Abstract
ObjectivesTo assess biodegradable nasal packing effectiveness for improving postoperative symptoms and mucosal healing after endoscopic sinonasal surgery as compared with conventional/non-packing groups.MethodsRelevant articles were searched on PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials. We included randomized controlled trials (RCTs) that compared biodegradable packings with conventional packings or no packing, reporting postoperative symptoms and/or mucosal healing outcomes.ResultsThis review included 19 studies, of which 11 compared biodegradable packings with conventional packings. Meta-analysis found that biodegradable packings significantly improved postoperative symptoms: bleeding at removal, pain at removal, pain in situ, and nasal blockage. Mucosal healing outcomes were inconsistent within studies, with no data could be pooled. Eight studies compared biodegradable packings with non-packing group. Postoperative symptom data in this comparison could not be pooled: A protective or equal effect on postoperative bleeding was reported in different studies; no difference was reported in pain status and nasal blockage. As for mucosal healing, meta-analysis showed that two arms of comparison had similar effect on synechiae, edema, infection and granulation at each time point.ConclusionThe limiting evidence suggests that biodegradable nasal packings are statistically better than conventional packings in postoperative symptoms, and probably comparable to non-packing group, as in this comparison we could not carry out meta-analysis. No beneficial or detrimental effect on postoperative mucosal healing could be determined based on existing evidence.
Highlights
BackgroundChronic rhinosinusitis (CRS), septal deviation, and inferior turbinate hypertrophy are among the most common diseases seen in the ENT department; these affect patients of all ages and both genders
Studies were eligible for inclusion if they met the following criteria: (1) Research design: randomized controlled trials (RCTs) (2) Language: English (3) Participants: patients who underwent any type of sinonasal surgeries as below: N functional endoscopic sinus surgery (FESS) or termed as endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS)
Our meta-analysis suggested biodegradable nasal packings can offer patients a good quality of life during the early recovery period
Summary
Chronic rhinosinusitis (CRS), septal deviation, and inferior turbinate hypertrophy are among the most common diseases seen in the ENT department; these affect patients of all ages and both genders They can cause recurrent or persistent nasal obstruction and/or a runny nose. Sometimes, they may induce anosmia, headache, dizziness, and/or insomnia, having a significant impact on life quality. At the close of operations, nasal packings are placed into the nasal cavities to prevent bleeding of the wound and provide a ‘‘scaffold’’ for wound healings These years, the development of functional endoscopic sinus surgery (FESS) and mucosal-sparing technique has made postoperative bleeding less threatening [1]. Rhinologists nowadays highly value minimal complications, satisfying life quality and optimized mucosal healing when choosing a postoperative treatment regimen [2]
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