Randomized controlled trial of steroid-soaked absorbable calcium alginate nasal packing following endoscopic sinus surgery

Chi Sang Hwang, Salma Saud Al Sharhan, Bo Ra Kim, Soo In Kim, Jin Woong Kim, Hyung Ju Cho, Joo Heon Yoon, Chang Hoon Kim

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Abstract

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.

Original languageEnglish
Pages (from-to)311-316
Number of pages6
JournalLaryngoscope
Volume128
Issue number2
DOIs
Publication statusPublished - 2018 Feb 1

All Science Journal Classification (ASJC) codes

  • Otorhinolaryngology

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    Hwang, C. S., Al Sharhan, S. S., Kim, B. R., Kim, S. I., Kim, J. W., Cho, H. J., Yoon, J. H., & Kim, C. H. (2018). Randomized controlled trial of steroid-soaked absorbable calcium alginate nasal packing following endoscopic sinus surgery. Laryngoscope, 128(2), 311-316. https://doi.org/10.1002/lary.26871