Comparative Study between Absorbable Carboxymethyl Cellulose and NonAbsorbable Merocel Nasal Packs after Sinonasal Surgery

Abstract

Background: Nasal packings can help in control of postoperative bleeding and healing following functional endoscopic sinus surgery (FESS) and nasal surgeries, but traditional non-resorbable packs have several inherent drawbacks. Objectives: This study was done to evaluate the effect of carboxy methyl cellulose (CMC) gel and merocel nasal packs after sinonasal surgery regarding postoperative bleeding, pain, pressure headache and formation of synechia. Patients and Methods: A total of 40 patients who had undergone sinonasal surgery were studied prospectively. At the end of the operation each patient was packed with dissolvable CMC gel in the right side of the nose and merocel in the left side. The haemostatic effect of the CMC and merocel was assessed during the recovery period. Results: six (15%) of the patients packed with CMC had primary postoperative bleeding during the recovery period. Bleeding appeared in four (10%) patients packed with merocel. We observed significant intergroup differences in the level of pain and pressure headache. The CMC group was superior to merocel group and there was a significant low level of pain and pressure headache in the CMC group. Two (5%) of CMC patients and six (15%) of merocel patients developed a synechia at the 4 weeks period. Four (10%) of CMC patients and Ten (25%) of merocel patients developed synechia at the 8 weeks period post operative. Conclusion: We found that dissolvable CMC pack is associated with very low levels of localised pain, pressure headache and with low levels of postoperative bleeding and synechia formation.