Product comparison model in otolaryngology: Equivalency analysis of absorbable hemostatic agents after endoscopic sinus surgery

Antisdel, Jastin L.; Meyer, A; Comer, Brett T.; Jang, David W.; Gurrola, José; Khabbaz, Eyad; Christopher, Kara M.; Kountakis, Stilianos E.

doi:10.1002/lary.25678

Cited by 12 publications

(19 citation statements)

References 44 publications

(90 reference statements)

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“…In terms of other biomaterials, two materials, fibrin [41] and chitosan [42,43], demonstrated superior wound healing and hemostatic properties in comparison to the non-absorbable nasal packing while cellulose [44], potato starch [45], carboxymethyl cellulose [46], polyurethane [47], and polyethylene glycol [48] remain similar to the untreated control or non-absorbable packing [31]. Table 1 summarizes the effect of absorbable nasal pack made with different biomaterials.…”

Section: Nasal Packingmentioning

confidence: 99%

Current and Alternative Therapies for Nasal Mucosa Injury: A Review

Selvarajah

Saim

Idrus

et al. 2020

IJMS

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Nasal mucosa injury can be caused by trauma, radiotherapy, chronic infection such as sinusitis, and post sinus surgery. The rate of healing and its treatment are important in the recovery of patients especially in post sinus surgery, which introduces new injuries. In this review, the current knowledge in terms of the mechanism underlying nasal wound healing was initially discussed. The currently available treatment options for enhancement of wound healing following sinus surgery were discussed and these had included intravenous antibiotics or steroids, various nasal sprays, and nasal packing. In addition, emerging alternative therapies in nasal mucosa wound healing such as herbal medicine and the advancement of regenerative medicine therapies such as stem cells and their byproducts were also discussed. Despite the various available treatment options for wound healing in nasal mucosa, rigorous strong evidence of their efficacy is gravely warranted in order to recommend them as part of the treatment modality.

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Section: Nasal Packingmentioning

confidence: 99%

Current and Alternative Therapies for Nasal Mucosa Injury: A Review

Selvarajah

Saim

Idrus

et al. 2020

IJMS

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“…The evolution of packing into AHP has lessened this discomfort, but AHPs have not been clearly shown to reduce complications significantly. [9][10][11][12] These concerns have raised questions of whether any type of packing is required after FESS. One retrospective study used hemostatic packing in 11% of patients, with the remainder of patients left without packing.…”

Section: Discussionmentioning

confidence: 99%

“…The use of VAS to evaluate outcomes following FESS has been described in the literature. 9,10,12,14 Both senior surgeons have participated in previous studies using this form and evaluation mechanism. See Appendix 1 for patient and surgeon forms.…”

Section: Methodsmentioning

confidence: 99%

“…Recent studies have demonstrated the potential for avoiding packing materials entirely, which would also serve as a cost-saving measure. [9][10][11][12] A 2014 study evaluated Nasopore V R specifically and found no hemostatic advantage, but improved comfort after its use. 13 The drawback to prior studies examining AHPs is that the studies were performed in controlled conditions to evaluate highly select patient types and operations that may not represent sinus surgery as it is performed a majority of the time.…”

Section: Introductionmentioning

confidence: 99%

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Analysis of Absorbable Hemostatic Packing Compared to Physiologic Hemostasis in Functional Endoscopic Sinus Surgery With or Without Septoplasty

Comer

Alfonso

Doyle

et al. 2019

Am J Rhinol�Allergy

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Background There currently are no randomized studies examining if absorbable hemostatic packing (AHP) results in better objective and subjective outcomes than physiologic healing in sinus surgery with or without septoplasty. Objective The objective of this study is to examine outcomes after functional endoscopic sinus surgery (FESS) with or without septoplasty with the use of AHP versus physiologic hemostasis and healing. Methods A prospective randomized control trial was performed at 2 tertiary academic institutions. Fifty-nine patients undergoing bilateral FESS with or without septoplasty were enrolled and randomized to receive AHP in 1 middle meatus and no packing contralaterally. Subjective outcomes (pain, bleeding, obstruction, discharge) on self-reported visual analog scale questionnaires were tabulated on postoperative days 0, 1, 7, and 14 by the patient. Endoscopic outcomes (synechiae formation, edema, infection, granulation, debridement, crusting) were measured at 1 week, 2 weeks, and 6 weeks postoperatively by their surgeon. Results No significant differences were identified in subjective or endoscopic outcomes with AHP use. Concurrent septoplasty patients with AHP experienced no sustainable difference in subjective or endoscopic outcomes compared to septoplasty control. No sustainable differences were found among the types of AHP or the 2 surgeons. Conclusion This first reported prospective randomized study of patients with nonstrict selection criteria found AHP made no significant difference on subjective and objective postoperative outcomes as compared to physiologic hemostasis. Previous AHP-specific studies have shown differences in carefully selected patient groups. Generalizing study-proved benefits of specific AHP to all AHP is shown to be not appropriate.

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“…8,9 Postoperative recovery was affected by scarring and reobstruction of the ostiomeatal complex. 8,10 Nasal packing was reported to be one common approach to prevent postoperative bleeding and promote wound healing. 11,12 Conventional nasal packings included gauze, cotton, and sponge.…”

mentioning

confidence: 99%