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European Archives of Oto-Rhino-Laryngology

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01-02-2021 | Neck Dissection | Laryngology

Platelet-rich fibrin: an autologous biomaterial for healing assistance of pharyngeal repair in total laryngectomy

Authors: Ahmed Mostafa Eid, Hisham Atef Ebada, Ahmed Musaad Abd El-Fattah, Ali Tawfik

Published in: European Archives of Oto-Rhino-Laryngology | Issue 2/2021

Abstract

Objectives

The aim of this study was to evaluate the potential role of platelet-rich fibrin (PRF) application on the pharyngeal repair on decreasing the incidence of pharyngocutaneous fistula (PCF) after total laryngectomy.

Methods

This randomized controlled clinical trial was conducted on 67 patients with advanced laryngeal carcinoma who underwent total laryngectomy, over 2 years in the Otorhinolaryngology Department, Mansoura University Hospitals, Egypt. Patients were randomly assigned into two groups: PRF group (n = 35) and control group (n = 32). Risk factors for development of PCF as well as the incidence of PCF were studied in both groups.

Results

There was no statistically significant difference between groups regarding demographic data, medical comorbidities, basal hemoglobin and albumin levels, data related to the tumor (location, grade and TNM staging) and surgical details (preoperative tracheotomy and neck dissection). However, regarding the incidence of PCF, there was a statistically significant difference between groups as shown in Table 2. PCF was detected in 2/35 patients (5.7%) in the PRF group and in 10/32 patients (31.3%) in the control group (p = 0.004).

Conclusion

PRF application on the pharyngeal repair after total laryngectomy enhances the healing process and consequently decreases the incidence of PCF.

Mattioli F, Bettini M, Molteni G, Piccinini A, Valoriani F, Gabriele S, Presutti L (2015) Analysis of risk factors for pharyngocutaneous fistula after total laryngectomy with particular focus on nutritional status. Acta Otorhinolaryngol Ital 35(4):243–248PubMedPubMedCentral

Eryılmaz A, Demirci B, Gunel C, Doger FK, Yukselen O, Omurlu IK, Basal Y, Agdas F, Basak S (2016) Can tissue adhesives and platelet-rich plasma prevent pharyngocutaneous fistula formation? Auris Nasus Larynx 43(1):62–67PubMedCrossRef

Fradi M, Podoshin L, David JB (1995) Post-laryngectomy pharyngocutaneous fistula–a still unresolved problem. J LaryngolOtol 109(3):221–224CrossRef

Casasayas M, Sansa A, García-Lorenzo J, López M, Orús C, Peláez X, Quer M, León X (2019) Pharyngocutaneous fistula after total laryngectomy: multivariate analysis of risk factors and a severity-based classification proposal. Eur Arch Otorhinolaryngol 276(1):143–151PubMedCrossRef

Herranz J, Sarandeses A, Fernández MF, Barro CV, Vidal JM, Gavilán J (2000) Complications after total laryngectomy in nonradiated laryngeal and hypopharyngeal carcinomas. Otolaryngol Head Neck Surg 122(6):892–898PubMedCrossRef

Íkiz A, Uca M, Güneri E, Erdağ T, Sütay S (2000) Pharyngocutaneous fistula and total laryngectomy: possible predisposing factors, with emphasis on pharyngeal myotomy. J LaryngolOtol 114(10):768–771CrossRef

Saki N, Nikakhlagh S, Kazemi M (2008) Pharyngocutaneous fistula after laryngectomy: incidence, predisposing factors, and outcome. Arch Iran Med 11(3):314–317PubMed

Hone RW, Rahman E, Wong G, Annan Y, Alexander V, Al-Lami A, Varadharajan K, Parker M, Simo R, Pitkin L (2017) Do salivary bypass tubes lower the incidence of pharyngocutaneous fistula following total laryngectomy? A retrospective analysis of predictive factors using multivariate analysis. Eur Arch Otorhinolaryngol 274(4):1983–1991PubMedCrossRef

Tsou YA, Hua CH, Lin MH, Tseng HC, Tsai MH, Shaha A (2010) Comparison of pharyngocutaneous fistula between patients followed by primary laryngopharyngectomy and salvage laryngopharyngectomy for advanced hypopharyngeal cancer. Head Neck 32(11):1494–1500PubMedCrossRef

10.

