Efficacy of Platelet-Rich Plasma as an Adjuvant Therapy to Endoscopic Sinus Surgery in Anosmia Patients with Sinonasal Polyposis: A Randomized Controlled Clinical Trial
Ali Goljanian Tabrizi, Mahboobe Asadi, Mehdi Mohammadi, Amirhosein Abedi Yekta, Mohammadreza Sohrabi, Ali Goljanian Tabrizi, Mahboobe Asadi, Mehdi Mohammadi, Amirhosein Abedi Yekta, Mohammadreza Sohrabi
Abstract
Background: Treatment of patients with anosmia is a major therapeutic challenge. The present study evaluated the efficacy of platelet-rich plasma (PRP) in the treatment of anosmia in patients with sinonasal polyposis. Methods:In the present clinical trial, atotal of 48 patients with sinonasal polyposis with theIran Smell Identification Test (I-SIT) score of <6 who completed the medical treatment and were observed 3 months after the sinus surgery were included and randomly divided in to 2groups. After endoscopic sinus surgery, the intranasal injection of 1 mL PRP and normal saline was performed in the olfactory region in the intervention and control groups, respectively. Odor function was assessed using the I-SIT at the baseline and at the end of the studyby an independent samples ttest. Results: Based on the findings of the present study, the I-SIT improved in both groups during the follow-up, as it reached from 2.63 ± 2.63 to 5.85 ± 2.46 after oral steroid administration and 18.93 ± 1.14 after surgery in the intervention group and from the baseline of 2.10 ± 2.83 to 5.62 ± 2.99 after receiving standard medical treatment and 18.43 ± 1.36in the control groupafter surgery. Although this improvement was significant in both groups in either time interval (all with p<0.001), there was no significant difference between the 2groups in terms of changes in the I-SIT score (p=0.802). Conclusion: According to the current study, PRP injection showed no short-term effect on the recovery of olfactory function in patients with sinonasal polyposis.
Keywords: Anosmia; Olfactory Epithelium; Platelet-Rich Plasma; Sinonasal Polyposis.
© 2021 Iran University of Medical Sciences.
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References
- Boesveldt S, Postma EM, Boak D, Welge-Luessen A, Schöpf V, Mainland JD. et al. Anosmia—a clinical review. Chem Sci. 2017 May 22:513.
- Addison AB, Philpott CM. A systematic review of therapeutic options for non-conductive olfactory dysfunction. Otorhinolaryngologist. 2018 Jan 1:61.
- Huang X, Sterling NW, Du G, Sun D, Stetter C, Kong L. et al. Brain cholesterol metabolism and Parkinson's disease. J Mov Disord. 2019 Mar:386.
- Eroglu U, Shah K, Bozkurt M, Kahilogullari G, Yakar F, Dogan İ. et al. Supraorbital keyhole approach: lessons learned from 106 operative cases. World Neurosurg. 2019 Apr 1
- Dintica CS, Marseglia A, Rizzuto D, Wang R, Seubert J, Arfanakis K. et al. Impaired olfaction is associated with cognitive decline and neurodegeneration in the brain. Neurology. 2019 Feb 12:e700.
- Kern RC, Quinn B, Rosseau G, Farbman AI. Post‐traumatic olfactory dysfunction. Laryngoscope. 2000 Dec:2106.
- Rombaux P, Bertrand B, Keller T, Mouraux A. Clinical significance of olfactory event‐related potentials related to orthonasal and retronasal olfactory testing. Laryngoscope. 2007 Jun:1096.
- Rombaux P, Duprez T, Hummel T. Olfactory bulb volume in the clinical assessment of olfactory dysfunction. Rhinology. 2009 Mar 1:3.
- Yousem DM, Geckle RJ, Bilker WB, Kroger H, Doty RL. Posttraumatic smell loss: relationship of psychophysica tests and volumes of the olfactory bulbs and tracts and the temporal lobes. Acad Radiol. 1999 May 1:264.
- Doty RL, Mishra A. Olfaction and its alteration by nasal obstruction, rhinitis, and rhinosinusitis. Laryngoscope. 2001 Mar:409.
- Li X, Lui F. Anosmia. In Stat Pearls. 2019 Feb 16
- Yasak AG, Yigit O, Araz Server, DurnaDastan S, Gul M. The effectiveness of platelet‐rich plasma in an anosmia‐induced mice model. Laryngoscope. 2018 May:E157.
- Fujii M, Fukazawa K, Takayasu S, Sakagami M. Olfactory dysfunction in patients with head trauma. Auris Nasus Larynx. 2002 Jan 1:35.
- Heilmann S, Huettenbrink KB, Hummel T. Local and systemic administration of corticosteroids in the treatment of olfactory loss. Am J Rhinol. 2004 Jan:29.
- Aiba T, Sugiura M, Mori J, Matsumoto K, Tomiyama K, Okuda F. et al. Effect of zinc sulfate on sensorineural olfactory disorder. Acta OtoLaryngol. 1998 Jan 1:202.
