Embedded Files
HYPE OR HOPE ??
๐๐ข๐ฌ๐๐จ๐ฏ๐๐ซ ๐ก๐จ๐ฐ ๐๐ฅ๐๐ญ๐๐ฅ๐๐ญ ๐๐ข๐๐ก ๐๐ฅ๐๐ฌ๐ฆ๐ ๐ซ๐๐ฏ๐จ๐ฅ๐ฎ๐ญ๐ข๐จ๐ง๐ข๐ณ๐๐ฌ ๐๐๐ ๐ญ๐ซ๐๐๐ญ๐ฆ๐๐ง๐ญ๐ฌ, ๐๐ซ๐จ๐ฆ ๐ญ๐ฒ๐ฆ๐ฉ๐๐ง๐จ๐ฉ๐ฅ๐๐ฌ๐ญ๐ฒ ๐ญ๐จ ๐ฌ๐ฎ๐๐๐๐ง ๐ฌ๐๐ง๐ฌ๐จ๐ซ๐ข๐ง๐๐ฎ๐ซ๐๐ฅ ๐ก๐๐๐ซ๐ข๐ง๐ ๐ฅ๐จ๐ฌ๐ฌ. ๐๐ฑ๐ฉ๐ฅ๐จ๐ซ๐ ๐ ๐ง๐๐ฐ ๐๐ซ๐ ๐จ๐ ๐ก๐๐๐ฅ๐ข๐ง๐ ๐ฐ๐ข๐ญ๐ก ๐ฒ๐จ๐ฎ๐ซ ๐๐จ๐๐ฒโ๐ฌ ๐จ๐ฐ๐ง ๐ฉ๐จ๐ฐ๐๐ซ. ๐ ๐ข๐ง๐ ๐จ๐ฎ๐ญ ๐ก๐จ๐ฐ ๐ซ๐๐ ๐๐ง๐๐ซ๐๐ญ๐ข๐ฏ๐ ๐ญ๐ก๐๐ซ๐๐ฉ๐ฒ ๐ข๐ฌ ๐ซ๐๐๐๐๐ข๐ง๐ข๐ง๐ ๐๐๐ ๐ฌ๐จ๐ฅ๐ฎ๐ญ๐ข๐จ๐ง๐ฌ ๐ญ๐จ๐๐๐ฒ.
In the evolving landscape of otolaryngology, regenerative medicine is rapidly gaining momentum as a transformative approach to patient care. One of the most promising frontiers in this domain is the use of Platelet Rich Plasma (PRP) therapy. As an ENT consultant deeply passionate about cutting-edge treatments, I am excited to share insights into how PRP is revolutionizing ENT careโfrom accelerating wound healing to enhancing surgical outcomes and even addressing complex conditions like SSNHL (Sudden sensorineural hearing loss) and atrophic rhinitis.
This article delves into the science behind PRP, its preparation, and its expanding applications within ENT, providing a comprehensive overview for clinicians, students, and curious readers alike.
๐๐๐๐ ๐๐ ๐๐๐???
Platelet rich plasma (PRP) is an autologous substance that has found its applications in different aspects of surgery.
PRP's healing power stems from its high concentration of platelets. These cellular components play a vital role in blood clotting and carry a potent mix of growth factors that stimulate tissue repair and regeneration. Key growth factors in PRP include:
Insulin-like Growth Factor (IGF): Boosts tissue growth and repair
Transforming Growth Factor (TGF): Regulates inflammation and promotes healing
Platelet-Derived Growth Factor (PDGF): Essential for blood vessel formation and tissue remodeling
Epithelial Growth Factor (EGF): Supports epithelial regeneration
Fibroblast Growth Factor (FGF): Vital for connective tissue repair
Vascular Endothelial Growth Factor (VEGF): Enhances new blood vessel formation
๐๐ก๐ ๐๐ซ๐๐ฉ๐๐ซ๐๐ญ๐ข๐จ๐ง ๐๐ซ๐จ๐๐๐ฌ๐ฌ: ๐๐ง๐ฅ๐จ๐๐ค๐ข๐ง๐ ๐๐๐'๐ฌ ๐๐จ๐ญ๐๐ง๐ญ๐ข๐๐ฅ
The journey from a patient's blood to a concentrated, bioactive PRP solution is a carefully orchestrated process. Here's a quick overview of the key steps involved:
Venous blood is drawn from the patient's antecubital vein and collected in an acid citrate dextrose tube or a glass container.
The collected blood is then subjected to a soft spin in a centrifuge, separating the plasma (the supernatant) from the cellular components.
The plasma is then transferred to another tube, without any anticoagulant, and undergoes a hard spin in the centrifuge, concentrating the platelets at the bottom of the tube.
