الفهرس 
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Abstract
Conclusion:
Our study confirmed the valuable role of the new biological and regenerative method for management of atrophic rhinitis via the use of autologous PRP injection. As the current lines of management of atrophic rhinitis are ineffective for long-term cure and requires frequent patient attendance to receive temporary care, PRP considered a golden option for these patients. Although not permanent; yet, it proved its efficacy to improve nasal symptoms and nasal mucociliary function with great impact on relieving the social and psychological burden of the patients for prolonged period of time in terms of months. In addition to that, it offers a simple micro-invasive, safe, not expensive and readily available procedure that could be easily accomplished at any time and place even in outpatient clinic. Younger patients (2nd and 3rd decade of life) and those with history of disease of short duration (early atrophic rhinitis) showed better improvement than the older ones (further studies needed). PRP proved its efficacy in treatment of both primary atrophic rhinitis and ENS, and no statistically significant difference was noted between them.
Recommendations:
• Further randomized controlled studies with a larger patient sample and a longer follow-up duration are needed to support these results and to evaluate the long-term outcome of the procedure.
• The efficacy of repeated or booster PRP injection needs further studies to evaluate its role in prolongation of the symptom free periods with each booster dose.
• It is greatly advisable to avoid excess turbinate tissue removal by using and testing the safest turbineplasty procedures to minimize the risk of ENS.
• There is possible need to add other physiologic medications that are essential for respiratory system function, namely surfactant which may add a synergistic effect to the valuable role of PRP in improving manifestations of atrophic rhinitis. Furthermore, change of the sites for injection to include the olfactory area of the nasal cavity to assess the possibility of improvement of olfactory function is another recommendation that should be kept in mind.
• In addition to that, variations on technique, lack of consensus regarding number of injections, spacing of injections, number of platelets, concentration of platelets over baseline, with or without leukocytes in the injection, exogenous versus endogenous activation of injected platelets and even appropriate definition of candidates for the procedure need further research and evaluation.