- Roemer A, Warnecke A, Lenarz T, Stolle SR. Successful Treatment of Intractable Facial Osteomyelitis with Autolo-gous PRP and Gentamicin. Otorhinolaryngol Clin. 2017
- Kuzucu I, Beriat GK, Ezerarslan H, Ozdemir S, Kocaturk S. Effects of the Autologous Platelet-Rich Plasma in Nasal Pack on Postoperative Quality of Life. J Craniofac Surg. 2017 May 1:e299.
- Mavrogeni P, Kanakopoulos A, Maihoub S, Maihoub S, Krasznai M, Szirmai A. Anosmia treatment by platelet rich plasma injection. Int. Tinnitus
- Lee CH, Jeon SW, Seo BS, Mo JH, Jeon EH, Choi AR. et al. Transplantation of neural stem cells in anosmic mice. Clin Exp Otorhinolaryngol. 2010 Jun:84.
- Nota J, Takahashi H, Hakuba N, Hato N, Gyo K. Treatment of Neural Anosmia by Topical Application of Basic Fibroblast Growth Factor–Gelatin Hydrogel in the Nasal Cavity: An Experimental Study in Mice. JAMA Otolaryngol Head Neck Surg. 2013 Apr 1:396.
- Okushi T, Nakayama T, Morimoto S, Arai C, Omura K, Asaka D. et al. A modified Lund–Mackay system for radiological evaluation of chronic rhinosinusitis. AurisNasus Larynx. 2013 Dec 1:548.
- Taherkhani S, Moztarzadeh F, Seraj JM, Nazari SS, Taherkhani F, Gharehdaghi J. et al. Iran smell identification test (Iran-SIT): A modified version of the university of pennsylvania smell identification test (UPSIT) for Iranian population. Chemosens Percept. 2015 Dec 1:183.
- Yan CH, Mundy DC, Patel ZM. The use of platelet‐rich plasma in treatment of olfactory dysfunction: A pilot study. Laryngoscope Investig Otolaryngol. 2020 Feb 21
- Nordin S, Brämerson A. Complaints of olfactory disorders: epidemiology, assessment and clinical implications. Curr Opin Allergy Clin Immunol. 2008 Feb 1:10.
- Fonteyn S, Huart C, Deggouj N, Collet S, Eloy P, Rombaux P. Non-sinonasal-related olfactory dysfunction: a cohort of 496 patients. Eur Ann Otorhinolaryngol Head Neck. 2014 Apr 1:87.
- Beites CL, Kawauchi S, Crocker CE, Calof AL. Identification and molecular regulation of neural stem cells in the olfactory epithelium. Exp Cell Res. 2005 Jun 10:309.
- Leung CT, Coulombe PA, Reed RR. Contribution of olfactory neural stem cells to tissue maintenance and regeneration. Nat Neurosci. 2007 Jun:720.
- Iwai N, Zhou Z, Roop DR, Behringer RR. Horizontal basal cells are multipotent progenitors in normal and injured adult olfactory epithelium. Stem Cells. 2008 May:1298.
- Duggan CD, Ngai J. Scent of a stem cell. Nat Neurosci. 2007 Jun:673.
- Schwob JE, Jang W, Holbrook EH, Lin B, Herrick DB, Peterson JN. et al. Stem and progenitor cells of the mammalian olfactory epithelium: Taking poietic license. J Comp Neurol. 2017 Mar 1:1034.
- Kim HY, Kim JH, Dhong HJ, Kim KR, Chung SK, Chung SC. et al. Effects of statins on the recovery of olfactory function in a 3-methylindole–induced anosmia mouse model. Am J Rhinol Allergy. 2012 Mar:e81.
- Lee CH, Mo JH, Shim SH, Ahn JM, Kim JW. Effect of ginkgo biloba and dexamethasone in the treatment of 3-methylindole-induced anosmia mouse model. Am J Rhinol. 2008 May:292.
- Farrag TY, Lehar M, Verhaegen P, Carson KA, Byrne PJ. Effect of platelet rich plasma and fibrin sealant on facial nerve regeneration in a rat model. Laryngoscope. 2007 Jan:157.
- Oppenheim RW, Qin-Wei Y, Prevette D, Yan Q. Brain-derived neurotrophic factor rescues developing avian motoneurons from cell death. Nature. 1992 Dec:755.
- Shirley DM, Williams SA, Santos PM. Brain‐derived neurotrophic factor and peripheral nerve regeneration: a functional evaluation. Laryngoscope. 1996 May:629.
- Elgazzar RF, Mutabagani MA, Abdelaal SE, Sadakah AA. Platelet rich plasma may enhance peripheral nerve regeneration after cyanoacrylate reanastomosis: a controlled blind study on rats Int J Oral Maxillofac Surg. 2008 Aug 1;37(8):748-55
- Sariguney Y, Yavuzer R, Elmas C, Yenicesu I, Bolay H, Atabay K. Effect of platelet-rich plasma on peripheral nerve regeneration. J Reconstr Microsurg. 2008 Apr:159.
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