A Prospective Single-Blind Randomized Controlled Study of use of Hyaluronic Acid Nasal Packs in Patients after Endoscopic Sinus Surgery

Wormald, Peter John; Boustred, R. Niell; Le, Tong; Hawke, Lianne; Sacks, Raymond

doi:10.1177/194589240602000102

Cited by 108 publications

(138 citation statements)

References 13 publications

(20 reference statements)

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“…1284 More recently a DBRCT by Kastl et al 1285 showed no postoperative hemostatic benefit of Nasopore R over not packing at all. There is some evidence to suggest that presoaking Nasopore R with lidocaine may improve its hemostatic effect within the first 24 hours after surgery, 1286 1289 Merogel R (Medtronic ENT, Jacksonville, FL), 1290 Sepragel R , 1291 and CD gel. 1268 Only CD gel, Merocel R , and Sepragel R were shown to confer any advantage over not packing at all, with both showing lower adhesion rates in their active treatment arms.…”

Section: Xd5 Surgical Principles/techniques: Use Of Packingmentioning

confidence: 99%

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Orlandi

Kingdom

Hwang

et al. 2016

Int Forum Allergy Rhinol

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554

888

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Background:The body of knowledge regarding rhinosinusitis (RS) continues to expand, with rapid growth in number of publications, yet substantial variability in the quality of those presentations. In an effort to both consolidate and critically appraise this information, rhinologic experts from around the world have produced the International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR:RS). Methods:Evidence-based reviews with recommendations (EBRRs) were developed for scores of topics, using previously reported methodology. Where existing evidence was insufficient for an EBRR, an evidence-based review (EBR) was produced. The sections were then synthesized and the entire manuscript was then reviewed by all authors for consensus. Results:The resulting ICAR:RS document addresses multiple topics in RS, including acute RS (ARS), chronic RS (CRS) with and without nasal polyps (CRSwNP and CRSsNP), recurrent acute RS (RARS), acute exacerbation of CRS (AE-CRS), and pediatric RS. Conclusion:As a critical review of the RS literature, ICAR:RS provides a thorough review of pathophysiology and evidence-based recommendations for medical and surgical treatment. It also demonstrates the significant gaps in our understanding of the pathophysiology and optimal management of RS. Too o en the foundation upon which these recommendations are based is comprised of lowerlevel evidence. It is our hope that this summary of the evidence in RS will point out where additional research efforts may be directed. C 2016 ARS-AAOA, LLC. Key Words:rhinosinusitis; chronic rhinosinusitis; acute rhinosinusitis; recurrent acute rhinosinusitis; evidence-based medicine; systematic review; endoscopic sinus surgery List of Abbreviations Used

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Section: Xd5 Surgical Principles/techniques: Use Of Packingmentioning

confidence: 99%

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Orlandi

Kingdom

Hwang

et al. 2016

Int Forum Allergy Rhinol

Self Cite

554

888

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“…Recently, platelet gel packing and sodium hyaluronate-carboxymethylcellulose (HA-CMC), which prevent adhesions, have been used, but the efficacy of these materials remains unclear. [7][8][9][10] Compared with the method described by Thornton,4 our technique is relatively simple to perform because fixation of the Silastic sheet is generally performed at the anterior to middle portion of septal cartilage. Our procedures also provide little difficulty in the postoperative care of the ethmoid sinus and frontal recess area, compared with inserting an inverted U-shaped Silastic sheet.…”

Section: Commentmentioning

confidence: 99%

Preventing Lateral Synechia Formation After Endoscopic Sinus Surgery With a Silastic Sheet

Lee¹,

Lee²

2007

Arch Otolaryngol Head Neck Surg

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“…34 However, a number of studies have disputed the role of Merogel in mucosal epithelium recovery. [35][36][37][38] Our study aimed to investigate whether Merogel coverage stimulates wound mucosal regeneration and its epithelialization around the ostia to improve long-term ostial patency in EES-DCR.…”

Section: Introductionmentioning

confidence: 99%

Effects of Merogel coverage on wound healing and ostial patency in endonasal endoscopic dacryocystorhinostomy for primary chronic dacryocystitis

Cannon

Yan

et al. 2011

Eye

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Purpose To investigate the effects of Merogel coverage on ostial patency in endonasal endoscopic dacryocystorhinostomy (EES-DCR) for primary chronic dacryocystitis (PCD). Methods In all, 260 patients with unilateral PCD were randomized into two groups: the Merogel group and the control group. All patients underwent EES-DCR. The Merogel group received Merogel covering the wound 1-2 mm around the ostium and the control group received no treatment. Patients were followed up for 9 months. The mucosal epithelialization of the wound, the proliferation of fibrosis tissue, and the success rate of ostial patency were compared. Results Our study included 112 patients in the Merogel group and 115 patients in the control group. At the 2-week review, intact mucosal epithelium lined the ostia in 96 Merogel patients compared with 80 control patients (ITT analysis: v 2 ¼ 4.502, P ¼ 0.034). At the 9-month review, scars were present in 18 patients in the Merogel group compared with 39 patients in the control group (ITT analysis: v 2 ¼ 9.909, P ¼ 0.002, ITT analysis). No differences were observed in the granulation formation between the two groups. The success rate of ostial patency reached 94.6% (106/112) in the Merogel group compared with 80% (92/115) in the control group (ITT analysis: v 2 ¼ 4.151, P ¼ 0.042). Conclusion Merogel coverage may enhance the success rate of EES-DCR for PCD by promoting mucosal epithelial healing and preventing excessive scarring.

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A Prospective Single-Blind Randomized Controlled Study of use of Hyaluronic Acid Nasal Packs in Patients after Endoscopic Sinus Surgery

Abstract: Merogel nasal packing has no significant beneficial or detrimental effect in terms of synechia, edema, or infection when placed in the middle meatus after ESS.

Cited by 108 publications

References 13 publications

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Preventing Lateral Synechia Formation After Endoscopic Sinus Surgery With a Silastic Sheet

Effects of Merogel coverage on wound healing and ostial patency in endonasal endoscopic dacryocystorhinostomy for primary chronic dacryocystitis

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