Kılıç Caner, Ak Semih, Yazıcı Ömer, Özlügedik Samet, Bozdoğan Nazan, Baltu Yahya, Tunçcan Tuncay, Ant Ayça
1 Department of Otorhinolaryngology, University of Health Sciences Ankara Dr Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey.
2 Department of Otorhinolaryngology, Sanlıurfa Government Hospital, Sanlıurfa, Turkey.
Ann Otol Rhinol Laryngol. 2019 Jun;128(6):541-547. doi: 10.1177/0003489419830121. Epub 2019 Feb 15.
Platelet-rich plasma (PRP) was administered into the temporomandibular joint (TMJ) space, which had been exposed to radiotherapy (RT), in an attempt to prevent and/or treat the late-term complications associated with RT when used for the treatment of head and neck cancers (nasopharyngeal cancer in particular) on the musculoskeletal system.
A total of 13 adult male New Zealand ( Oryctolagus cuniculus) rabbits were used in the study. The animals were classified into 3 groups: 6 in the RT group, 6 in the RT+PRP group, and 1 in the control group (exposed to neither). The TMJ space of each rabbit was exposed to 2240 cGy external RT in total, and PRP was administered into the TMJ space 1 month later. The joints were surgically removed 1 month later and examined histopathologically.
In the group given RT+PRP, the level of inflammation, amount of muscle fibrosis, vascular wall fibrosis, synovial membrane and condyle cartilage thickness, temporal extrabone fibrous cell layer count, and intramuscular changes were similar to those recorded in the control group, although the positive effects of PRP were not found to be statistically significant.
The findings of the present study demonstrate that injections of PRP may increase joint inflammation and therefore enhance blood supply, resulting in the onset of regeneration. These favorable effects of PRP may be helpful in the fight against late-term musculoskeletal complications of RT and may minimize such side effects as sore jaw, malnutrition, and weight loss.
将富含血小板血浆（PRP）注入接受过放射治疗（RT）的颞下颌关节（TMJ）间隙，旨在预防和/或治疗头颈部癌症（尤其是鼻咽癌）放射治疗时对肌肉骨骼系统产生的晚期并发症。
本研究共使用13只成年雄性新西兰（穴兔属）兔。动物被分为3组：放疗组6只，放疗+PRP组6只，对照组1只（未接受任何处理）。每只兔的颞下颌关节间隙共接受2240 cGy的外照射放疗，1个月后将PRP注入颞下颌关节间隙。1个月后通过手术取出关节并进行组织病理学检查。
在放疗+PRP组中，炎症水平、肌肉纤维化程度、血管壁纤维化、滑膜和髁突软骨厚度、颞骨外纤维细胞层数以及肌肉内变化与对照组记录的情况相似，尽管PRP的积极作用未发现具有统计学意义。
本研究结果表明，注射PRP可能会增加关节炎症，从而增强血液供应，导致再生的发生。PRP的这些有利作用可能有助于对抗放疗引起的晚期肌肉骨骼并发症，并可能将诸如颌部疼痛、营养不良和体重减轻等副作用降至最低。
