Endoscopic outcomes of resorbable nasal packing after functional endoscopic sinus surgery: a multicenter prospective randomized controlled study |
| |
| Authors: | Marco Berlucchi Paolo Castelnuovo Andrea Vincenzi Bruno Morra Ernesto Pasquini |
| |
| Affiliation: | (1) Department of Otorhinolaryngology, University of Brescia, Brescia, Italy;(2) Department of Otorhinolaryngology, University of Pavia, Pavia, Italy;(3) Department of Otolaryngology, University of Modena, Modena, Italy;(4) Department of Otolaryngology, San Giovanni Battista Hospital, Turin, Italy;(5) Department of Otolaryngology, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy;(6) Present address: Department of Pediatric Otorhinolaryngology, Spedali Civili, Piazza Spedali Civili 1, 25123 Brescia, Italy |
| |
| Abstract: | Nasal packings can aid in control of postoperative bleeding and healing following functional endoscopic sinus surgery (FESS), but traditional non-resorbable stents have several inherent drawbacks. We performed a randomized, controlled, multicenter clinical trial to assess efficacy of resorbable nasal packing in patients undergoing FESS for chronic rhinosinusitis. A total of 66 patients for 88 nasal cavities were randomized to receive either hyaluronan resorbable packing (MeroGel®) or standard non-resorbable nasal dressing after FESS. All underwent preoperative rhinoscopy, CT of sinuses, and, after surgery, were reassessed by rhinoscopy at 2, 4, and 12 weeks in blinded fashion. A total of 44 nasal cavities (MeroGel®-group) received resorbable packing, whereas the remaining 44 were packed with non-resorbable nasal dressing. At follow-up endoscopic visit, the presence of nasal synechia was evaluated as primary outcome. Moreover, the tolerability and surgical handling properties of MeroGel® and its comfort were assessed by surgeons and patients. Preoperative severity of rhinosinusitis was similar in both groups. No significant adverse events were observed in all patients. Follow-up endoscopy showed a lower proportion of nasal adhesions in MeroGel®-group at both 4 (P = 0.041) and 12 weeks (P < 0.001). Moreover, an improvement of other endoscopic nasal findings such as re-epithelialization, presence of granulation tissue, and appearance of nasal mucosa of nasal cavities after FESS was observed in the MeroGel®-group. Tolerability and surgical handling properties of MeroGel® were positively rated by clinicians and the overall patient judged comfort of MeroGel® was favorable. In conclusion, MeroGel® can be considered a valid alternative to standard non-resorbable nasal dressings. It is safe, well-accepted, well-tolerated, and has significant advantage of being resorbable. Moreover, it may favor improved healing in patients undergoing FESS and reduce formation of adhesions. |
| |
| Keywords: | Endoscopic sinus surgery FESS MeroGel?
Resorbable Hyaluronan Nasal synechia Nasal packing Nasal complications |
| 本文献已被 SpringerLink 等数据库收录！ |
|
