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Randomized controlled trial of steroid‐soaked absorbable calcium alginate nasal packing following endoscopic sinus surgery
Author(s) -
Hwang Chi Sang,
Sharhan Salma Saud,
Kim Bo Ra,
Kim Soo In,
Kim Jin Woong,
Cho HyungJu,
Yoon JooHeon,
Kim ChangHoon
Publication year - 2018
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.26871
Subject(s) - medicine , triamcinolone acetonide , surgery , functional endoscopic sinus surgery , nostril , sinus (botany) , perioperative , endoscopic sinus surgery , nasal polyps , saline , nasal cavity , mucociliary clearance , randomized controlled trial , sinusitis , placebo , nasal packing , anesthesia , nose , botany , alternative medicine , pathology , lung , biology , genus
Objectives/Hypothesis To evaluate the potential efficacy of steroid‐soaked, absorbable calcium alginate nasal packing following endoscopic sinus surgery. Study Design Prospective, randomized, single‐blinded, placebo‐controlled trial. Methods Twenty‐two patients (44 nostrils) who had chronic rhinosinusitis with polyps underwent bilateral endoscopic sinus surgery. Only those with an intersinus difference in Lund‐Mackay severity score of 1 or less were included. In each patient, one randomly selected nostril was packed with calcium alginate soaked with 2 mL of triamcinolone (40 mg/mL) (triamcinolone group), whereas the contralateral nostril received an identical packing soaked in 2 mL of normal saline (saline group). Two independent investigators blinded to the packing allocation scored the surgical field using the validated Perioperative Sinus Endoscopy (POSE) scores 1, 4, and 8 weeks after surgery. Results All 44 nostrils were analyzed; the Lund‐Mackay scores did not differ significantly between the groups before surgery. Eight weeks after surgery, the total POSE scores were significantly lower in the triamcinolone group ( P = .014). The POSE scoring parameters were then compared between groups, and the following variables were significantly different: middle turbinate synechiae with the lateral wall ( P = .037), polypoid degeneration of the ethmoid cavity ( P = .006), and sphenoid sinus severity ( P = .036). Conclusions This study demonstrated that steroid‐soaked, absorbable nasal packing can be used to enhance wound healing after endoscopic sinus surgery and to prevent polypoid changes in the nasal mucosa. Level of Evidence 1b. Laryngoscope , 128:311–316, 2018