Stephenson KA, Fagan JJ (2015) Effect of perioperative proton pump inhibitors on the incidence of pharyngocutaneous fistula after total laryngectomy: a prospective randomized controlled trial. Head Neck 37(2):255–259PubMed

11.

Andrades P, Pehler SF, Baranano CF, Magnuson JS, Carroll WR, Rosenthal EL (2008) Fistula analysis after radial forearm free flap reconstruction of hypopharyngeal defects. The Laryngoscope 118(7):1157–1163PubMed

12.

Palomar-Asenjo V, Capell ES, Gómez ST, Hernández IP, Palomar-García V (2008) Pharyngocutaneous fistula following total laryngectomy. A case-control study of risk factors implicated in its onset. ActaOtorrinolaringol (English Edition) 59(10):480–484CrossRef

13.

Markou KD, Vlachtsis KC, Nikolaou AC, Petridis DG, Kouloulas AI, Daniilidis IC (2004) Incidence and predisposing factors of pharyngocutaneous fistula formation after total laryngectomy. Is there a relationship with tumor recurrence. Eur Arch Oto-Rhino-Laryngol Head Neck 261(2):61–67CrossRef

14.

Dedivitis RA, Aires FT, Cernea CR, Brandao LG (2015) Pharyngocutaneous fistula after total laryngectomy: systematic review of risk factors. Head Neck 37(11):1691–1697PubMedCrossRef

15.

Demir B, Sarı M, Binnetoglu A, Yumusakhuylu AC, Filinte D, Tekin İÖ, Bağlam T, Batman AÇ (2018) Comparison of pharyngocutaneous fistula closure with and without bacterial cellulose in a rat model. Auris Nasus Larynx 45(2):301–305PubMedCrossRef

16.

Calli C, Pinar E, Oncel S (2011) Pharyngocutaneous fistula after total laryngectomy: less common with mechanical stapler closure. Ann OtolRhinolLaryngol 120(5):339–344

17.

Lou Z, Wang Y (2015) Evaluation of the optimum time for direct application of fibroblast growth factor to human traumatic tympanic membrane perforations. Growth Factors 33(2):65–70PubMedCrossRef

18.

Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J, Gogly B (2006) Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part II: platelet-related biologic features. Oral Surg Oral Med Oral Pathol Oral RadiolEndodontol 101(3):e45–e50CrossRef

19.

Ehrenfest DMD, Rasmusson L, Albrektsson T (2009) Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte-and platelet-rich fibrin (L-PRF). Trends Biotechnol 27(3):158–167CrossRef

20.

Choukroun J, Adda F, Schoeffler C, Vervelle A (2001) Une opportunité en paro-implantologie: le PRF. Implantodontie 42:55–62

21.

Zhao Q, Ding Y, Si T (2013) Platelet-rich fibrin in plastic surgery. OA Evidence-Based Med 1(1):3

22.

Paydarfar JA, Birkmeyer NJ (2006) Complications in head and neck surgery: a meta-analysis of postlaryngectomypharyngocutaneous fistula. Arch Otolaryngology-Head Neck Surg 132(1):67–72

23.

Sayles M, Grant DG (2014) Preventing pharyngo-cutaneous fistula in total laryngectomy: a systematic review and meta-analysis. The Laryngoscope 124(5):1150–1163PubMed

24.

Erdag MA, Arslanoglu S, Onal K, Songu M, Tuylu AO (2013) Pharyngocutaneous fistula following total laryngectomy: multivariate analysis of risk factors. Eur Arch Otorhinolaryngol 270(1):173–179PubMed

25.

Pinar E, Oncel S, Calli C, Guclu E, Tatar B (2008) Pharyngocutaneous fistula after total laryngectomy: emphasis on lymph node metastases as a new predisposing factor. J Otolaryngology-Head Neck Surg 37(3):312–318

26.

de Zinis LOR, Ferrari L, Tomenzoli D, Premoli G, Parrinello G, Nicolai P (1999) Postlaryngectomy pharyngocutaneous fistula: incidence, predisposing factors, and therapy. Head Neck J Sci Spec Head Neck 21(2):131–138

27.

Liang J-W, Li Z-D, Li S-C, Fang F-Q, Zhao Y-J, Li Y-G (2015) Pharyngocutaneous fistula after total laryngectomy: a systematic review and meta-analysis of risk factors. Auris Nasus Larynx 42(5):353–359PubMed

28.

