Use of platelet rich plasma in persistent olfactory dysfunction after COVID-19: a prospective study
DOI:
https://doi.org/10.34631/sporl.2048Keywords:
COVID-19, olfactory dysfunction, anosmia, hyposmia, platelet rich plasma, single-site, injectionAbstract
Introduction: A promising technique to treat persistent olfactory impairment has recently been explored: platelet rich plasma (PRP) injection into the olfactory mucosa.
Objectives: This study aimed to determine efficacy, safety, and feasibility of a new PRP injection protocol in treating persistent COVID-19 induced olfactory dysfunction (pCIOD).
Material and Methods: Patients with pCIOD lasting for ≥ 12 months were enrolled. All patients had previously performed olfactory training and adjuvant therapy without achieving substantial improvement. Olfactory perception threshold (OPT) and visual analog scale (VAS) were measured at baseline, one month and three months after injection.
Results: Twenty patients were enrolled. There was a significant change in OPT after injection (mean baseline OPT: 4.36 ± 1.6 versus 1-month after injection: 6.9 ± 2.6, p = 0.012 versus 3-months after injection: 7.2 ± 2.8, p =0.009). No severe complications were reported.
Conclusions: Single-site PRP injection into the olfactory mucosa is a novel, safe and effective approach that may enhance olfactory recovery in pCIOD patients.
References
Sousa FA de, Machado AS, da Costa JC, Silva AC, Pinto AN, Coutinho MB. et al. Tailored approach for persistent olfactory dysfunction after SARS-CoV-2 infection: a pilot study. Ann Otol Rhinol Laryngol. 2022 Jul 12;34894221111093. doi: 10.1177/00034894221111093.
Brann DH, Tsukahara T, Weinreb C, Lipovsek M, Van den Berge K, Gong B. et al. Non-neuronal expression of SARS-CoV-2 entry genes in the olfactory system suggests mechanisms underlying COVID-19-associated anosmia. Sci Adv. 2020 Jul 31;6(31):eabc5801. doi: 10.1126/sciadv.abc5801
Bénézit F, Le Turnier P, Declerck C, Paillé C, Revest M, Dubée V. et al. Utility of hyposmia and hypogeusia for the diagnosis of COVID-19. Lancet Infect Dis. 2020 Sep;20(9):1014-1015. doi: 10.1016/S1473-3099(20)30297-8.
Butowt R, von Bartheld CS. Anosmia in COVID-19: underlying mechanisms and assessment of an olfactory route to brain infection. Neuroscientist. 2021 Dec;27(6):582-603. doi: 10.1177/1073858420956905.
Lechien JR, Chiesa-Estomba CM, Beckers E, Mustin V, Ducarme M, Journe F. et al. Prevalence and 6-month recovery of olfactory dysfunction: a multicentre study of 1363 COVID-19 patients. J Intern Med. 2021 Aug;290(2):451-461. doi: 10.1111/joim.13209.
Printza A, Katotomichelakis M, Metallidis S, Panagopoulos P, Sarafidou A, Petrakis V. et al. The clinical course of smell and taste loss in COVID-19 hospitalized patients. Hippokratia. 2020 Apr-Jun;24(2):66-71.
Tan BKJ, Han R, Zhao JJ, Tan NKW, Quah ESH, Tan CJ. et al. Prognosis and persistence of smell and taste dysfunction in patients with covid-19: meta-analysis with parametric cure modelling of recovery curves. BMJ. 2022 Jul 27;378:e069503. doi: 10.1136/bmj-2021-069503.BMJ.
Patel ZM, Holbrook EH, Turner JH, Adappa ND, Albers MW, Altundag A. et al. International consensus statement on allergy and rhinology: olfaction. Int Forum Allergy Rhinol. 2022 Apr;12(4):327-680. doi: 10.1002/alr.22929.
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;5(2):187-193. doi: 10.1002/lio2.357.
