Effect of platelet-rich plasma on surgical outcomes in chronic rhinosinusitis with nasal polyps: a systematic review and meta-analysis.

PURPOSE OF REVIEW: This review evaluates the current evidence on the effectiveness of platelet-rich plasma (PRP) as an adjuvant therapy to endoscopic sinus surgery (ESS) in adults with chronic rhinosinusitis with nasal polyps (CRSwNP).

RECENT FINDINGS: Nine randomized controlled trials involving 488 participants were included. PRP significantly improved mucosal healing based on postoperative endoscopic scores, particularly when delivered via injection into the middle meatus or olfactory region. Borderline improvements in olfactory function were observed, with significant benefits when PRP was applied directly to the olfactory region. PRP consistently reduced postoperative pain, scarring or synechiae, bleeding, crusting and oedema. No significant improvement was found in health-related quality of life (SNOT-22). Heterogeneity across studies was substantial, largely due to variations in PRP preparation, delivery methods and outcome assessment.

SUMMARY: PRP appears to be a promising adjunct to ESS, offering improvements in mucosal healing and postoperative recovery, with potential but uncertain benefits for olfactory outcomes. Standardized, larger-scale trials are needed to further define optimal administration and long-term efficacy.