The platelet-poor plasma in the upper two-thirds of the tube is discarded, and the platelet-rich plasma (PRP) is carefully extracted from the bottom one-third.
The PRP is then mixed with a small amount of the patient's own plasma, creating a bioactive concentrate ready for application at the target site, whether it's the nasal mucosa, tympanic membrane, or a post-operative surgical bed.
This meticulous process ensures the purity and potency of the PRP, maximizing its regenerative potential and making it a valuable asset in the clinician's arsenal.
๐๐๐๐๐ฅ๐๐ซ๐๐ญ๐ข๐ง๐ ๐๐จ๐ฎ๐ง๐ ๐๐๐๐ฅ๐ข๐ง๐ ๐ข๐ง ๐๐๐ ๐๐ฎ๐ซ๐ ๐๐ซ๐ข๐๐ฌ ๐ฐ๐ข๐ญ๐ก ๐๐๐
One of PRP's most significant applications in ENT is its role in post-surgical wound healing. Clinical studies have shown that PRP application can lead to:
Quicker reduction in wound size
Enhanced tissue granulation
Faster epithelialization
Improved angiogenesis
Comparative studies have demonstrated the advantages of PRP in post-operative wound care. In one study, the PRP group showed a noticeable advantage in terms of smaller wound diameter as early as day 4, and by day 8, the difference became even more prominent. By day 10, both groups reached similar scar sizes, but the PRP group achieved this milestone much faster, minimizing discomfort and infection risk.
SOURCE: Saha, Sutirtha & Sikder, Biswajit & Prusti, Trailokeswar & Chowdhury, Kanishka & Banerjee, Pranabashish. (2023). APPLICATIONS OF PLATELET RICH PLASMA IN CHRONIC ULCERS OF HEAD AND NECK- A PROSPECTIVE STUDY. INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH. 15-17. https://doi.org/10.36106/ijsr/3606905.
Histopathological comparisons between PRP-treated and untreated wounds reveal marked differences. PRP-treated wounds exhibit:
Well-formed epithelium
Active collagen deposition
Dense vascular network
These findings highlight PRP's ability to promote not just surface healing, but comprehensive tissue rebuilding from the inside out. This makes PRP a valuable tool in ENT procedures where wound healing can significantly impact voice, breathing, and appearance.
This innovative use of PRP enhances both structural success and functional recovery, making it a valuable tool in modern tympanoplasty procedures. By harnessing the power of the patient's own biological resources, clinicians can now offer their patients a better chance at successful middle ear reconstruction and improved hearing outcomes.
The results have been nothing short of remarkable. A study by Taneja in 2020 showed that the use of PRP significantly increased the graft uptake rate to 95%, compared to 85% in the control group. Even more impressively, hearing improvement was observed in 78% of PRP patients, far superior to the 46% seen without PRP.
SOURCE: Taneja, M.K. Role of Platelet Rich Plasma in Tympanoplasty. Indian J Otolaryngol Head Neck Surg 72, 247โ250 (2020). https://doi.org/10.1007/s12070-020-01815-y .
๐๐๐: ๐ ๐๐ซ๐จ๐ฆ๐ข๐ฌ๐ข๐ง๐ ๐๐ซ๐๐๐ญ๐ฆ๐๐ง๐ญ ๐๐จ๐ซ ๐๐ฎ๐๐๐๐ง ๐๐๐ง๐ฌ๐จ๐ซ๐ข๐ง๐๐ฎ๐ซ๐๐ฅ ๐๐๐๐ซ๐ข๐ง๐ ๐๐จ๐ฌ๐ฌ
Theoretically, PRP's growth factors might promote repair in the inner ear, potentially reducing inflammation, protecting remaining cells, or enhancing blood supply, though they may not regenerate hair cells.
PRP is administered intratympanically, allowing it to diffuse across the round window membrane and reach the inner ear. This approach offers a potentially safer and more effective treatment option, especially in cases where steroids may be contraindicated or ineffective.
Recent meta-analyses comparing PRP to traditional steroid treatments have shown consistently better hearing outcomes with PRP:
Kanaujia et al. (2023): 25 dB improvement with PRP vs. 18 dB with steroids
Shawky (2024): 30 dB improvement with PRP vs. 22 dB with steroids
Tom et al. (2022): 28 dB improvement with PRP vs. 20 dB with steroids
SOURCE:
Shawky, M. (2024). Management of Idiopathic Sudden Sensorineural Hearing Loss (ISSNHL) Intratympanic Platelet-Rich Plasma (PRP) Versus Intratympanic Steroid Injections: A Cross-Sectional Study. Otolaryngol Pol, 78(3), 32-37. https://doi.org/10.5604/01.3001.0054.4671.
