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.
Bibliographical noteFunding Information:
C.-H.K. received funding from the Basic Science Research Program through the National Research Foundation of Korea (NRF), funded by the Ministry of Education (2015R1D1A1A02062228), and the Bio and Medical Technology Development Program of the NRF, funded by the Ministry of Science, Information and Communications Technology, and Future Planning (MSIP) (2016M3A9D5A01952414). C.-H.K. is also supported by an NRF grant funded by the Korean Government (MSIP) (2016R1A5A2008630), the Yonsei University Future-Leading Research Initiative of 2015 (<2015-22-0114), and a faculty research grant from Yonsei University College of Medicine (6-2011-0122). The funding organizations had no role in study design, data collection or analysis, manuscript preparation, or the decision to publish.
The present study was approved by the institutional review board (IRB) of Yonsei University College of Medicine (IRB No. 1-2016-0052). Informed consent was obtained from all individual participants. All procedures performed in studies involving human participants were conducted in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments, or with comparable ethical standards. The present study was approved by the institutional review board (IRB) of Yonsei University College of Medicine (IRB No. 1-2016-0052). Informed consent was obtained from all individual participants.
© 2017 The American Laryngological, Rhinological and Otological Society, Inc.
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