Bioabsorbable dressing impregnated with betamethasone and ciprofloxacin after endoscopic sinus surgery: A randomized, double-blind, placebo-controlled study

2021 ◽  
pp. 014556132110624
Author(s):  
Małgorzata Wierzchowska ◽  
Paulina Kalińczak-Górna ◽  
Błażej Grześkowiak ◽  
Kamil Radajewski ◽  
Jakub Burduk ◽  
...  
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Healing Process ◽  
Nasal Packing ◽  
Sinus Surgery ◽  
Controlled Study ◽  
Nasal Surgery ◽  
Double Blind ◽  
Nasal Blockage ◽  
Positive Effects ◽  
Mucosal Edema

Background In addition to its hemostatic and stabilization role, biodegradable nasal packing can be used as a carrier for drugs after functional endoscopic sinus surgery (FESS). The aim of this study was to compare the influence of biodegradable synthetic polyurethane foam (NasoPore) soaked with ciprofloxacin, or betamethasone, or both to the same foam soaked with saline after FESS. Methods 120 adults with chronic rhinosinusitis, with and without polyps, directed for bilateral full-house FESS were enrolled for the study. The patients were randomized and blinded into 3 groups, depending on the type of postoperative procedure applied. Thus, NasoPore soaked with antibiotic was provided to the first group; in the second group, the steroid was used; and the combination of both, in the third group. In each case, the aforementioned procedure was administered on one side of the nose, while NasoPore was soaked in saline on the other, at the end of the surgery, respectively. The patients were requested to complete a questionnaire during their postoperative visits at 2, 10, 30, 90, and 180 days, scoring the level of complaints on the VAS scale, separately for each side. The evaluation of the healing process was performed at each visit using rigid endoscopy and subsequently rated on numerical scales. Results Decreased mucosal edema and secretion; reduced Lund-Kennedy score; and favorable influences on facial pressure, nasal blockage, and smell were most evidently seen in the group receiving the antibioticsteroid combination. Conclusions The application of biodegradable nasal packing with betamethasone and ciprofloxacin in sino-nasal surgery has positive effects not only on the healing process but also impacts patient’s comfort. To optimize it, however, further research is needed.

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

2019 ◽  
Vol 85 (4) ◽  
pp. 473-480 ◽  
Author(s):  
Blazej Grzeskowiak ◽  
Malgorzata Wierzchowska ◽  
Rafal Walorek ◽  
Malgorzata Seredyka-Burduk ◽  
Katarzyna Wawrzyniak ◽  
...  
Keyword(s):  
Wound Healing ◽  
Endoscopic Sinus Surgery ◽  
Nasal Packing ◽  
Sinus Surgery ◽  
Controlled Study ◽  
Double Blind ◽  
Double Blind Placebo

scholarly journals Metoprolol Significantly Improves Visual Clarity and Hemodynamic Parameters during Functional Endoscopic Sinus Surgery

2019 ◽  
Vol 4 (2) ◽  
pp. 1-8
Author(s):  
Ahmed A. Sadek ◽  
Mokhtar Mostafa ◽  
Tarek Abdel-Monem
Keyword(s):  
Blood Loss ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Controlled Study ◽  
Double Blind ◽  
Arterial Blood ◽  
Surgical Field ◽  
Group 2

Background and Objectives: The success of functional endoscopic sinus surgery (FESS) depends on the visual clarity of the surgical field, which is understudied. Controlled hypotension has many advantages for FESS including reduction in blood loss and improved quality of the surgical field. This study determined whether the use of β-blockers as a premedication could improve the operative field in FESS. Methods: Sixty patients aged from 18 to 50 years, undergoing septoplasty and FESS were included in this prospective, randomized, double-blind, placebo-controlled study. Patients were randomly assigned to receive either metoprolol (100 mg, group 1) or a placebo (a vitamin tablet, group 2) 60 min before surgery. Results: The average blood loss and surgery duration were not significantly higher in the placebo group. The surgical field was graded using the Fromme-Boezaart scale, and it was significantly clearer (p < 0.001) in metoprolol group. The mean arterial blood pressure was significantly lower in the metoprolol group after 30 min of induction until the end of surgery (p < 0.001). The heart rate was also significantly lower (p < 0.001) in those who received metoprolol from before induction of anesthesia up to the end of surgery. Conclusion: Metoprolol significantly improves visual clarity and hemodynamics during FESS. We would recommend the use of metoprolol in FESS and septoplasty.