Yan CH, Jang SS, Lin HC, Ma Y, Khanwalkar AR, Thai A. et al. Use of platelet-rich plasma for COVID-19–related olfactory loss: a randomized controlled trial. Int Forum Allergy Rhinol. 2022 Dec 12;10.1002/alr.23116. doi: 10.1002/alr.23116.
Everts P, Onishi K, Jayaram P, Lana JF, Mautner K. Platelet-rich plasma: new performance understandings and therapeutic considerations in 2020. Int J Mol Sci. 2020 Oct 21;21(20):7794. doi: 10.3390/ijms21207794.
Chamata ES, Bartlett EL, Weir D, Rohrich RJ. Platelet-rich plasma: evolving role in plastic surgery. Plast Reconstr Surg. 2021 Jan 1;147(1):219-230. doi: 10.1097/PRS.0000000000007509.
Alves de Sousa F, Tarrio J, Sousa MacHado A, Costa JR, Pinto C, Nóbrega Pinto A. et al. Olfactory cleft length: a possible risk factor for persistent post-COVID-19 olfactory dysfunction. ORL J Otorhinolaryngol Relat Spec. 2022 Nov 1;1-9. doi: 10.1159/000527141.
Abo El Naga HA, El Zaiat RS, Hamdan AM. The potential therapeutic effect of platelet-rich plasma in the treatment of post-COVID-19 parosmia. Egypt J Otolaryngol [Internet]. 2022; 38:130. Available from: https://doi.org/10.1186/s43163-022-00320-z
Lechien JR, Le Bon SD, Saussez S. Platelet-rich plasma injection in the olfactory clefts of COVID-19 patients with long-term olfactory dysfunction. Eur Arch Otorhinolaryngol. 2022 Dec 15;1-8. doi: 10.1007/s00405-022-07788-8.
Duffy A, D’Souza Glen E, Chaskes, Mark B, Klug Theodore D, MPH G. et al. Topical platelet-rich plasma: a novel delivery method for an emerging treatment of olfactory ddysfunction. Otolaryngol Head Neck Surg. [Internet]. 2022 Sep; 167(1_suppl):140–52. Available from: https://doi.org/10.1177/01945998221107672
Escada P. Localization and distribution of human olfactory mucosa in the nasal cavities. Acta Med Port. 2013 May-Jun;26(3):200-7.
Lee DY, Lee WH, Wee JH, Kim JW. Prognosis of postviral olfactory loss: follow-up study for longer than one year. Am J Rhinol Allergy 2014 Sep-Oct;28(5):419-22. doi: 10.2500/ajra.2014.28.4102.
Stavrakas M, Karkos PD, Markou K, Grigoriadis N. Platelet-rich plasma in otolaryngology. J Laryngol Otol. 2016 Dec;130(12):1098-1102. doi: 10.1017/S0022215116009403.
Rice DH. Platelet-rich plasma in endoscopic sinus surgery. Ear Nose Throat J. 2006 Aug;85(8):516, 518.
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;28(3):e299-e302. doi: 10.1097/SCS.0000000000003664.
Al Gerrah DA. Use of PRP in Rhinoplasty. Otolaryngology Open Access. 2016; 06(06):6-7. doi: 10.4172/2161-119X.1000280
El-Anwar MW, El-Ahl MAS, Zidan AA, Yacoup MARAS. Topical use of autologous platelet rich plasma in myringoplasty. Auris Nasus Larynx. 2015 Oct;42(5):365-8. doi: 10.1016/j.anl.2015.02.016
El-Anwar MW, Nofal AAF, Khalifa M, Quriba AS. Use of autologous platelet-rich plasma in complete cleft palate repair. Laryngoscope. 2016 Jul;126(7):1524-8. doi: 10.1002/lary.25868.
Whitcroft KL, Ezzat M, Cuevas M, Andrews P, Hummel T. The effect of intranasal sodium citrate on olfaction in post-infectious loss: results from a prospective, placebo-controlled trial in 49 patients. Clin Otolaryngol. 2017 Jun;42(3):557-563. doi: 10.1111/coa.12789.
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