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

Publication date: Available online 10 May 2018
Source:Brazilian Journal of Otorhinolaryngology
Author(s): Blazej Grzeskowiak, Malgorzata Wierzchowska, Rafal Walorek, Malgorzata Seredyka-Burduk, Katarzyna Wawrzyniak, Pawel Krzysztof Burduk
IntroductionEndoscopic sinus surgery can lead to crusting or synechiae formation, which can affect the healing process.ObjectiveThe aim of our study was to compare the influence of steroid versus antibiotic versus saline solution impregnated absorbable nasal spacers on postoperative wound healing and patient satisfaction.MethodsEighty patients, 33 women and 47 men, were enrolled in this study. At the end of the surgery, two pieces of 4cm biodegradable material were applied in each ethmoid cavity. One of them was impregnated with saline solution, while the second one with steroid, or with antibiotic.ResultsWe observed statistically significant differences in the Lund–Kennedy score between the control and both treatment groups: for the Antibiotic-group on days 10 and 30 (p=0.009; p=0.009) and for the Steroid-group on day 90 (p=0.008). The extended endoscopic appearance of nasal mucosa indicated statistically significant differences in crust formation on day 10 comparing the steroid and control dressing (p=0.025), in secretion type on days 10 and 30 comparing the antibiotic and control dressing (p=0.003; p=0.016) and additionally for steroid and control on day 90 (p=0.046). On Day 90 we observed statistically significant differences in the absence of mucosal edema in the S-group compared to controls (p=0.007).ConclusionsThe results of this study reveal the significant positive influence of steroid- and antibiotic-impregnated biodegradable nasal packing on the postoperative healing process and patient satisfaction compared to the saline soaked dressing.



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