Research Article
Potential Effect of Leukocyte-Platelet-Rich Fibrin in Bone
Healing of Skull Base: A Pilot Study
Felipe Fredes,
1
Jaime Pinto,
2
Nelson Pinto,
3
Pablo Rojas,
1
Daniel M. Prevedello,
4,5
Ricardo L. Carrau,
4,5
and Thomas Schmidt
1
1
Department of Otolaryngology-Head & Neck Surgery, Universidad de Concepci´ on, Concepci´ on, Chile
2
Department of Neurosurgery, Universidad de Concepci´ on, Concepci´ on, Chile
3
Graduate School of Periodontics and Implant Dentistry, University of the Andes, Research Center for Regenerative Medicine and
Tissue Engineering, Concepci´ on, Chile
4
Department of Otolaryngology-Head & Neck Surgery, Te Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
5
Department of Neurologic Surgery, Te Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
Correspondence should be addressed to Tomas Schmidt; emsaschmidt@gmail.com
Received 28 January 2017; Revised 4 September 2017; Accepted 11 October 2017; Published 16 November 2017
Academic Editor: Cherie-Ann Olympia Nathan
Copyright © 2017 Felipe Fredes et al. Tis is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background. Reconstruction of surgical defects following cranial base surgery is challenging. Others have demonstrated that
leukocyte-platelet-rich fbrin (L-PRF) stimulates tissue healing and bone regeneration. However, these studies have addressed
mostly maxillofacial surgical wounds. Objective. Te objective of this study was to assess the possible adjuvant role of L-PRF
in inducing neoossifcation of the surgical bone defect in anterior skull base surgery. Methods. We identifed patients who had
undergone an endoscopic endonasal surgery of the anterior skull base in which L-PRF membranes were used for the reconstruction
of the bone defect and who were followed up with postoperative CT scans. CT fndings were then correlated with baseline scans
and with the CT scans of a patient who had undergone imaging and histologic analysis afer maxillofacial surgery in which L-PRF
was used and in which we demonstrated bone formation. Results. Five patients fulflled the inclusion criteria. In four patients, the
CT scan demonstrated closure of the bony defect by neoosteogenesis; however, the bone appeared less dense than the surrounding
normal bone. A comparison with the control patient yielded similar radiological features. Conclusion. Tis case series suggests
that L-PRF may induce bone healing and regeneration at the surgical site defect. Multi-institutional studies with a larger series of
patients are required to confrm this possibility.
1. Introduction
Te endonasal endoscopic approach for lesions of the anterior
skull base has decreased the morbidity associated with open
approaches while achieving similar results in terms of disease
control. Te use of vascularized tissues to repair surgical
defects has dramatically decreased the rate of postoperative
complications such as cerebrospinal fuid (CSF) leaks and
infections [1]. Te introduction of the nasoseptal fap in 2006
reduced the incidence of CSF leaks from 30% to 5% [2].
Despite these advances in reconstructive skull base surgery,
complications continue to be reported, so the search for
new therapeutic alternatives is necessary to further reduce
morbidity.
Te use of platelet concentrates in surgery and wound
management is an attractive option to enhance tissue healing.
One of these products is the leucocyte and platelet-rich fbrin
(L-PRF), a platelet concentrate characterized by containing
a dense matrix of fbrin, platelets, and leucocytes, thus
representing a considerable improvement over its prede-
cessor, platelet-rich plasma (PRP) [3]. PRP products are
preparations without leukocytes and with a low-density fbrin
network, and all the products of this family can be used
as liquid solutions or in an activated gel form, but not as
a solid flling material like L-PRF [3]. L-PRF is a simple,
natural, and inexpensive product obtained from the patient’s
blood, which is centrifuged without using anticoagulants.
Coagulation occurs during centrifugation, leading to the
Hindawi
International Journal of Otolaryngology
Volume 2017, Article ID 1231870, 7 pages
https://doi.org/10.1155/2017/1231870