Hyaluronic Acid: Perspectives in Upper Aero-Digestive Tract. A Systematic Review

Abstract

BackgroundTo date, topical therapies guarantee a better delivery of high concentrations of pharmacologic agents to the mucosa of the upper aerodigestive tract (UADT). The use of topical drugs, which are able to reduce mucosal inflammation and to improve healing tissues, can represent a relevant therapeutic advance. Topical sodium hyaluronate (SH) has recently been recognized as adjuvant treatment in the chronic inflammatory disease of the UADT.AimsThe aim of our work was to review the published literature regarding all the potential therapeutic effects of SH in the chronic inflammatory disease of UADT.MethodsRelevant published studies were searched in Pubmed, Google Scholar, Ovid using keywords (“sodium hyaluronate” and “upper airways”) or Medical Subject Headings.ResultsAt the end of our selection process, sixteen publications have been included. Six of them in the post-operative period of nasal-sinus surgery, 2 of them in pediatric patients affected by recurrent upper respiratory tract infections, 4 of them in reducing symptoms and preventing exacerbations of chronic upper airways in adult population, 4 of them in patients with chronic inflammatory disease of UADT, including gastro-esophageal reflux disease (GERD).ConclusionsTopical administration of SH plays a pivotkey role in the postoperative phase of patients undergoing FESS and nasal surgery, and positive results are generally observed in all the patients suffering from UADT chronic inflammatory disease.

Effect of topically applied hyaluronic acid on pain and palatal epithelial wound healing: An examiner‐masked, randomized, controlled clinical trial

“…On day 14, none of the patients had burning sensation in the test groups, whereas four had burning sensation in the control group. These results are consistent with properties of HA . Its application may act as a barrier for protection against irritating stimuli arising in the oral cavity which promotes disappearance of pain and burning sensation as stated in a previous study …”

“…This disappearance comes with the concomitant surface CE . During the healing period of the current study, postoperative discomfort was scored by patient self‐assessment using two aforementioned parameters, pain and burning sensation after exogenous use of HA, introduced as a practical means to enhance wound healing with unique physiochemical and biologic properties and, thus, quality of life …”

Hyaluronate effect on bacterial biofilm in ENT district infections: a review

“…Its highlights include non-immunogenicity, biocompatibility, biodegradability, and viscoelasticity. It also does not show interactions with drugs or general contraindications (11,28).…”

“…It also seems to play a role in the treatment of mucosal lesions such as oral ulcers, oral mucositis after radiation therapy, injury due to gastroesophageal reflux, and injuries to the gastric mucosa (28,32…”

Randomised trial on performance, safety and clinical benefit of hyaluronic acid, hyaluronic acid plus dexpanthenol and isotonic saline nasal sprays in patients suffering from dry nose symptoms

“…Such structures can reach large size and are able to trap large quantities of water and ions, providing hydration and tissue turgescence. Some studies indicate that hyaluronic acid enables the control of tissue hydration during inflammatory processes and/or the response to tissue injury, without exhibiting allergenic or immunogenic potential [29] .…”