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

    1. 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.
    1. Addison AB, Philpott CM. A systematic review of therapeutic options for non-conductive olfactory dysfunction. Otorhinolaryngologist. 2018 Jan 1:61.
    1. 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.
    1. 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
    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.
    1. Kern RC, Quinn B, Rosseau G, Farbman AI. Post‐traumatic olfactory dysfunction. Laryngoscope. 2000 Dec:2106.
    1. 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.
    1. Rombaux P, Duprez T, Hummel T. Olfactory bulb volume in the clinical assessment of olfactory dysfunction. Rhinology. 2009 Mar 1:3.
    1. 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.
    1. Doty RL, Mishra A. Olfaction and its alteration by nasal obstruction, rhinitis, and rhinosinusitis. Laryngoscope. 2001 Mar:409.
    1. Li X, Lui F. Anosmia. In Stat Pearls. 2019 Feb 16
    1. 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.
    1. Fujii M, Fukazawa K, Takayasu S, Sakagami M. Olfactory dysfunction in patients with head trauma. Auris Nasus Larynx. 2002 Jan 1:35.
    1. Heilmann S, Huettenbrink KB, Hummel T. Local and systemic administration of corticosteroids in the treatment of olfactory loss. Am J Rhinol. 2004 Jan:29.
    1. 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.
    1. Roemer A, Warnecke A, Lenarz T, Stolle SR. Successful Treatment of Intractable Facial Osteomyelitis with Autolo-gous PRP and Gentamicin. Otorhinolaryngol Clin. 2017
    1. 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.
    1. Mavrogeni P, Kanakopoulos A, Maihoub S, Maihoub S, Krasznai M, Szirmai A. Anosmia treatment by platelet rich plasma injection. Int. Tinnitus
    1. 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.
    1. 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.
    1. 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.
    1. 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.
    1. 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
    1. Nordin S, Brämerson A. Complaints of olfactory disorders: epidemiology, assessment and clinical implications. Curr Opin Allergy Clin Immunol. 2008 Feb 1:10.
    1. 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.
    1. 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.
    1. Leung CT, Coulombe PA, Reed RR. Contribution of olfactory neural stem cells to tissue maintenance and regeneration. Nat Neurosci. 2007 Jun:720.
    1. 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.
    1. Duggan CD, Ngai J. Scent of a stem cell. Nat Neurosci. 2007 Jun:673.
    1. 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.
    1. 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.
    1. 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.
    1. 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.
    1. Oppenheim RW, Qin-Wei Y, Prevette D, Yan Q. Brain-derived neurotrophic factor rescues developing avian motoneurons from cell death. Nature. 1992 Dec:755.
    1. Shirley DM, Williams SA, Santos PM. Brain‐derived neurotrophic factor and peripheral nerve regeneration: a functional evaluation. Laryngoscope. 1996 May:629.
    1. 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
    1. 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.

Source: PubMed

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