Steroid vs. antibiotic impregnated absorbable nasal packing for wound healing after endoscopic sinus surgery: a randomized, double blind, placebo-controlled study

Grześkowiak, Błażej; Wierzchowska, Małgorzata; Walorek, Rafal; Seredyka-Burduk, Małgorzata; Wawrzyniak, Katarzyna; Burduk, Paweł

doi:10.1016/j.bjorl.2018.04.002

Cited by 19 publications

(45 citation statements)

References 20 publications

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“…Nasopore ® is a bioabsorbable nasal packing that is made of a fragmentable poly (DL-lactide-co-E-caprolactone) urethane. In a randomized, placebo-controlled study, Grzeskowiak and colleagues compared the efficacy of the Nasopore ® packing impregnated with either steroid (betamethasone) or antibiotics (ciprofloxacin) [51]; Nasopore ® impregnated with saline was used as a placebo. The study indicated a significant improvement with both steroid-eluting and antibiotic-eluting bioabsorbable packing on the postoperative healing process and patient satisfaction as compared to saline-soaked packing.…”

Section: Nasal Packingmentioning

confidence: 99%

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Current and Alternative Therapies for Nasal Mucosa Injury: A Review

Selvarajah

Saim

Idrus

et al. 2020

IJMS

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Nasal mucosa injury can be caused by trauma, radiotherapy, chronic infection such as sinusitis, and post sinus surgery. The rate of healing and its treatment are important in the recovery of patients especially in post sinus surgery, which introduces new injuries. In this review, the current knowledge in terms of the mechanism underlying nasal wound healing was initially discussed. The currently available treatment options for enhancement of wound healing following sinus surgery were discussed and these had included intravenous antibiotics or steroids, various nasal sprays, and nasal packing. In addition, emerging alternative therapies in nasal mucosa wound healing such as herbal medicine and the advancement of regenerative medicine therapies such as stem cells and their byproducts were also discussed. Despite the various available treatment options for wound healing in nasal mucosa, rigorous strong evidence of their efficacy is gravely warranted in order to recommend them as part of the treatment modality.

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Section: Nasal Packingmentioning

confidence: 99%

“…Nasal Pack Drug Delivered Outcomes [49] Silsos gel Silver Improves SNOT22 score and mucosal healing [50] SinuBandFP Fluticasone propionate Improves polyp score, adhesion, pain [51] Nasopore Betamethasone Improves healing and satisfaction Ciprofloxacin Improves healing and satisfaction…”

Section: Studymentioning

confidence: 99%

Current and Alternative Therapies for Nasal Mucosa Injury: A Review

Selvarajah

Saim

Idrus

et al. 2020

IJMS

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“…But when expanded to time periods greater than 90 days, significant differences are not observed between groups. 43 Due to the chronic nature of CRS, consistent, long-term results are necessary to achieve appropriate improvement. Additionally, the nasal packing material has yet to show significant promise as a potential therapeutic intervention due to the lack of reliability in drug release.…”

Section: Potential Nonstent Topical Therapiesmentioning

confidence: 99%

“…Recent studies have shown some success in short‐term use of nasal packing materials with antibiotic groups demonstrating improved endoscopic scoring compared to control. But when expanded to time periods greater than 90 days, significant differences are not observed between groups 43 . Due to the chronic nature of CRS, consistent, long‐term results are necessary to achieve appropriate improvement.…”

Section: Potential Nonstent Topical Therapiesmentioning

confidence: 99%

Antibiotic eluting sinus stents

Thompson

Lim

Banks

et al. 2020

Laryngoscope Investig Oto

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Objectives Chronic rhinosinusitis (CRS) is a multifactorial disease affecting up to 16% of the United States population and disproportionately affecting the cystic fibrosis (CF) patient population. Despite treating the underlying infection, the use of systemic antibiotics has shown little efficacy in alleviation of symptom burden. This review seeks to discuss recent research on novel antibiotic eluting stent therapy in vitro and within animal models as well as the factors that contribute to its efficacy. Data Sources PubMed literature review. Review Methods A review of all published literature related to antibiotic eluting sinus stents was conducted to integrate and summarize this innovative approach to chronic sinus infections. Results Placement of the ciprofloxacin sinus stent (CSS) and ciprofloxacin‐ivacaftor sinus stent (CISS) exhibited improvement in endoscopic and radiographic findings in rabbit CRS models. While the CSS showed an overall trend toward improvement in microscopic findings and a reduction in biofilm mass, there remained a significant quantity of planktonic bacteria due to antibiotic depletion from an initial burst release in the first 48 hours of stent placement. The CISS and ciprofloxacin‐azithromycin sinus stents (CASSs) exhibited controlled antibiotic release over the study period leading to greatly reduced planktonic bacterial load and biofilm mass. In vitro studies indicate that CASS may be just as efficacious at reducing biofilm mass. Conclusion Antibiotic eluting sinus stents show significant promise as a novel therapeutic strategy for CRS. The CISS may have particular promise for the CF patient population by addressing both the infectious and genetic components of disease. Animal studies demonstrate significant promise for translation into human studies. Human clinical trials are warranted to determine the efficacy of antibiotic sinus stents in human patients. Level of Evidence NA

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“…There were then 3 prospective, randomized, double-blinded, controlled trials, [18][19][20] which have all shown that POSE and/or LK scores were significantly improved at various time points during the postoperative period (Table 1). These trials differed in terms of the length of NasoPore used, choice of corticosteroid, and method of study control (intrapatient vs interpatient).…”

Section: Evidence On Clinical Outcomesmentioning

confidence: 99%

Intraoperative Applications of Topical Corticosteroid Therapy for Chronic Rhinosinusitis

2020

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Objectives: To provide an overview of recent techniques and technologies for the application of topical corticosteroid therapy immediately following endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS). Methods: A comprehensive search in the PubMed and Google Scholar databases was conducted to identify publications between January 2000 and December 2019 detailing clinical trials that have evaluated the efficacy and safety of intraoperative applications of topical corticosteroids for CRS. Results: A total of 21 articles, all of which highlight a variety of corticosteroid-infused products, including Propel corticosteroid-eluting stents, NasoPore, Merocel, SinuBand, calcium alginate, and bioresorbable gel-type products, are included for review. Propel stents are the only devices that have achieved level 1A evidence in terms of efficacy and have data to support their safety. The remaining products have shown mixed results in terms of efficacy and safety. Conclusion: A wide range of techniques and technologies have been introduced to enhance the topical delivery of corticosteroids into the neosinuses after ESS for CRS. Regarding efficacy, there is level 1A evidence to support the use of Propel stents. Most of the remaining strategies show some degree of efficacy. Direct comparisons across the different strategies are limited owing to the varied uses of delivery vectors, corticosteroid choices, and doses of corticosteroids. Propel stents and SinuBand have sufficient data to support systemic and ocular safety, whereas the remaining products have limited data to support their safety.

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Steroid vs. antibiotic impregnated absorbable nasal packing for wound healing after endoscopic sinus surgery: a randomized, double blind, placebo-controlled study

Abstract: The results of this study reveal the significant positive influence of steroid- and antibiotic-impregnated biodegradable nasal packing on the postoperative healing process and patient satisfaction compared to the saline soaked dressing.

Cited by 19 publications

References 20 publications

Current and Alternative Therapies for Nasal Mucosa Injury: A Review

Current and Alternative Therapies for Nasal Mucosa Injury: A Review

Antibiotic eluting sinus stents

Intraoperative Applications of Topical Corticosteroid Therapy for Chronic Rhinosinusitis

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