scholarly journals Comparison of Absorbable Packing versus No Packing in Wound Healing after Endoscopic Sinus Surgery: A Systematic Review and Pooled Analysis

ORL ◽  
2021 ◽  
pp. 1-8
Author(s):  
Zhenxiao Huang ◽  
Bing Zhou
Keyword(s):  
Systematic Review ◽  
Wound Healing ◽  
Endoscopic Sinus Surgery ◽  
Adhesion Formation ◽  
Pooled Analysis ◽  
Nasal Packing ◽  
Sinus Surgery ◽  
Cochrane Library ◽  
Significant Difference ◽  
Mucosal Edema

<b><i>Introduction:</i></b> Nasal packing after endoscopic sinus surgery (ESS) is controversial. The aim of this systematic review was to compare absorbable packing versus no packing in wound healing after ESS for the treatment of chronic rhinosinusitis. <b><i>Data Source:</i></b> English electronic databases, including Cochrane Library, EMBASE, MEDLINE, and PubMed, were searched, and only randomized controlled trials were included. <b><i>Methods:</i></b> The outcome measures were the presence of synechiae/adhesion formation, mucosal edema, crusting, granulation formation, and infection. The McNemar’s test was used for pooled analysis. <b><i>Results:</i></b> Four studies with 148 participants were included. The pooled analysis showed that absorbable packing may offer benefit in reducing adhesion at 6–8 weeks (odds ratio [OR]: 0.3864; 95% confidence interval [CI]: 0.2136–0.7235) and 12 weeks (OR: 0.2396, 95% CI: 0.08267–0.7709) postoperatively compared with no packing. There was no significant difference between the packed and the unpacked side at 2, 6–8, and 12 weeks after ESS in terms of presence of crusting, edema, and granulation formation. <b><i>Conclusion:</i></b> There is insufficient evidence to suggest that absorbable packing after ESS does not increase mucosal edema, granulation formation, and infection. However, the absorbable packing may be more effective than no packing for the prevention of mucosal adhesion after ESS. The use of absorbable nasal packing after ESS is recommended when used to reduce postoperative mucosal adhesion. More research in this area is clearly needed.

scholarly journals Effects of intrapolyp steroid injection on intraocular pressure and recurrent polyp treatment

Eye ◽  
2021 ◽  
Author(s):  
Tae-Hoon Lee ◽  
Jung-Gwon Nam ◽  
Chang Kyu Lee
Keyword(s):  
Intraocular Pressure ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Controlled Study ◽  
Polyp Size ◽  
Double Blind ◽  
Injection Group ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

Abstract Purpose To examine the effects of intrapolyp triamcinolone acetonide (TA) injections on intraocular pressure (IOP) and recurrence of nasal polyps after endoscopic sinus surgery. Patients and methods This was a prospective, randomized, double-blind, placebo-controlled study. Patients were randomized into either the TA injection group (Group I, 20 mg/ml, 2 mL) or the placebo normal saline injection group (group II, 2 mL). There were a total of five study visits: one baseline visit and one at 2, 4, 8, and 12 w after the injection. The primary safe outcome was the change in IOP between two groups at 4 w. The secondary safe outcome was the IOP at each visit and proportion of patients having IOP above 21 mmHg at 4 and 8 w. Changes in the nasal polyp size were measured between two groups at each visit. Results A total of 43 consenting participants completed this study (22 in group I and 21 in group II). The mean IOP elevation in both eyes was not significantly different between the groups (p > 0.05) and was not over 2 mmHg at the 4-w mark. There was also no significant difference in the proportion of patients having IOP above 21 mmHg at 4 and 8 w between the groups (p > 0.05). However, there was a significant difference in the change in polyp size until 8 w between both groups (p < 0.01). Conclusions Intrapolyp TA injection is a safe and effective method for the management of recurrent polyps after endoscopic sinus surgery.

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