Galli J, De Corso E, Volante M, Almadori G, Paludetti G (2005) Postlaryngectomy pharyngocutaneous fistula: incidence, predisposing factors, and therapy. Otolaryngology-Head Neck Surg 133(5):689–694

29.

Dedivitis R, Ribeiro K, Castro M, Nascimento P (2007) Pharyngocutaneous fistula following total laryngectomy. Acta Otorhinolaryngol Ital 27(1):2–5PubMedPubMedCentral

30.

Busoni M, Deganello A, Gallo O (2015) Pharyngocutaneous fistula following total laryngectomy: analysis of risk factors, prognosis and treatment modalities. Acta Otorhinolaryngol Ital 35(6):400–405PubMedPubMedCentral

31.

Patel UA, Moore BA, Wax M, Rosenthal E, Sweeny L, Militsakh ON, Califano JA, Lin AC, Hasney CP, Butcher RB (2013) Impact of pharyngeal closure technique on fistula after salvage laryngectomy. JAMA Otolaryngology–Head Neck Surg 139(11):1156–1162CrossRef

32.

Aires FT, Dedivitis RA, de Castro MAF, Ribeiro DA, Cernea CR, Brandão LG (2012) Pharyngocutaneous fistula following total laryngectomy. Braz J Otorhinolaryngol 78(6):94–98PubMedCrossRef

33.

White HN, Golden B, Sweeny L, Carroll WR, Magnuson JS, Rosenthal EL (2012) Assessment and incidence of salivary leak following laryngectomy. The Laryngoscope 122(8):1796–1799PubMedPubMedCentralCrossRef

34.

Zhang X, Liu Z, Li Q, Liu X, Li H, Liu W, Li Q, Guo Z, Zeng Z (2013) Using a linear stapler for pharyngeal closure in total laryngectomy. Eur Arch Otorhinolaryngol 270(4):1467–1471PubMedCrossRef

35.

Ismi O, Unal M, Vayisoglu Y, Yesilova M, Helvaci I, Gorur K, Ozcan C (2017) Stapler esophageal closure during total laryngectomy. J CraniofacSurg 28(1):e35–e40CrossRef

36.

Bedrin L, Ginsburg G, Horowitz Z, Talmi YP (2005) 25-year experience of using a linear stapler in laryngectomy. Head Neck J Sci Spec Head Neck 27(12):1073–1079CrossRef

37.

Benson EM, Hirata RM, Thompson CB, Ha PK, Fakhry C, Saunders JR, Califano JA, Arnaoutakis D, Levine M, Tang M (2015) Pharyngocutaneous fistula after total laryngectomy: a single-institution experience, 2001–2012. Am J Otolaryngol 36(1):24–31PubMedCrossRef

38.

Smith TJ, Burrage KJ, Ganguly P, Kirby S, Drover C (2003) Prevention of postlaryngectomy pharyngocutaneous fistula: the Memorial University experience. J Otolaryngol 32(4):222–225PubMedCrossRef

39.

Fung K, Teknos TN, Vandenberg CD, Lyden TH, Bradford CR, Hogikyan ND, Kim J, Prince ME, Wolf GT, Chepeha DB (2007) Prevention of wound complications following salvage laryngectomy using free vascularized tissue. Head Neck J Sci Spec Head Neck 29(5):425–430CrossRef

40.

Ibrahim SG, Wahba BM, Elbatawi AM, Eltelety AM (2017) Sternocleidomastoid flap augmentation of the pharyngeal closure after total laryngectomy. Eur Arch Otorhinolaryngol 274(8):3197–3202PubMedCrossRef

41.

Kadota H, Fukushima J, Kamizono K, Masuda M, Tanaka S, Yoshida T, Nakashima T, Komune S (2013) A minimally invasive method to prevent postlaryngectomy major pharyngocutaneous fistula using infrahyoidmyofascial flap. J PlastReconstrAesthetSurg 66(7):906–911

42.

Higgins KM, Ashford B, Erovic BM, Yoo J, Enepekides DJ (2012) Temporoparietal fascia free flap for pharyngeal coverage after salvage total laryngectomy. The Laryngoscope 122(3):523–527PubMedCrossRef

43.

Stephenson KA, Pandey S, Lubbe DE, Fagan JJ (2018) Use of surgical sealant in the prevention of pharyngocutaneous fistula after total laryngectomy. Head Neck 40(12):2606–2611PubMedCrossRef

44.

