Objectives: To compare the effect of steroid-impregnated spacers to conventional management after endoscopic sinus surgery (ESS) in patients with chronic rhinosinusitis (CRS). Methods: Six databases were searched from inception until November 2022. Sixteen studies were found that compared the improvement of chronic sinusitis-related symptoms and postoperative outcomes between a steroid-impregnated spacer group and control group (non-steroid impregnated spacers). The Cochrane risk of bias tool (randomized controlled studies) and Newcastle–Ottawa Scale (non-randomized controlled studies) were used to assess the quality of the works included.Results: Regarding the endoscopic findings, the degree of mucosal edema, ethmoid inflammation, crust formation at 2–3 months postoperatively, nasal discharge, polyposis, and scarring/synechia were significantly lower in the steroid-impregnated spacers group. Also, the steroid-impregnated spacer significantly reduced the Lund–Kennedy score and perioperative sinus endoscopy score compared with the control group at 2–3 weeks postoperatively. Also, the steroid-impregnated spacer group had lower rates of adhesions, middle turbinate lateralization, polypoid change, the need for oral steroid, the need for postoperative therapeutic intervention, and lysis of adhesions compared to controls. However, there were no significant group differences in the short-term (2–3 weeks postoperatively) endoscopic findings regarding nasal discharge, postoperative crusting, polyposis, or scarring/synechia.Conclusion: Steroid-impregnated nasal packing reduced the rates of postoperative intervention and recurrent polyposis and inflammation in CRS patients undergoing ESS.
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