The use of platelet-rich plasma gel in superficial parotidectomy

Supernatant of activated platelet-rich plasma rejuvenated aging-induced hyposalivation in mouse

Hyposalivation is a common complaint among the elderly, but no established treatment prevents age-induced hyposalivation. Platelet derivatives such as platelet-rich plasma (PRP), platelet-rich fibrin (PRF), and plasma rich in growth factor (PRGF), are used widely in different areas of regenerative medicine to enhance the wound healing processes. This study examined whether the local injection of the supernatant of activated PRP (saPRP) into the salivary gland (SG) could help prevent aging-induced SG dysfunction and explored the mechanisms responsible for the protective effects on the SG hypofunction. The platelets were separated from the blood of male SD rats (220 ± 20 g). saPRP was manufactured by removing the fibrin clot after activating platelet with calcium ionophore 10 μM (A23187). The total protein and TGF-β1 levels were significantly higher in saPRP than in PRP. Human salivary gland epithelial cell(hSGEC) was treated with saPRP or PRP after senescence through irradiation. The significant proliferation of hSGEC was observed in saPRP treated group compared to irradiation only group and irradiation + PRP group. Cellular senescence, apoptosis, and inflammation significantly reduced in saPRP group. The SG function and structural tissue remodeling by the saPRP were investigated with naturally aged mice. The mice were divided into three groups: 3 months old (3 M), 22 months old (22 M), and 22 months old treated with saPRP (22 M + saPRP). Salivary flow rate and lag time were significantly improved in 22 M + saPRP group compared to 22 M group. The histologic examinations showed the significant proliferation of acinar cell in 22 M + saPRP group. The decrease of senescence, apoptosis, and inflammation observed by western blot in 22 M + saPRP group. The saPRP induced the proliferation of hSGECs, leading to a significant decrease in cellular senescence via decrease inflammation and apoptosis, in vitro. Moreover, the acini cells of the salivary gland were regenerated, and the salivary function increased in aged mice. These results showed that saPRP could be a treatment agent against aging-induced SG dysfunction.

Assessment of the observation management of sialocele after partial superficial parotidectomy

PURPOSE

This study aimed to investigate the usefulness of management of sialocele formation and to evaluate the quality of life of patients under elective management post-parotidectomy.

MATERIALS AND METHODS

A prospective study was performed including patients who underwent postoperative management with either compression therapy or observation. The self-filled questionnaire method was used to assess the quality of life of participants who changed from compression therapy to observation. Demographic and operative data, variables regarding wound complications and scores for quality of life were documented and analysed.

RESULTS

A total of 86 patients met the eligibility criteria. The respective rates of sialocele formation within 1 month were 5.3% in the compression therapy group (2/38) and 16.0% in the observation group (4/25), but no significant difference was observed (p = 0.204). Meanwhile, both groups displayed comparable times of needle aspiration and time for sialocele resolution (p > 0.05). Based on 23 valid paired questionnaires, scores for physical and social-emotional function before changing from compression therapy to observation were significantly lower than scores after the change (p < 0.001).

CONCLUSION

The application of observation after partial superficial parotidectomy appears to have acceptable clinical outcomes and considerable improvements in quality of life.

Prospects of Extracellular Vesicles in Otorhinolaryngology, Head and Neck Surgery

The diagnostic and therapeutic potential of extracellular vesicles (EVs) has been recognised in many fields of medicine for several years. More recently, it has become a topic of increasing interest in otorhinolaryngology, head and neck surgery (ORL-HNS). With this narrative review, we have aspired to determine different aspects of those nanometrically sized theranostic particles, which seem to have promising potential as biomarkers in some of the most common diseases of the ORL-HNS by being available via less invasive diagnostic methods. At the same time, a better understanding of their activity provides us with new possibilities for developing specific target treatments. So far, most research has been oriented towards the role of EVs in the progression of head and neck cancer, notably head and neck squamous cell cancer. Nonetheless, some of this research has focused on chronic diseases of the ears, nose and paranasal sinuses. However, most research is still in the preclinical or experimental phase. It therefore requires a further and more profound understanding of EV content and behaviour to utilise their nanotheranostic capacities to their fullest potential.

