Navigating the efficacy, safety and outcome of intranasal platelet-rich plasma for persistent olfactory loss: a systematic review and meta-analysis
- Journal
- European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery (Q1)
- Published
- 27 July 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Anas Bassam Barnawi, Ibrahim Mahdi Aseeri, Abdulmajeed Ali Alotaibi, Khaled Abdullah S Alasmari, Feras Alkholaiwi
- PMID
- 42507202
- DOI
- 10.1007/s00405-026-10467-7
Why clinicians should know about it
- Picked for Otorhinolaryngology (top studies of the week, 2 August 2026): Intranasal PRP for olfactory loss, peripheral ENT but not core
Abstract
BACKGROUND: Persistent olfactory dysfunction (OD) poses a significant clinical challenge with limited therapeutic options. Intranasal platelet-rich plasma (PRP), an autologous source of regenerative growth factors, presents a biologically plausible intervention, yet its efficacy across various OD etiologies remains synthetically underexplored. METHODS: This systematic review and meta-analysis adhered to PRISMA guidelines. A comprehensive search of PubMed/MEDLINE, Web of Science, and Cochrane Library (2010-2025) identified studies assessing intranasal PRP for persistent OD (> 6 months). Random-effects models pooled standardized mean differences (SMD) for objective (e.g., Sniffin' Sticks TDI) and subjective outcomes. RESULTS: Seven studies (n = 473) were included. Meta-analysis of controlled studies (n = 314) demonstrated a moderate, significant improvement in objective olfactory scores favoring PRP over control (SMD 0.61, 95% CI 0.38-0.84). The pooled mean TDI change from baseline was 7.73 points (95% CI 6.59-8.87), exceeding the minimal clinically important difference of 5.5 points. Benefits were observed across post-COVID-19, post-viral, and post-traumatic etiologies. Adverse events were predominantly mild and transient (e.g., epistaxis). CONCLUSION: Intranasal PRP appears to be a generally well-tolerated and promising therapeutic strategy, yielding clinically meaningful improvements in persistent OD of diverse origins. However, the evidence remains preliminary and should be interpreted cautiously, as it is based on only two small RCTs plus non-randomized or single-arm studies. Future studies must optimize its protocol and evaluate its potential synergy with standard therapies like olfactory training.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.