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Clinical Outcomes of Platelet-Rich Plasma Injection for Vocal Fold Disorders: A Systematic Review and Meta-Analysis
Guilherme A M Santoro1, Suellen A de Oliveira1, Erika L M M de Almeida1
1Department of Otorhinolaryngology-Head and Neck Surgery, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.
Background:
Platelet-rich plasma (PRP) has emerged as a promising regenerative treatment for vocal fold disorders, particularly conditions involving lamina propria alterations such as vocal fold atrophy, sulcus vocalis, and scarring. However, clinical evidence remains limited and heterogeneous. This systematic review and meta-analysis evaluated the clinical efficacy of PRP injection for vocal fold disorders.
Study Design:
Systematic review and meta-analysis.
Methods:
This review followed PRISMA 2020 guidelines and was prospectively registered in PROSPERO (CRD420261341691). A systematic search of PubMed/MEDLINE, Scopus, Web of Science, Embase, and CENTRAL was performed through February 2026. Clinical studies evaluating PRP injection for vocal fold disorders were included. Risk of bias was assessed using established tools according to study design. Random-effects meta-analysis was performed for Voice Handicap Index-10 (VHI-10) outcomes and exploratory pooled clinical improvement rates.
Results:
Ten studies comprising 350 patients were included. Most studies were case series, with only two randomized controlled trials identified. Substantial heterogeneity was observed regarding PRP protocols, injection techniques, and outcome assessment methods. Most studies demonstrated improvement in patient-reported voice outcomes, perceptual voice evaluation, and stroboscopic findings, whereas acoustic outcomes remained inconsistent. Meta-analysis demonstrated a pooled reduction in VHI-10 scores of 8.02 points (95% confidence interval [CI]: 5.83-10.21; I² = 44.3%). Exploratory pooled analysis demonstrated a clinical improvement rate of 80.5% (95% CI: 69.2-88.3; I² = 58.7%). No serious adverse events were reported.
Conclusions:
PRP appears to be a promising and safe treatment option for selected vocal fold disorders. However, interpretation of the current evidence is limited by methodological heterogeneity and the scarcity of randomized controlled trials. Further standardized studies are needed to better define the role of PRP in vocal fold regeneration.