Predictors of Sialocele or Salivary Fistula After Partial Superficial Parotidectomy for Benign Parotid Tumor: A Retrospective Study

PURPOSE

Partial superficial parotid (PSP) resection is the mainstay of treatment for benign parotid tumor. Unfortunately, the post-surgical formation of sialocele or salivary fistula is a well-recognized complication of parotid surgery. The aim of this study was to determine the predictors of sialocele or salivary fistula after PSP resection for parotid benign tumor.

METHODS

This retrospective cohort study includes patients who underwent PSP resection for benign parotid tumors from January 1, 2015 to December 31, 2019. The predictor variables were demographic data, systemic disease, smoking history, tumor size and type, surgical approach, and area. The outcome variables were the occurrence of sialocele or salivary fistula after PSP resection. Each possible risk factor was then examined using univariate analysis. Variables associated with sialocele or salivary fistula in the univariate analysis were then included in a multiple logistic regression model, and analyzed for possible factors related to the occurrence of sialocele or salivary fistula after partial superficial parotid resection.

RESULTS

The sample was composed of 872 subjects with a mean age of 51.0 ± 8.3, and 59.5% were male. The frequency of sialocele or salivary fistula after partial superficial parotid resection was 10.4% (n = 92). Based on the multiple logistic regression model, hypertension and location of the lesion were associated with sialocoele formation. Hypertension was associated with a decreased risk for the formation of sialocele or salivary fistula (ORs = 0.6, 95% CI = [0.4,1.003], P = .051). When compared the superior lesions, anterior lesions were associated with a decreased risk for the formation of sialocele or salivary fistula (ORs = 0.32, 95% CI = [0.111,0.92], P = .034) and lesions in the middle were associated with an increased risk for sialocele or salivary fistula development (ORs = 2.315,95% CI = [1.199,4.469], P = .012).

CONCLUSIONS

The incidence of sialocele or salivary fistula development was 10.4% in patients undergoing partial superficial parotidectomy in this study. Moreover, middle and anterior tumor location was shown to increase sialocele or salivary fistula risk.

Platelet-rich plasma and cytokines in neuropathic pain: A narrative review and a clinical perspective

BACKGROUND AND OBJECTIVE

Neuropathic pain arises as a direct consequence of a lesion or disease affecting the somatosensory system. A number of preclinical studies have provided evidence for the involvement of cytokines, predominantly secreted by a variety of immune cells and by glial cells from the nervous system, in neuropathic pain conditions. Clinical trials and the use of anti-cytokine drugs in different neuropathic aetiologies support the relevance of cytokines as treatment targets. However, the use of such drugs, in particularly biotherapies, can provoke notable adverse effects. Moreover, it is challenging to select one given cytokine as a target, among the various neuropathic pain conditions. It could thus be of interest to target other proteins, such as growth factors, in order to act more widely on the neuroinflammation network. Thus, platelet-rich plasma (PRP), an autologous blood concentrate, is known to contain a natural concentration of growth factors and immune system messengers and is widely used in the clinical setting for tissue regeneration and repair.

DATABASE AND DATA TREATMENT

In the present review, we critically assess the current knowledge on cytokines in neuropathic pain by taking into consideration both human studies and animal models.

RESULTS

This analysis of the literature highlights the pathophysiological importance of cytokines. We particularly highlight the concept of time- and tissue-dependent cytokine activation during neuropathic pain conditions.

RESULTS

Conclusion: Thus, direct or indirect cytokines modulation with biotherapies or growth factors appears relevant. In addition, we discuss the therapeutic potential of localized injection of PRP as neuropathic pain treatment by pointing out the possible link between cytokines and the action of PRP.

SIGNIFICANCE

Preclinical and clinical studies highlight the idea of a cytokine imbalance in the development and maintenance of neuropathic pain. Clinical trials with anticytokine drugs are encouraging but are limited by a 'cytokine candidate approach' and adverse effect of biotherapies. PRP, containing various growth factors, is a new therapeutic used in regenerative medicine. Growth factors can be also considered as modulators of cytokine balance. Here, we emphasize a potential therapeutic effect of PRP on cytokine imbalance in neuropathic pain. We also underline the clinical interest of the use of PRP, not only for its therapeutic effect but also for its safety of use.