Effect of Platelet-Rich Plasma Injection in Patients With Atrophic Rhinitis: A Systematic Review

Background Atrophic rhinitis (AR) is a chronic condition characterized by mucosal atrophy, crusting, and impaired mucociliary clearance. Current treatments are palliative and do not focus on tissue regeneration. Although platelet-rich plasma (PRP) has gained attention for its regenerative properties, evidence supporting its effectiveness in AR remains limited. Objective To systematically evaluate the effectiveness and safety of PRP in the treatment of AR, focusing on nasal symptom relief, mucociliary clearance, and tissue repair biomarkers. Methods A systematic literature search was conducted in PubMed and the Cochrane Library from database inception to September 2024 for randomized clinical trials, prospective trials, and case series evaluating PRP for AR. Study quality was assessed using the Cochrane Risk of Bias tool and Newcastle-Ottawa Scale. Results PRP treatment resulted in significant improvements in nasal symptoms, with sino-nasal outcome test scores decreasing from 22.4 to 12.7. Four studies demonstrate enhanced mucociliary clearance, including a reduction in saccharin transit time from 420 s to 220 s in 1 study. Biochemical analyses revealed elevated levels of nitric oxide synthase and arginase, suggesting tissue regeneration. Improvements in anosmia and nasal obstruction symptom scores were also reported. No severe adverse effects were observed. Conclusion While PRP shows promise for AR, current evidence is compromised by diagnostic uncertainty, methodological inconsistencies, and potential commercial bias. Significant demographic variations suggest different patient populations were evaluated. Rigorous, independently funded trials with standardized protocols are essential before clinical recommendations.