Platelet‑rich plasma nasal packing in endoscopic sinus surgery

Osama Hassana, Mohamed Ibrahimb, Ahmed ElFarouka, Aly El Garema

aDepartment of Otorhinolaryngology – Head and Neck Surgery, Kasr Alainy School of Medicine, Cairo University, bDepartment of Otorhinolaryngology, Cairo University Hospitals, Cairo, Egypt

Introduction: Synech ia and scarring are the most common complications encountered after endoscopic sinus surgery that may result in occlusion of sinus drainage pathway, leading to recurrent symptoms and subsequent surgical failure. Platelet‑rich plasma (PRP) has been used in many aspects of medicine to accelerate healing, avoid bleeding, and prevent synechia. 

Patients and methods: A total of 40 patients with bilateral sinusitis candidate for endoscopic sinus surgery were encountered in the study. The middle meatus and ethmoidal cavity at one side of the nose was irrigated using PRP, whereas the other side was irrigated with normal saline. Postoperative assessment was done by subjective (questionnaire) and objective (endoscope) methods.

Results: This study showed that PRP side was more comfortable, giving less pain, bleeding, nasal crustations, and synechiae compared with the other side of the nose irrigated with saline (control) and that was statically significant.

Conclusion: PRP is a safe and simple procedure that can improve mucosal healing and decrease postoperative synechiae, crust, and edema. It also provides better quality of life for patient by decreasing postoperative pain and bleeding.

Keywords: Crustations, functional endoscopic sinus surgery, platelet‑rich plasma, sinusitis, synechia.

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