Jing Su, Yinhong Bai, Guangli Wu, Dan Li, Hao Li, Ruiyun Lu, Ma Qian
Background Poor mucosal wound healing and recurrence of polyps remain significant challenges following functional endoscopic sinus surgery (FESS) for chronic rhinosinusitis with nasal polyps (CRSwNP). While platelet-rich plasma (PRP) shows regenerative potential in various fields, its rhinologic application remains understudied. Objective To evaluate the efficacy of local PRP application on postoperative time to epithelialization, endoscopic appearance, long-term recurrence, and quality of life in patients undergoing FESS for CRSwNP. Methods A retrospective cohort study was conducted on 120 CRSwNP patients undergoing FESS (2022-2025). The PRP group ( n = 60) received intraoperative and postoperative local PRP application to the ethmoid cavity and middle meatus. The control group ( n = 60) received standard care. The primary outcome was time to complete epithelialization. Secondary outcomes, assessed at scheduled intervals up to 48 weeks, included Lund–Kennedy Endoscopic Scores (LKES), SNOT-22, debridement frequency, 1-year polyp recurrence, and complications. Results Baseline demographics were comparable. The PRP group demonstrated a significantly shorter mean time to epithelialization compared to controls (3.4 ± 0.8 vs 5.1 ± 1.2 weeks, P < .001). Longitudinal analysis revealed better LKES in the PRP group at 8 ( P = .012) and 12 weeks ( P = .004). SNOT-22 score improvements were more pronounced in the PRP group at 3 months ( P = .021). Crucially, the PRP group required significantly fewer postoperative debridements (1.5 ± 0.6 vs 2.8 ± 0.9, P < .001). The 1-year polyp recurrence rate (8.3% vs 23.3%, P = .024) and synechiae incidence (5.0% vs 16.7%, P = .041) were significantly lower in the PRP group. Conclusion Local application of autologous PRP accelerates mucosal epithelialization, reduces the need for postoperative debridement, decreases 1-year polyp recurrence, and improves early-to-intermediate endoscopic outcomes in CRSwNP patients. It represents an effective adjunctive therapy for enhancing functional recovery.