scholarly journals Hot saline irrigation in comparison to nasal packing after sinus surgery

2021 ◽  
Author(s):  
Axel Nordström ◽  
Mattias Jangard ◽  
Marie Svedberg ◽  
Helena Kullenberg ◽  
Michael Ryott ◽  
...  
Keyword(s):  
Nasal Packing ◽  
Sinus Surgery ◽  
Saline Irrigation

Bioabsorbable dressing impregnated with betamethasone and ciprofloxacin after endoscopic sinus surgery: A randomized, double-blind, placebo-controlled study

2021 ◽  
pp. 014556132110624
Author(s):  
Małgorzata Wierzchowska ◽  
Paulina Kalińczak-Górna ◽  
Błażej Grześkowiak ◽  
Kamil Radajewski ◽  
Jakub Burduk ◽  
...  
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Healing Process ◽  
Nasal Packing ◽  
Sinus Surgery ◽  
Controlled Study ◽  
Nasal Surgery ◽  
Double Blind ◽  
Nasal Blockage ◽  
Positive Effects ◽  
Mucosal Edema

Background In addition to its hemostatic and stabilization role, biodegradable nasal packing can be used as a carrier for drugs after functional endoscopic sinus surgery (FESS). The aim of this study was to compare the influence of biodegradable synthetic polyurethane foam (NasoPore) soaked with ciprofloxacin, or betamethasone, or both to the same foam soaked with saline after FESS. Methods 120 adults with chronic rhinosinusitis, with and without polyps, directed for bilateral full-house FESS were enrolled for the study. The patients were randomized and blinded into 3 groups, depending on the type of postoperative procedure applied. Thus, NasoPore soaked with antibiotic was provided to the first group; in the second group, the steroid was used; and the combination of both, in the third group. In each case, the aforementioned procedure was administered on one side of the nose, while NasoPore was soaked in saline on the other, at the end of the surgery, respectively. The patients were requested to complete a questionnaire during their postoperative visits at 2, 10, 30, 90, and 180 days, scoring the level of complaints on the VAS scale, separately for each side. The evaluation of the healing process was performed at each visit using rigid endoscopy and subsequently rated on numerical scales. Results Decreased mucosal edema and secretion; reduced Lund-Kennedy score; and favorable influences on facial pressure, nasal blockage, and smell were most evidently seen in the group receiving the antibioticsteroid combination. Conclusions The application of biodegradable nasal packing with betamethasone and ciprofloxacin in sino-nasal surgery has positive effects not only on the healing process but also impacts patient’s comfort. To optimize it, however, further research is needed.

The Effect of FloSeal on Mucosal Healing after Endoscopic Sinus Surgery: A Comparison with Thrombin-Soaked Gelatin Foam

2003 ◽  
Vol 17 (1) ◽  
pp. 51-55 ◽  
Author(s):  
Rakesh K. Chandra ◽  
David B. Conley ◽  
Robert C. Kern
Keyword(s):  
Granulation Tissue ◽  
Endoscopic Sinus Surgery ◽  
Adhesion Formation ◽  
Mucosal Healing ◽  
Nasal Packing ◽  
Sinus Surgery ◽  
Patient Comfort ◽  
Rapid Healing ◽  
Extent Of Surgery ◽  
High Degree

Background The optimal form of nasal packing after endoscopic sinus surgery (ESS) still has not been established. Although wide variations exist among sinus surgeons, the goals are adequate hemostasis, rapid healing, and patient comfort. Preliminary studies indicated that FloSeal (FS), a novel absorbable hemostatic paste used as a nasal pack, was associated with minimal postoperative discomfort and effective hemostasis. This study was designed to evaluate the effects of this agent on mucosal healing in ESS. Methods Twenty consecutive patients underwent bilateral ESS. For each patient, one ethmoid cavity was randomized to receive FS and the other received thrombin-soaked gelatin foam. The extent of granulation tissue and adhesion formation was evaluated at 6–8 weeks after surgery. Results No significant differences were observed between the FS and the thrombin-soaked gelatin foam groups with respect to the preoperative Lund-Mackay score, extent of surgery performed, or need for additional nasal packing. However, the FS group showed clear trends toward increased granulation tissue (p = 0.007) and adhesion (p = 0.006) formation. Conclusion: Absorbable hemostatic agents are associated with a high degree of patient comfort and provide hemostasis comparable with traditional techniques. Different materials may induce differential patterns of mucosal healing, potentially affecting the ultimate result of ESS.

scholarly journals Assessment of Nasal Airflow and Pain, Safety and Cost of an Improvised Nasal Airway (Nasogastric) Tube After Endoscopic Sinus Surgery

2020 ◽  
Vol 35 (2) ◽  
pp. 22
Author(s):  
Josephine Grace Rojo ◽  
Rachel Zita Ramos
Keyword(s):  
Pain Score ◽  
Postoperative Period ◽  
Nasogastric Tube ◽  
Endoscopic Sinus Surgery ◽  
Nasal Packing ◽  
Sinus Surgery ◽  
Nasal Airway ◽  
Nasal Airflow ◽  
Significant Difference ◽  
Group A

