Efficacy and Safety of 3 Nasal Packing Materials Used After Functional Endoscopic Sinus Surgery for Chronic Rhinosinusitis: A Comparative Study in China

Abstract

BackgroundThis study aimed to investigate the efficacy and safety of 3 nasal packing products (silicone tube, Beschitin-F, and Aquacel1-Ag) after functional endoscopic sinus surgery (FESS) for chronic rhinosinusitis (CRS) patients in China.Material/MethodsSixty-six CRS patients undergoing FESS surgery were randomly divided into 3 groups (22 patients in each group): the silicone tube group, the Beschitin-F group, and the Aquacel1-Ag group. Postoperative headache, nasal pain, nasal bleeding, and swelling of the nasal mucosa were observed at 1 month after FESS surgery. Bacteriology of chronic rhinosinusitis was conducted by culturing the removed nasal packing.ResultsThe VAS scores of nasal pain in the silicone tube group were lower than in the Beschitin-F and the Aquacel1-Ag groups. The volume of nasal bleeding in the Beschitin-F group was higher than in the silicone tube and Aquacel1-Ag groups. The adhesion rate of the nasal cavity in the Beschitin-F1 group (2/22, 9.1%) was also higher than in the silicone tube group (0/22, 0%) and the Aquacel1-Ag group (0/22, 0%). The results of bacterial culture from removed nasal packing showed that coagulase-negative staphylococci (CNS) was more frequent in the silicone tube group than in the Beschitin-F and Aquacel1-Ag groups, but Streptococcus pneumonia, Haemophilus influenza, and Gram-negative rods were more common in the Aquacel1-Ag group than in the silicone tube and Beschitin-F groups.ConclusionsThese results indicate that the silicone tube may be more effective and safe than Beschitin-F and Aquacel1-Ag as nasal packing after FES surgery for CRS.

Optimizing Perioperative Care in Transsphenoidal Pituitary Surgery: Considerations for Enhanced Recovery After Surgery

“…These include but are not limited to sinusitis, epistaxis, synechia formation, and anosmia 71,76,101. Nasal packing is a commonly implemented intervention for improvement of hemostasis following ESS, and has been extensively investigated through RCTs and systematic reviews in recent years 102–106. Nasal packing has also been suggested as a component of routine operative care in patients undergoing TSA 107…”

“…71,76,101 Nasal packing is a commonly implemented intervention for improvement of hemostasis following ESS, and has been extensively investigated through RCTs and systematic reviews in recent years. [102][103][104][105][106] Nasal packing has also been suggested as a component of routine operative care in patients undergoing TSA. 107 The level of evidence supporting nasal packing after ESS has not yet been established in the TSA patient population.…”

Influence of Chitosan-Based Dressing on Prevention of Synechia and Wound Healing after Endoscopic Sinus Surgery: A Meta-Analysis

“…32,33 Many biodegradable material products, e.g., NasoPore, Cutanplast (Mascia Brunelli Spa, Milano, Italy), hyaluronic acid, and carboxymethylcellulose, have been developed to serve as nasal packings. [34][35][36][37] Biodegradable packings were reported to enhance sufficient hemostasis though facilitating water uptake or stimulating clotting. 4 Their dissolution occurred in a couple of days.…”

Postoperative Bioresorbable Chitosan-Based Dressing for Endoscopic Middle Meatal Dacryocystorhinostomy With Balloon Dilation

“…Reviews also offered mixed evidence for improved granulation at the operative site. 11,14 More specifically, another study found that one type of chitosan-based hemostatic dressing was effective as a hemostatic agent across multiple DCR modalities. 15 A more recent addition to our practice, XeroGel (Entellus Medical Inc, Plymouth, Minnesota) is a biocompatible, dissolvable chitosan-based sponge that expands when hydrated to tamponade local intranasal structures, thereby minimizing postoperative bleeding and edema.…”

“…12 Induction of endothelin production and promotion of red blood cell and platelet adhesion contribute to barrier formation and wound sealing in the surgical setting. 13 Multiple systematic reviews reported that, unlike conventional packing or most other bioresorbable dressings, chitosan-based gel reduced synechiae following endoscopic sinus surgery. No impact on crusting or infection was observed.…”