Platelet-rich plasma following endoscopic sinus surgery in patients with chronic sinusitis: A systematic review and meta-analysis of randomised controlled trials

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY Clinical Otolaryngology Pub Date : 2024-05-30 DOI:10.1111/coa.14186

Ebraheem Albazee, Hemail M. Alsubaie, Roaa Alkanderi, Mubarak Althaidy, Husain Alsafar, Saad Alsaleh, Shawkat Abdulrahman

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Abstract

Introduction

To comprehensively evaluate the reported clinical effectiveness of platelet-rich plasma (PRP) in patients with chronic sinusitis undergoing endoscopic sinus surgery (ESS).

Methods

We performed a systematic review and meta-analysis of randomised controlled trials (RCTs). Five digital online databases (PubMed, Scopus, Web of Science, Google Scholar and Cochrane CENTRAL) were searched from inception up to 1st May 2023. Our specific outcomes involved postoperative nasal endoscopy scores measured via Lund-Kennedy score or Meltzer score, olfactory sensation scores and pre-operative anosmia duration. All data were pooled as standardised mean difference (SMD) with a 95% confidence interval (CI), using the RevMan software.

Results

Six RCTs were included in this systematic review and meta-analysis, with a total of 169 patients. The risk of bias in the included RCTs was low in three RCTs, some concerns in one RCT and high risk in two RCTs. The overall analysis of the postoperative nasal endoscopy scores showed that the PRP group had lower scores compared to the control group (n = 3 RCTs, SMD = −1.19; 95% CI [−1.94, −0.44], p = .002). There was no significant difference between the PRP and control groups regarding anosmia duration (n = 2 RCTs, SMD = 0.21; 95% CI [−0.17, 0.59], p = 0.28) or olfactory sensation scores, despite the PRP group having higher scores (n = 2 RCTs, SMD = 0.53; 95% CI [−0.32, 1.39], p = 0.22).

Conclusion

This study highlights the potential advantages of using PRP as an additional treatment for individuals with chronic sinusitis undergoing ESS. The improvements associated with PRP include facilitating wound healing, reducing inflammation and enhancing surgical outcomes. To optimise the use of PRP in clinical settings, future research should focus on conducting larger trials with standardised protocols.

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慢性鼻窦炎患者内窥镜鼻窦手术后的富血小板血浆：随机对照试验的系统回顾和荟萃分析。

引言全面评估富血小板血浆（PRP）对接受内窥镜鼻窦手术（ESS）的慢性鼻窦炎患者的临床疗效：我们对随机对照试验（RCT）进行了系统回顾和荟萃分析。我们检索了五个数字在线数据库（PubMed、Scopus、Web of Science、Google Scholar 和 Cochrane CENTRAL），检索时间从开始到 2023 年 5 月 1 日。我们的具体结果包括通过伦德-肯尼迪评分或梅尔策评分测量的术后鼻内窥镜检查评分、嗅觉评分和术前无嗅持续时间。所有数据均采用RevMan软件以标准化平均差（SMD）和95%置信区间（CI）的形式进行汇总：本系统综述和荟萃分析共纳入了六项研究，共涉及 169 名患者。三项研究的偏倚风险较低，一项研究的偏倚风险较高，两项研究的偏倚风险较高。对术后鼻内窥镜检查评分的总体分析表明，与对照组相比，PRP 组的评分较低（n = 3 项研究，SMD = -1.19; 95% CI [-1.94, -0.44]，p = .002）。PRP 组和对照组在嗅觉缺失持续时间（n = 2 项研究数据，SMD = 0.21；95% CI [-0.17，0.59]，p = 0.28）或嗅觉评分方面没有明显差异，尽管 PRP 组的评分更高（n = 2 项研究数据，SMD = 0.53；95% CI [-0.32，1.39]，p = 0.22）：本研究强调了使用 PRP 作为接受 ESS 治疗的慢性鼻窦炎患者的额外治疗方法的潜在优势。PRP 可促进伤口愈合、减轻炎症反应并提高手术效果。为优化 PRP 在临床环境中的应用，未来的研究应重点关注采用标准化方案进行更大规模的试验。

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来源期刊

Clinical Otolaryngology 医学-耳鼻喉科学

CiteScore

4.00

自引率

4.80%

发文量

106

审稿时长

>12 weeks

期刊介绍： Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with: current otorhinolaryngological practice audiology, otology, balance, rhinology, larynx, voice and paediatric ORL head and neck oncology head and neck plastic and reconstructive surgery continuing medical education and ORL training The emphasis is on high quality new work in the clinical field and on fresh, original research. Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject. • Negative/null results In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.