Ruchika, Gautam HK, Kanaujia SK, et al. Role of Platelet-rich Plasma in Sensory Neural Hearing Loss. Int J Otorhinolaryngol Clin 2023;15(1):38โ41. https://doi.org/10.5005/jp-journals-10003-1438.
Tom, S. M., Sachdeva, K., Kabade, M. V., Shukla, A., & Raj, L. V. (2022). Clinicoaudiological evaluation of hearing improvement in patients with sensorineural hearing loss using intratympanic platelet rich plasma versus steroid injection. International Journal of Otorhinolaryngology and Head and Neck Surgery, 8(4), 327โ332. https://doi.org/10.18203/issn.2454-5929.ijohns20220799.
๐๐ฆ๐ฉ๐ซ๐จ๐ฏ๐ข๐ง๐ ๐๐จ๐ง๐ฌ๐ข๐ฅ๐ฅ๐๐๐ญ๐จ๐ฆ๐ฒ ๐๐๐๐จ๐ฏ๐๐ซ๐ฒ ๐ฐ๐ข๐ญ๐ก ๐๐๐
๐๐ฆ๐ฉ๐ซ๐จ๐ฏ๐ข๐ง๐ ๐๐จ๐ง๐ฌ๐ข๐ฅ๐ฅ๐๐๐ญ๐จ๐ฆ๐ฒ ๐๐๐๐จ๐ฏ๐๐ซ๐ฒ ๐ฐ๐ข๐ญ๐ก ๐๐๐
Tonsillectomy is a routine yet often painful procedure with potential complications like post-operative bleeding and significant discomfort.ย
PRP application on the tonsillar bed after removal creates a biologically active scaffold that promotes faster mucosal healing.
Additionally, PRP-treated patients show a reduced risk of post-operative bleeding. In observed cases, no bleeding events occurred in the PRP group, whereas untreated patients experienced some bleeding complications.
Clinical evidence shows that patients treated with PRP experience considerably less post-operative pain, with visual analog scale (VAS) scores averaging below 3 compared to scores above 6 in untreated groups. This pain reduction translates into lower analgesic requirements, improving patient comfort and recovery experience.
This regenerative approach offers a minimally invasive option for patients with this difficult-to-treat condition.
๐๐ก๐ ๐๐ฏ๐จ๐ฅ๐ฏ๐ข๐ง๐ ๐๐๐ง๐๐ฌ๐๐๐ฉ๐ ๐จ๐ ๐๐๐ ๐ข๐ง ๐๐๐
As research progresses, the applications of PRP in ENT are likely to expand.
Its versatility, safety profile, and regenerative potential make it a promising tool for addressing a wide range of otolaryngological conditions.
Ongoing studies are exploring new applications and refining existing protocols to maximize PRP's benefits.
The integration of PRP into ENT practice represents a shift towards more personalized, regenerative approaches to treatment.
As our understanding of PRP's mechanisms deepens, we can expect to see even more innovative applications in the future, potentially reshaping the landscape of ENT care.
FAQ (Frequently Asked Questions)
Q. What is the success rate of PRP treatments in ENT?
Success rates vary depending on the specific application, but studies have shown promising results. For example, in tympanoplasty, PRP has been associated with graft uptake rates of up to 95%, compared to 85% without PRP. In sudden sensorineural hearing loss, PRP treatments have shown hearing improvements of 25-30 dB, outperforming traditional steroid treatments.
Q. Are there any side effects associated with PRP treatments in ENT?
PRP is generally considered safe as it uses the patient's own blood. However, as with any medical procedure, there can be minor risks such as temporary pain at the injection site, minor bleeding, or infection. Serious side effects are rare, but patients should always discuss potential risks with their ENT specialist.
Q. How long does it take to see results from PRP treatment in ENT conditions?
The timeline for results can vary depending on the specific condition and treatment area. In wound healing applications, improvements can be seen within days. For conditions like sudden hearing loss or atrophic rhinitis, patients may notice improvements over several weeks to months. Your ENT specialist can provide a more specific timeline based on your individual case.
Q. Is PRP treatment covered by insurance for ENT procedures?
Insurance coverage for PRP treatments in ENT can vary widely depending on the specific procedure, insurance provider, and policy. Some applications, particularly those considered experimental or investigational, may not be covered. It's best to check with your insurance provider and discuss options with your ENT specialist.
Q. Can PRP be combined with other treatments in ENT?
Yes, PRP is often used in combination with other treatments to enhance outcomes. For example, in tympanoplasty, PRP is used alongside traditional surgical techniques. In atrophic rhinitis, it may be combined with saline rinses or other topical treatments. The specific combination of treatments will depend on your condition and should be determined by your ENT specialist.
Page updated
Google Sites
Report abuse