Karimi K, Rockwell H (2019) The benefits of platelet-rich fibrin. Facial PlastSurgClin 27(3):331–340

45.

Ehrenfest DD, Sammartino G, Shibli JA, Wang H-L, Zou D-R, Bernard J-P (2013) Guidelines for the publication of articles related to platelet concentrates (Platelet-Rich Plasma-PRP, or Platelet-Rich Fibrin-PRF): the international classification of the POSEIDO. Poseido J 1:17–28

46.

Gür ÖE, Ensari N, Öztürk MT, Boztepe OF, Gün T, Selçuk ÖT, Renda L (2016) Use of a platelet-rich fibrin membrane to repair traumatic tympanic membrane perforations: a comparative study. Acta Otolaryngol 136(10):1017–1023PubMedCrossRef

47.

Dohan M, Ehrenfest D, Bielecki T, Jimbo R, Barbe G, Del Corso M, Inchingolo F, Sammartino G (2012) Do the fibrin architecture and leukocyte content influence the growth factor release of platelet concentrates? An evidence-based answer comparing a pure platelet-rich plasma (P-PRP) gel and a leukocyte-and platelet-rich fibrin (L-PRF). Curr Pharm Biotechnol 13(7):1145–1152CrossRef

48.

Dohan Ehrenfest DM (2010) How to optimize the preparation of leukocyte-and platelet-rich fibrin (L-PRF, Choukroun's technique) clots and membranes: introducing the PRF Box. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 110(3):275–278PubMedCrossRef

49.

Cortese A, Pantaleo G, Borri A, Caggiano M, Amato M (2016) Platelet-rich fibrin (PRF) in implant dentistry in combination with new bone regenerative technique in elderly patients. Int J Surg Case Rep 28:52–56PubMedPubMedCentralCrossRef

50.

Eshghpour M, Majidi MR, Nejat AH (2012) Platelet-rich fibrin: An autologous fibrin matrix in surgical procedures: a case report and review of literature. Iran J Otorhinolaryngol 24(69):197–202PubMedPubMedCentral

51.

Navarrete Álvaro ML, Ortiz N, Rodriguez L, Boemo R, Fuentes J, Mateo A, Ortiz P (2011) Pilot study on the efficiency of the biostimulation with autologous plasma rich in platelet growth factors in otorhinolaryngology: otologic surgery (tympanoplasty type I). IntSch Res Not 2011:1–4

52.

Kumar R (2013) A study of efficiency of autologous platelet rich plasma in myringoplasty. Kilpauk Medical College, Chennai

53.

Cho HH, Lee SC, Jang SJ, Kim SH, Jeong HS, Park JS, Han JY, Lee KH, Cho YB (2009) Effect of platelet rich plasma on facial nerve regeneration in acute nerve injury model. Korean J Otorhinolaryngology-Head and Neck Surg 52(6):486–491

54.

Tutar B, Ekincioglu E, Karaketir S, Berkiten G, Saltürk Z, Arkan ME, Göker AE, Uyar Y (2020) The impact of platelet-rich fibrin (PRF) on olfactory function and pain after septoplasty operations. Eur Arch of Oto-Rhino-Laryngol 277:1115–1120

55.

Vieira F, Pierre C, Castro C (2018) Haverroth R Platelet Rich Fibrin (PRF): an autologous biomaterial for turbinectomy healing assistance. Am J Otolaryngol Head Neck Surg 1(6):1027–1034

56.

Khafagy YW, Abd Elfattah AM, Moneir W, Salem EH (2018) Leukocyte-and platelet-rich fibrin: a new graft material in endoscopic repair of spontaneous CSF leaks. Eur Arch Otorhinolaryngol 275(9):2245–2252PubMed

Title: Platelet-rich fibrin: an autologous biomaterial for healing assistance of pharyngeal repair in total laryngectomy
Authors: Ahmed Mostafa Eid
Hisham Atef Ebada
Ahmed Musaad Abd El-Fattah
Ali Tawfik
Publication date: 01-02-2021
Publisher: Springer Berlin Heidelberg
Keywords: Neck Dissection
Laryngectomy
Published in: European Archives of Oto-Rhino-Laryngology / Issue 2/2021
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-020-06404-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Platelet-rich fibrin: an autologous biomaterial for healing assistance of pharyngeal repair in total laryngectomy

Abstract

Objectives

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

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