Background: Chronic rhinosinusitis (CRS) poses significant health challenges, requiring comprehensive management strategies including endoscopic sinus surgery (ESS). Platelet-rich plasma (PRP) therapy holds promise in CRS management by promoting tissue repair and regeneration.

Aim: Evaluate PRP's efficacy as adjunctive treatment during ESS for CRS.

Methods: Prospective controlled double-blinded randomized study at Zagazig University Hospitals. Sample size: 36 patients undergoing bilateral ESS (72 sides). Preoperative assessments included SNOT-22 and Meltzer's Polyp score. PRP was applied in one randomly selected side at the end of ESS, while the other side served as control. Postoperative evaluations using VAS symptom score and endoscopic score were carried at 1 week, 1 month, and 3 months postoperatively

Results: Baseline data: Mean age 33.39 ± 7.06 years, Lund McKay score 16.06 ± 0.78, Meltzer criteria 2.83 ± 0.73. PRP improved symptoms like nasal blowing, blockage, runny nose, and thick nasal discharge (p<0.05) mainly in the short term. One-week post-management, PRP improved mucosal healing (p=0.0455) and reduced bleeding and edema (p<0.05). One month follow up showed significant differences regarding crustations(p=0.0409) and edema(p=0.0161) . Three-month evaluation found no significant difference in the outcome criteria with PRP (p>0.05). However, adhesion incidence was less in PRP side (p=0.1643)

Conclusion: PRP therapy adjunctive to ESS in CRS may offer short-term symptom relief and improved mucosal healing. Further studies are needed to elucidate its long-term efficacy and application.