Treatment with platelet- and extracellular vesicle-rich plasma in otorhinolaryngology-a review and future perspectives

Extracellular vesicles (EVs), also known as microvesicles, exosomes, nanovesicles, microparticles etc. are a heterogeneous group of nanometrically sized cell-derived membranous structures which can originate from any cell, including plant cell or bacteria. They were found in many body fluids including platelet-rich plasma (PRP). PRP is a blood-derived product with immune, hemostatic and regenerative effects. PRP is expected to contain important concentrations of EVs which could be important contributors to PRPs effects. For that reason, we call the preparation from PRP a platelet- and extracellular vesicle-rich plasma (PVRP). PVRP has been used in various medical fields including orthopedics, traumatology, wound care surgery, plastic, reconstructive and esthetic surgery, hand surgery, maxillofacial and oral surgery, gynecology, urology, ophthalmology, cardiothoracic surgery, neurosurgery and otorhinolaryngology. Otorhinolaryngology is a field in which PVRP has a great potential in the treatment of diseases of the face, neck, nose, paranasal sinuses, anterior skull base, lips, oral cavity, pharynx, esophagus, salivary glands, ear and lateral skull base. To present this potential and also hitherto gathered results in the field of otorhinolaryngology, this chapter describes the role of platelets and EVs in diagnostics and treatment with an emphasis on otorhinolaryngology. Also, we discuss future perspectives of EVs and PVRP in treatment of moist radical cavities after cholesteatoma surgery.