Endoscopic outcomes of resorbable nasal packing after functional endoscopic sinus surgery: a multicenter prospective randomized controlled study
Articolo
Data di Pubblicazione:
2008
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.
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.
Tipologia CRIS:
Articolo su Rivista
Elenco autori:
Berlucchi, M.; Castelnuovo, PAOLO GIOCONDO MARIA; Vincenzi, A.; Morra, B.; Pasquini, E.
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