As we all know, atrophic rhinitis is a thankfully rare but debilitating condition characterised by nasal obstruction, dryness, crusting and foul smell (ozaena). There are currently minimal treatment options available, none of which have proven particularly effective. The authors present a systematic review of plasma-rich protein (PRP) to treat this condition. After the screening process, five studies were evaluated, with a variety of protocols of injection dosage, duration and injection sites. All studies used SNOT 22 as a primary outcome measure. Other outcome measures included mucociliary clearance (saccharine transit time), nitric oxygen oxide synthase levels, NOSE scores and anosmia. The treatment protocols consisted of either single or multiple injections of PRP at various sites within the nasal cavity, at one time point or via several separate staged injections. The results are fairly compelling – across both objective and subjective markers, all studies reported a significant improvement, with lower SNOT 22 & NOSE scores, reduction in rates of anosmia and improved mucociliary clearance. However, these findings should be interpreted with caution, as the studies showed considerable variation in subject selection and treatment protocols. In addition, there was some uncertainty regarding the initial diagnosis of atrophic rhinitis, as no firm diagnostic criteria exist and the sample sizes were very small. Ultimately, I think this very much opens the door to new studies evaluating PRP to treat atrophic rhinitis with particular attention to selection criteria. It’s exciting to potentially have new treatment options available.
Can PRP injections treat atrophic rhinitis?
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