A recent clinical study evaluated the effectiveness of topical, autologous platelet-rich plasma (PRP) application in reducing post-tonsillectomy pain and morbidity in adult patients.
All patients were assessed for two weeks following the procedure. Those treated with PRP showed significant improvements in the following outcomes:
This article provides an overview of the challenges tonsillectomy presents for the physician and patient, as well as a review of the clinical study showing PRP's effectiveness as a post-tonsillectomy treatment.
Tonsillectomy is one of the most common ENT surgical procedures performed worldwide to treat recurrent tonsillitis, obstructive sleep apnea, and snoring. Despite the development of numerous techniques to enhance recovery and reduce symptoms post-procedure, physicians haven't reached consensus on one best technique.
Unlike most surgical procedures, which are primarily closed, tonsillectomy produces an open wound that heals over time. The procedure is often complicated by moderate-to-severe pain and hemorrhage that continues until the pharyngeal muscles are covered with mucosa 14 to 21 days later.1
Patients, especially children, may be reluctant to eat and drink early in their recovery, further stalling the healing process. For adult patients, the complications can delay their return to normal activities and lead to extended follow-up periods.
Because of these issues, discovering methods to reduce pain and improve healing for post-tonsillectomy patients is an urgent concern for otolaryngologists.
Several studies have shown that combining PRP therapy with tonsillectomy is better than tonsillectomy alone in improving post-operative outcomes in pediatric and adult patients.2,3
PRP contains numerous proteins that play a critical role in wound healing, including:
The present study evaluated 56 adult patients with signs and symptoms of chronic tonsillitis. Patients were excluded from the study if they had a history of the following:
Patients undergoing a tonsillectomy for reasons other than tonsillitis were also excluded.
The patients were randomized into two groups — 28 into the PRP intervention group (“PRP group”) and 28 into the control group. For each patient in the PRP group, the investigator applied 1 mL of autologous PRP topically on the tonsillar fossae for 5 minutes following the surgery. Patients in the control group did not receive any PRP application.
All patients were assessed for pain levels using the visual analogue scale (VAS) at six time points (day 0, 1, 2, 3, 7, and 14). Tonsillar fossae healing was also assessed one week following the tonsillectomy and graded as follows based on the surface of the raw area:
The investigator also documented the time taken for each patient to return to their normal activities as a secondary outcome.
The results of the study showed that patients in the PRP group had a significant decrease in the tonsillar fossae on days 2 and 3 post-procedure. PRP application also resulted in a significant reduction in pain levels from day 0 to day 7. All patients were categorized as grade 1 healing on day 14, and most patients in both groups returned to their normal routines after 1 week.
The findings from this study support the use of PRP to boost the recovery rate of post-tonsillectomy patients. Because autologous PRP was used, it also emphasizes topical PRP application as a safe, cost-effective technique.
This study indicates that PRP application is a safe, effective, and minimally-invasive treatment to improve post-operative outcomes for tonsillectomy patients.
Patients and physicians need a safe, effective solution that can reduce pain and speed up the recovery process after a tonsillectomy.
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