federal University, Niterói 24020-140, Brazil
| | - Carlos Fernando Mourão
- Department of Periodontology, Tufts University School of Dental Medicine, Boston, MA 02111, USA
| | | | | | - Madelaine Torres
- Graduate Program in Dentistry, Fluminense Federal University, Niterói 24020-140, Brazil
| | | | - Paulo Emilio Correa Leite
- Clinical Research Unit, Antonio Pedro Hospital, Fluminense Federal University, Niterói 24033-900, Brazil
| | - José Mauro Granjeiro
- Department of Oral Surgery, Fluminense Federal University, Niterói 24020-140, Brazil
| | - Gutemberg Gomes Alves
- Department of Biotechnology, Fluminense Federal University, Niterói 24033-900, Brazil
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Guan S, Xiao T, Bai J, Ning C, Zhang X, Yang L, Li X. Clinical application of platelet-rich fibrin to enhance dental implant stability: A systematic review and meta-analysis. Heliyon 2023; 9:e13196. [PMID: 36785817 PMCID: PMC9918761 DOI: 10.1016/j.heliyon.2023.e13196] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 12/23/2022] [Accepted: 01/20/2023] [Indexed: 01/27/2023] Open
Abstract
Objective To investigate the effect of platelet-rich fibrin application on implant stability. Study design Five databases, namely, PubMed, Embase, Web of Science, Wiley, and China National Knowledge Infrastructure, were searched for reports published up to November 20, 2022. Randomized controlled trials (RCT), including parallel RCTs and split-mouth RCTs, with at least 10 patients/sites were considered for inclusion. Results After screening based on the inclusion criteria, ten RCTs were included. Low heterogeneity was observed in study characteristics, outcome variables, and estimation scales (I2 = 27.2%, P = 0.19). The qualitative and meta-analysis results showed that PRF increased the effect of implant stabilizers after implant surgery. Conclusions The results of the present systematic review and meta-analysis suggest that PRF can increase implant stability after implant surgery. PRF may also have a role in accelerating bone healing and tends to promote new bone formation at the implant site.
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Affiliation(s)
- Shuai Guan
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Hebei Medical University and Hebei Key Laboratory of Stomatology, Shijiazhuang, 050017, PR China
| | - Tiepeng Xiao
- The Second Affiliated Hospital of Hebei Medical University, Shijiazhuang, 050000, PR China
| | - Jiuping Bai
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Hebei Medical University and Hebei Key Laboratory of Stomatology, Shijiazhuang, 050017, PR China
| | - Chunliu Ning
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Hebei Medical University and Hebei Key Laboratory of Stomatology, Shijiazhuang, 050017, PR China
| | - Xingkui Zhang
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Hebei Medical University and Hebei Key Laboratory of Stomatology, Shijiazhuang, 050017, PR China
| | - Lei Yang
- Department of Epidemiology and Statistics, School of Public Health, Hebei Key Laboratory of Environment and Human Health, Hebei Medical University, Shijiazhuang, 050017, PR China
| | - Xiangjun Li
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Hebei Medical University and Hebei Key Laboratory of Stomatology, Shijiazhuang, 050017, PR China,Corresponding author.
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