orabase and Rhinitis

Calcium alginate is a biodegradable gel-transforming agent widely used for nasal packing. It can reduce pain and improve comfort. However, few randomised controlled trials have compared the efficacy of calcium alginate nasal packing with that of other biodegradable gel-transforming materials.. Prospective, randomised, single-blinded controlled study.. Yonsei University Severance Hospital, a tertiary academic medical centre.. Twenty-seven patients (54 nostrils) with chronic rhinosinusitis who were scheduled for bilateral endoscopic sinus surgery were enrolled. After surgery, one nostril was packed with calcium alginate and the other with carboxymethyl cellulose. Only patients with an intersinus chronic rhinosinusitis severity score difference of ≤1 were included.. Visual analogue scale (VAS) scores for postoperative pain, discomfort from nasal discharge and pain during packing removal were analysed. Two independent rhinologists who were blinded to the assessments separately scored adhesions, oedema and infection by endoscopic digital photography at 1, 4 and 8 weeks postoperatively.. There were no significant differences in VAS scores for postoperative pain, discomfort from nasal discharge or pain during packing removal between calcium alginate packings and carboxymethyl cellulose packings. Inter-rater variability of adhesion, oedema and infection scores was acceptable. Adhesion severity and oedema scores at 4 weeks were significantly lower with calcium alginate packing than with carboxymethyl cellulose. Infection severity scores also tended to be lower with calcium alginate than with carboxymethyl cellulose, but the difference was not significant.. Calcium alginate nasal packing is associated with reduced severity of oedema and adhesions after endoscopic sinus surgery.

Topics: Adult; Aged; Alginates; Carboxymethylcellulose Sodium; Endoscopy; Female; Glucuronic Acid; Hexuronic Acids; Humans; Male; Middle Aged; Pain Measurement; Prospective Studies; Rhinitis; Single-Blind Method; Sinusitis; Tampons, Surgical; Treatment Outcome

Silver-containing carboxymethylcellulose fiber dressing (Aquacel®-Ag) has been used to treat burns and ulcers with a large amount of exudate. The aim of this investigation was to confirm whether Aquacel®-Ag has beneficial effects when it is used as nasal packing.. We included 44 patients who underwent bilateral endoscopic sinus surgery due to chronic rhino-sinusitis. Beschitin-F® or Aquacel®-Ag was packed postoperatively into the bilateral middle meatus. Patient's comfort was recorded using a VAS, as well as wound healing, postoperative bleeding and local infection. Postoperative-specific organisms were also evaluated from the removed packing materials located in the middle meatus when they were removed on the 4th day after surgery.. The scores for nasal obstruction and pain were not statistically different in each group. Postoperative bacteriologic studies indicated marked differences. Coagulase-negative staphylococci were predominant and potential pathogens were recovered in a few cases in the Aquacel®-Ag group. In contrast, potential pathogens, including Streptococcus pneumonia, Haemophilus influenza, and Gram-negative rods, were predominant in the Beschitin-F® group.. The results indicate that Aquacel®-Ag might contribute to hemostasis, wound healing, and patient comfort after endonasal surgery, similar to Beschitin-F®. Additionally, it may have advantages concerning the prevention of postoperative infection.

Topics: Adult; Bandages; Carboxymethylcellulose Sodium; Chronic Disease; Endoscopy; Female; Humans; Male; Middle Aged; Pain, Postoperative; Paranasal Sinuses; Postoperative Care; Postoperative Hemorrhage; Rhinitis; Silver Compounds; Single-Blind Method; Sinusitis; Surgical Wound Infection; Treatment Outcome; Wound Healing

The aim of this study is to evaluate the haemostatic effect of carboxy-methylated cellulose (CMC) nasal packing following functional endoscopic sinus surgery (FESS). The design includes an investigator-initiated, randomized, single-blinded, controlled, prospective clinical study. A bilateral FESS procedure was performed on 41 patients. At the end of the operation, one side was randomly filled with CMC nasal packing, the other side remained without packing. The patients were blinded to the side of nasal packing and were postoperatively examined on the 1st day, after 2 and 4 weeks and the extent of the postoperative bleeding was quantified with a clinical grading system. Even though there were slightly more postoperative bleedings reported for the non-packed sides as compared to the CMC-packed sides, these differences were at no point statistically significant within the monitored postoperative period of 4 weeks. In the examined collective, the CMC packing investigated did not statistically prove to have an effect on bleeding control in this study design.

Topics: Administration, Intranasal; Bandages; Biocompatible Materials; Carboxymethylcellulose Sodium; Chronic Disease; Endoscopy; