No Packing versus Packing after Endoscopic Sinus Surgery: Pursuit of Patients’ Comfort after Surgery

Mo, Ji‐Hun; Han, Doo Hee; Shin, Hyun Woo; Cha, Wonjae; Chang, Mun Seog; Jin, Hong

doi:10.2500/ajr.2008.22.3218

Cited by 44 publications

(49 citation statements)

References 14 publications

(25 reference statements)

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“…Their results showed that in unilateral endoscopic sinus surgery (ESS) cases, subjective estimated blood loss and mucosal inflammation were decreased in the no‐packing group. However, for bilateral ESS, no statistically significant clinical differences were found . Despite the lack of clear, compelling evidence to support the use of nasal packing, Nasopore (Stryker Corporation, Kalamazoo, MI) has become one of the most commonly used absorbable synthetic nasal‐packing materials in patients post‐ESS.…”

Section: Introductionmentioning

confidence: 99%

Antibodies directed against integration host factor mediate biofilm clearance from nasopore

et al. 2013

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Objectives Intranasal resorbable packing, such as Nasopore®, is commonly used during sinus surgery despite a paucity of evidence that demonstrates clinical benefit. We theorized that Nasopore supports bacterial growth and biofilm formation. The DNABII family of bacterial nucleic acid binding proteins stabilizes the extracellular polymeric substance of the biofilm, thus protecting bacteria from host defenses and traditional antibiotics. We tested the hypothesis that use of anti-IHF antibodies in conjunction with antibiotics would enhance biofilm eradication from Nasopore. Study Design In vitro experiments. Methods Non-typeable Haemophilus influenzae (NTHI) biofilms were grown on Nasopore. Following 24-hour incubation, biofilms were incubated for an additional 16 hours with either: medium alone, naïve rabbit serum, rabbit anti-IHF serum, amoxicillin/clavulanate or anti-IHF serum + amoxicillin/clavulanate. COMSTAT analysis was performed on images of biofilms obtained via confocal microscopy. Results NTHI readily formed a biofilm on Nasopore. Treatment with amoxicillin/clavulanate alone mediated an increase in biomass by 92% to 6.63 μ2/μ3 compared to incubation in sterile medium alone (3.46 μ2/μ3). Treatment with anti-IHF alone reduced the biomass by 77% to 1.29 μ2/μ3 compared to incubation with naïve rabbit serum (5.53 μ2/μ3). Anti-IHF + amoxicillin/clavulanate reduced biomass by 88% to 0.66 μ2/μ3 (p<0.02) compared to incubation with naïve rabbit serum. Conclusion Antibiotics alone were ineffective in eradicating NTHI biofilms that had formed on Nasopore in vitro. Anti-IHF antibodies plus amoxicillin/clavulanate therapy synergistically reduced biofilm biomass by 88%. These data support clinical studies for the use of anti-IHF combined with antibiotics to reduce biofilm formation on intranasal packing.

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Section: Introductionmentioning

confidence: 99%

Antibodies directed against integration host factor mediate biofilm clearance from nasopore

et al. 2013

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“…The lack of consensus for the end point of these studies appears to be a matter of discussion. A great number of the studies evaluated the outcomes from 1 to 12 weeks . There is only one study in addition to ours that compared packing until 6 months .…”

Section: Discussionmentioning

confidence: 99%

Role of nasal packing in surgical outcome for chronic rhinosinusitis with polyposis

et al. 2014

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“…The most common approaches are the placement of a Merocel spacer in the middle meatus, or nothing at all. Studies have shown that nasal packing is uncomfortable for the patient and contributes to nasal obstruction and postnasal drip [53,54]. The senior author's preference is to place a Merocel middle meatal spacer upon completion of surgery, and to remove it within 24 h. The use of resorbable packing or gels has become quite popular.…”

Section: Packings and Dressingsmentioning

confidence: 98%

Advances in the Surgical Management of Chronic Sinusitis and Nasal Polyps

Ramakrishnan¹,

Kennedy

2011

Curr Allergy Asthma Rep

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Current research has only reinforced the belief that chronic rhinosinusitis is a multifactorial and idiosyncratic disease process. Most basic science research on the topic focuses on delineating the many proposed contributing factors and attempting to establish therapeutic targets. In patients whose symptoms do not respond to medical therapy, endoscopic sinus surgery may be offered. Several surgical techniques have been proposed, and it would appear that certain techniques are ideal for certain situations. Recent clinical research has focused on the introduction of new technology and new techniques. Additionally, investigators have looked for ways to optimize current techniques and to determine which patient populations may expect to benefit from which types of interventions.

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No Packing versus Packing after Endoscopic Sinus Surgery: Pursuit of Patients’ Comfort after Surgery

Abstract: Nasal packing can be safely used less frequently to help the patients experience less discomfort after ESS. The need for nasal packing after ESS can be decided by judicious estimation of bleeding during and after the surgery.

Cited by 44 publications

References 14 publications

Antibodies directed against integration host factor mediate biofilm clearance from nasopore

Antibodies directed against integration host factor mediate biofilm clearance from nasopore

Role of nasal packing in surgical outcome for chronic rhinosinusitis with polyposis

Advances in the Surgical Management of Chronic Sinusitis and Nasal Polyps

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