Effects of mometasone furoate–impregnated biodegradable nasal dressing on endoscopic appearance in healing process following endoscopic sinus surgery: a randomized, double‐blind, placebo‐controlled study

Abstract

Background Postoperative care is an important factor affecting the outcome of endoscopic sinus surgery (ESS) in patients with chronic rhinosinusitis (CRS). The aim of this study was to test the effect of mometasone furoate (MF)‐soaked biodegradable nasal dressings (BNDs) on endoscopic appearance in CRS patients with nasal polyps (CRSwNP) after ESS. Methods This study was a prospective, randomized, double‐blinded, placebo‐controlled study. A total of 64 CRSwNP patients with bilateral ESS were enrolled and randomly given 4 mL or 8 mL of MF‐soaked BNDs (NasoPore) in 1 nasal cavity and the same amount of normal saline‐soaked BNDs in the contralateral side. The BNDs were removed on the 7th or 14th postoperative day. Perioperative sinus endoscopy (POSE) and Lund‐Kennedy scores were collected, on the 7th or 14th postoperative days and at 1, 2, and 3 postoperative months. Results The POSE and Lund‐Kennedy scores showed that in the 4‐mL, 1‐week group, no significant differences between the sides treated with MF‐soaked BNDs and the normal saline‐soaked control were observed at any postoperative visits. In the 4‐mL, 2‐week group, significant differences were found at the 2‐week and 1‐month postoperative visits but not at the 2‐month and 3‐month visits. In the 8‐mL, 1‐week group, significant differences were found at the 1‐week, 1‐month, and 2‐month postoperative visits but not at the 3‐month visit. In the 8‐mL, 2‐week group, significant differences were found at all postoperative visits. Conclusion This study reveals that MF‐impregnated BNDs improve the endoscopic appearance in the healing process of CRSwNP after ESS.

Efficacy and safety of steroid‐impregnated implants following sinus surgery: A meta‐analysis

“…10,14 Furthermore, the differences in the durations of the included trials (1, 2, or 3 months) were a potential source of heterogeneity, and the follow-up time is extremely short. Finally, the types of bioabsorbable implants were different, including Gelfoam dressing (Pfizer, New York, NY), 18 NasoPore dressing (Stryker, Kalamazoo, MI), 16,17 calcium alginate dressing (Algi-Pack，Seoul), 21 SinuBand dressing (MedtronicXomed Inc., Jacksonville), 20 stents, 10,14 and Sinus-Foam spacer (Athrocare, Sunnyvale), 19 which may have led to heterogeneous results. To reinforce the validity of our meta-analysis, clinical trials of the same implant soaked in steroid following ESS as well as extended followup trials should be conducted in the future.…”

“…14 Six studies were ruled out because the treatment was in-office; six studies were excluded because the dates were not available; and 13 studies were ruled out because the studies were not randomized controlled trials (RCTs). Ultimately, eight published articles were eligible for analysis, 10,14,[16][17][18][19][20][21] and the study reported by Adriaensen et al 20 was a three-arm study.…”

Efficacy of Absorbable Steroid‐Impregnated Nasal Packing in Functional Endoscopic Sinus Surgery for Chronic Rhinosinusitis: A Systematic Review

“…Two independent reviewers assessed the abstracts of the identified articles, excluding 1,067 of these records. Twenty-five full-text articles were assessed, with eight studies [18][19][20][21][22][23][24][25] having met eligibility criteria and thus were included in this review (Fig. 1).…”

Intraoperative Applications of Topical Corticosteroid Therapy for Chronic Rhinosinusitis

“…Finally, a randomized, double-blind, placebo-controlled trial was published in 2018 by Zhao et al 21 using a mometasone-impregnated NasoPore. Patients were randomized to receive first an 8-cm NasoPore, dosed with either 4 (1400 mg) or 8 (2800 mg) mL of mometasone, in one nasal cavity, and then a saline-impregnated NasoPore in the contralateral nasal cavity.…”