ABSTRACT Objective: To compare subjective nasal airflow and overall pain score (as well as safety and added cost of) using an improvised nasal airway tube (nasogastric tube) versus nasal packing after endoscopic sinus surgery (ESS) for chronic rhinosinusitis with nasal polyposis (CRSwNP). Methods:Design: Quasi - Experimental Prospective Cohort StudySetting: Tertiary Government Training HospitalParticipants: Twenty-six (26) consecutive patients aged 18 to 77 years old diagnosed with CRSwNP who underwent ESS were alternately assigned to an experimental group (A) of 13, where an improvised nasal airway (nasogastric) tube was placed in addition to the nasal pack or a control group (B) of 13 with nasal packing alone. Results: There was a significant difference in subjective nasal airflow between experimental (A) and control (B) groups during the immediate postoperative period where the mean subjective airflow was 8.07 and 0.00 over 10.00, respectively. No significant difference was noted between the groups in terms of age, gender, severity of polyposis and overall pain score. No complications such as bleeding, Toxic Shock Syndrome, vestibular or alar injury and septal necrosis were noted immediately post-op and after one week follow-up in both groups. An approximate cost of PhP 25 was added to group A. Conclusion: An improvised nasal airway using a nasogastric tube provides adequate airflow without additional pain in the immediate postoperative period. It is safe to use and an affordable option for patients in need of nasal airway stents residing in areas where a preformed nasal packing with incorporated tube stent is not available.

scholarly journals Maximal Medical Therapy for Chronic Rhinosinusitis: A Survey of Chinese Otolaryngologists

2019 ◽  
Vol 99 (3) ◽  
pp. 159-164
Author(s):  
Zhenxiao Huang ◽  
Jingying Ma ◽  
Yan Sun ◽  
Bing Zhou
Keyword(s):  
Chronic Rhinosinusitis ◽  
Medical Therapy ◽  
Practice Patterns ◽  
Demographic Data ◽  
Sinus Surgery ◽  
Oral Antibiotics ◽  
Intranasal Corticosteroid ◽  
Saline Irrigation ◽  
Frequency Of Use ◽  
Maximal Medical Therapy

The aim of the present study was to evaluate the clinical practice patterns in maximal medical therapy (MMT) before endoscopic sinus surgery for chronic rhinosinusitis (CRS) by Chinese otolaryngologists. An anonymous web-based survey of MMT was performed. This survey assessed types of therapies, the frequency of use, duration of use, and demographic data of respondents. A total of 134 (26.8%) questionnaires were completed and returned. The majority (62.69%) of respondents would consider surgery less than 3 months after commencing MMT, 33.58% would wait 3 to 6 months. Intranasal corticosteroid sprays, saline irrigation, oral antibiotics, oral mucolytics, and oral Chinese herbals were the most commonly used therapies and listed as “often (>70%)”. Macrolides were most commonly antibiotics prescribed among the clinicians surveyed (51.49%). Intranasal corticosteroid sprays, oral antibiotics, oral mucolytics, nasal saline irrigations, and oral Chinese herbals are most commonly prescribed by the majority of Chinese otolaryngologists as MMT for CRS. Current practice patterns of MMT among Chinese otolaryngologists are not uniformly based on evidence-based guidelines.

Use of Fibrin Glue as a Hemostatic in Endoscopic Sinus Surgery

2005 ◽  
Vol 114 (3) ◽  
pp. 237-241 ◽  
Author(s):  
Michael Vaiman ◽  
Nathan Shlamkovich ◽  
Ephraim Eviatar ◽  
Samuel Segal
Keyword(s):  
Fibrin Glue ◽  
Endoscopic Sinus Surgery ◽  
Second Generation ◽  
Postoperative Bleeding ◽  
Nasal Packing ◽  
Sinus Surgery ◽  
Special Treatment ◽  
Nasal Bleeding ◽  
Group 2 ◽  
Group 1

Endoscopic sinus surgery (ESS), especially when combined with turbinectomy and/or with submucous resection of the septum, may involve postoperative bleeding that might end with nasal packing. Nasal packing causes pain, rhinorrhea, and inconvenience and may not stop the postoperative bleeding. The aim of our study was to compare the hemostatic properties of the second-generation surgical sealant Quixil (Crosseal) with those of nasal packing in ESS. We performed a prospective randomized trial in 64 consecutive patients who underwent ESS and presented excessive intraoperative and/or postoperative bleeding. They were allocated by the sealed-envelope method into two groups. A routine ESS procedure was ended with Merocel nasal packing in group 1, and with aerosol application of Quixil sealant at the operative site in group 2. The hemostatic effects were evaluated objectively in the clinic by anterior rhinoscopy and endoscopy and assessed subjectively by the patients at follow-up visits. In group 1, various types of postoperative bleeding occurred in 25% of patients. In group 2 there was no postoperative bleeding, except for 1 case of late hemorrhage (3.12%). Drainage and ventilation of the paranasal sinuses were not impaired. There were no allergic reactions to the glue. We conclude that aerosol application of fibrin glue can be readily performed in ESS, requires no special treatment (antibiotics), and appears to have an adequate hemostatic effect. The use of this second-generation glue in ESS appears to stop nasal bleeding well and to be relatively safe and convenient.

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