Prof. Dr. Cemil Tascioglu City Hospital, Otorhinolaryngology Department, Turkey.
Bulanik State Hospital, Otorhinolaryngology Department, Turkey.
Am J Otolaryngol. 2021 Sep-Oct;42(5):103010. doi: 10.1016/j.amjoto.2021.103010. Epub 2021 Mar 29.
Chronic rhinosinusitis (CRS) is one of the most common chronic diseases seen worldwide. Endoscopic sinus surgery (ESS) has become a widely accepted procedure for medically refractory chronic rhinosinusitis and nasal polyps. Prevention of revision surgery often depends on good wound healing and less adhesion formation. In recent years, the effects of platelet-rich fibrin (PRF) on tissue healing have been addressed in many surgical branches, especially for dental implant surgery and plastic surgery.
This prospective study was conducted with 50 patients who underwent endoscopic sinus surgery for the diagnosis of nasal polyposis. While the middle meatus in one nasal cavity was filled with PRF and supported with Nasopore, only Nasopore was used in the other nasal cavity middle meatus. The patients were followed up clinically at weeks 1, 2, 3, 4, 8, and 12 postoperatively. The assessor determined the presence of adhesion, crusting, bleeding, frontal ostium stenosis, granulation, and infection, and if present, the grades of these complications were scored according to a questionnaire.
In our study, adhesion, infection, bleeding, granulation, and frontal ostium stenosis were less common in the PRF group, and a statistically significant difference was found between the groups.
In our study, better results were obtained in terms of adhesion, infection, bleeding, granulation, and frontal ostium stenosis after ESS as a result of the effects of PRF on wound healing. The application of PRF is an inexpensive and easy procedure. PRF can be a good alternative to other types of tampons after ESS.
慢性鼻-鼻窦炎(CRS)是全球最常见的慢性疾病之一。内镜鼻窦手术(ESS)已成为治疗药物难治性慢性鼻-鼻窦炎和鼻息肉的广泛接受的方法。预防再次手术通常取决于良好的伤口愈合和减少粘连形成。近年来,富血小板纤维蛋白(PRF)在许多外科领域,特别是在牙科种植手术和整形手术中,对组织愈合的影响已得到研究。
本前瞻性研究纳入了 50 名因鼻息肉而行内镜鼻窦手术的患者。一侧鼻腔的中鼻道填充 PRF 并用 Nasopore 支撑,另一侧鼻腔的中鼻道仅使用 Nasopore。患者在术后 1、2、3、4、8 和 12 周进行临床随访。评估者根据问卷确定粘连、结痂、出血、额窦口狭窄、肉芽组织和感染的存在情况,如果存在,对这些并发症的严重程度进行评分。
在我们的研究中,PRF 组的粘连、感染、出血、肉芽组织和额窦口狭窄较少见,两组之间存在统计学显著差异。
在我们的研究中,由于 PRF 对伤口愈合的影响,ESS 后粘连、感染、出血、肉芽组织和额窦口狭窄的结果更好。PRF 的应用是一种廉价且简单的方法。PRF 可以成为 ESS 后其他类型填塞物的良好替代品。