Page 9 - Revista Portuguesa - SPORL - Vol 61. Nº4

(48 pens), a validated method. Furthermore, Figure 2
nasal endoscopy was performed at each time Platelet rich plasma (PRP) prefilled syringes after
centrifugation (one for each nasal cavity).
point to rule out baseline structural pathology
such as polyposis, which would exclude the
patient from the cohort, and evaluate possible
local complications of the procedure.

PRP preparation and injection procedures
To obtain a reproducible procedure for clinical
practice application, the authors performed
a primary comprehensive literature search.
Additionally, an experienced physician in
osteoarticular PRP injections was present
throughout the first three cases to ensure
adequate PRP sample preparation. Patients
were seated in an upright position as shown
in Figure 1. The technique started with venous
blood extraction onto three different 3.5 ml carefully placed by endoscopic visualization
tubes containing 3.2% sodium citrate. PRP and maintained in situ for ≥ 10 minutes. Under
samples were obtained through a 10-minutes endoscopic control, a single-site injection was
continuous centrifugation at 4000 rotations performed along the superior nasal septum
per minute. The PRP samples were then drawn posterior to the head of the middle turbinate,
into two separate 1‐mL syringes until the 0.9 as shown in Figure 3.
ml mark was reached and a 27‐g needle was
adapted for injection (Figure 2). Figure 3
A 30º rigid nasal optic was used to inspect the Single-site injection being performed in the
patient’s nasal cavity to visualize and predict right superior nasal septum, posteriorly to the
the injection site. Both the inferior meatus level of the head of the middle turbinate. PRP
dispersion can be perceived by the resulting
and predicted injection site were anesthetized mucosal blanching in a superior and posterior
using lidocaine + prilocaine and phenylephrine direction (dashed circular line). Care must
hydrochloride eluted cotton pledgets, be taken to avoid pinching the presumable
site of S-point (blue circle), which can occur if
the puncture occurs too highly in the septal
Figure 1
Positioning of the patient´s nose and mucosa. Dashed green lines and numeration
endoscopy screen relative to the operator: a are displaying three virtually marked vertical
divisions of the middle turbinate – the injection
schematic model.
is performed at the level of the superior part of
the middle portion (labeled as 2).

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