Randomized, Controlled, Study of Absorbable Nasal Packing on Outcomes of Surgical Treatment of Rhinosinusitis with Polyposis

Franklin, Jason; Wright, Erin D.

doi:10.2500/ajr.2007.21.3011

Cited by 68 publications

(91 citation statements)

References 19 publications

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“…There have been two recent randomized studies that have evaluated the effects of absorbable HA nasal packing in patients with rhinosinusitis with or without NP who have undergone sinus surgery. Franklin et al [24] conducted a prospective, randomized, controlled study that investigated the effect of absorbable HA nasal packing on postoperative discomfort and mucosal healing in 35 patients with rhinosinusitis without NP following sinus surgery. Improvements in endoscopic appearances were reported with the absorbable HA nasal packing.…”

Section: Discussionmentioning

confidence: 99%

Hyaluronan in the Treatment of Chronic Rhinosinusitis with Nasal Polyposis

Cassandro

Chiarella

Cavaliere

et al. 2014

Indian J Otolaryngol Head Neck Surg

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Chronic rhinosinusitis (CRS) is a common condition and affects the quality of life of approximately 16 % of adults in US and 10.9 % in Europe. Hyaluronan (HA) is a nonsulphate glycosaminoglycan found in the extracellular matrix of connective tissues, and plays an important role in the healing process and repair of mucosal surfaces. We aim to evaluate the effect of HA on nasal symptoms and endoscopic appearance in patients with CRS and nasal polyps (NP) who have not undergone sinus surgery. Eighty patients older than 18 years old were randomized to receive either open-label nebulized saline solution (NS) or intranasal corticosteroid spray (ICS) 200 lg bid or nebulized sodium hyaluronate (NHA, YABRO Ò ) or both ICS and NHA. Results were collected at 1 month, 3 months and 3 months after treatment. Significant improvements in nasal symptoms scores, endoscopic appearance scores, radiologic scores, rhinomanometry and saccharine clearance test were observed in the NHA, ICS and ICS ? NHA groups after 1 month and 3 months of treatment compared with baseline (all p B 0.005). The use of oral steroids was significantly reduced after 3 months of therapy in the same groups versus baseline (all p \ 0.05). The incidence of adverse events at 3 months was similar between the 4 groups (all p [ 0.05). Throat irritation, nasal burning and drug-related epistaxis were not reported in the group NHA. HA, as a nebulized nasal douche preparation, improved nasal symptoms and endoscopic appearances in patients with CRS and NP who have not undergone sinus surgery.

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Section: Discussionmentioning

confidence: 99%

Hyaluronan in the Treatment of Chronic Rhinosinusitis with Nasal Polyposis

Cassandro

Chiarella

Cavaliere

et al. 2014

Indian J Otolaryngol Head Neck Surg

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“…1293 suggested better early and long-term wound healing for Merogel R , no difference between these agents was observed in 2 other independent RCTs. 1294,1295 Interestingly an RCT by Shi et al 1296 evaluating a similar hyaluronan-based gel, PureRegen Gel R (BioRegen Biomedical, Changzhou, China), observed improved wound healing in terms of adhesion formation, edema, and crusting when the gel was applied to Merocel R prior to packing. This does suggest a possible benefit of hyaluronan gel.…”

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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“…Although when evaluating the efectiveness of any treatment, this is a very important consideration; we believe that it is more important to conclusively determine which means of nasal packing is most clinically efective. We do have to mention that the results from a previous randomized controlled trial, which was not eligible for inclusion in our systematic review/meta-analysis, suggested that the majority of patients prefer absorbable nasal packing material (speciically MeroGel) over nonabsorbable material [10]. Finally four, we only included a relatively small number of studies for our meta-analysis which limited the power of analysis.…”

Section: Discussionmentioning

confidence: 99%

“…There were a number of studies comparing the eicacy of nonabsorbable and absorbable nasal packing after FESS [8][9][10][11][12][13][14]; however, the results on if a method is beter than another or if the methods used had a comparable eicacy were conlicting among the studies. In an efort to gain a beter understanding of the eicacy and other outcomes on nonabsorbable vs. absorbable nasal packing after FESS for the treatment of chronic rhinosinusitis, we have conducted a systematic review and a meta-analysis of the available literature.…”

Section: Introductionmentioning

confidence: 99%

“…Due to this reason, after FESS, the nasal cavity is often packed with material designed to stop bleeding, reduce clot formation, lower the risk of synechia, and promote healing [8,9]. Nonabsorbable nasal packing was applied after FESS traditionally [7]; nonetheless, patients seem not be able to tolerate the packing and its removal [10]. Absorbable nasal packing was introduced more recently and appears to be well tolerated by patients [11,12].…”

Section: Introductionmentioning

confidence: 99%

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Nasal Packing after Functional Endoscopic Sinus Surgery

Wang¹,

Hsiao²

2017

Paranasal Sinuses

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This chapter was to have a systematic review and meta-analysis on the available literature in order to compare the eicacy and postoperative outcomes of nasal packing (absorbable vs. nonabsorbable) after treatment of chronic rhinosinusitis with functional endoscopic sinus surgery (FESS). The systematic review included ive studies with 241 nasal cavities in each treatment group. The prevalence of synechia in the absorbable groups ranged from 4.6 to 8.0% while nonabsorbable groups ranged from 8.0 to 35.7%. The absorbable group had a lower postoperative bleeding; however, there were no clear indings on postoperative pain. Postoperative edema was in general similar among groups, and no consistent indings were found on bleeding and pain while removing packing. The meta-analysis included two studies using the same type of packing material. The combined OR (0.33, 95% CI = 0.04-2.78) for postoperative synechia did not signiicantly favor (P = 0.016308) absorbable packing over nonabsorbable packing. The available literature showed that there is some evidence that absorbable nasal packing may provide superior outcomes to nonabsorbable packing after FESS. However, lack of homogeneity between these studies makes it impossible to have a deinitive conclusion.

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Randomized, Controlled, Study of Absorbable Nasal Packing on Outcomes of Surgical Treatment of Rhinosinusitis with Polyposis

Abstract: The absorbable dressing showed a trend toward positive effect on early wound healing and in late results. Strong patient preference was indicated for the absorbable dressing over standard sponges.

Cited by 68 publications

References 19 publications

Hyaluronan in the Treatment of Chronic Rhinosinusitis with Nasal Polyposis

Hyaluronan in the Treatment of Chronic Rhinosinusitis with Nasal Polyposis

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Nasal Packing after Functional Endoscopic Sinus Surgery

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