Efficacy of Platelet-Rich Plasma (PRP) on Post-Surgical Outcomes Following Endoscopic Frontal Sinusotomy: A Randomised Controlled Trial.

OBJECTIVE

This study aimed to evaluate the efficacy of platelet-rich plasma (PRP), a biologic agent that facilitates tissue regeneration and wound healing, in improving postoperative outcomes of frontal sinus ostium (FSO) and need for postoperative intervention.

MATERIALS AND

METHODS

A prospective, randomised controlled trial included chronic rhinosinusitis (CRS) patients undergoing bilateral endoscopic frontal sinus surgery. PRP-soaked absorbable hemostat was applied to the frontal sinus ostium on the randomised side, while a plain absorbable hemostat was used on the control side. Endoscopic evaluations were conducted intraoperatively (baseline), and at 30 and 90 days postoperatively to assess the FSO area, FSO patency, inflammatory visual analog scale (VAS) score, presence of polypoid edema, adhesion/scarring grade, and the need for postoperative interventions.

RESULTS

Thirty participants were enrolled and PRP was applied to 30 frontal sinus ostia on randomised side. On 30-day post-ESS PRP significantly improved inflammatory VAS score (p = 0.041), reduced polypoid edema (odds ratio (OR) 0.49; 95% CI: 0.24, 0.98) and adhesion scarring (OR 0.33; 95% CI: 0.15, 0.74), and improved the need of postoperative intervention compared to the control (risk ratio (RR) 0.25; 95% CI: 0.11, 0.58). On 90-day post-ESS, PRP significantly reduced polypoid edema (OR 0.35; 95% CI: 0.17, 0.67), and adhesion scarring (OR 0.20; 95% CI 0.07, 0.52) compared to the control. The FSO area changes and patency grade were not significantly different between groups.

CONCLUSION

The PRP application following frontal sinusotomy improved the inflammatory VAS score, polypoid edema and adhesion scarring grades, and reduces the need for oral steroid intervention.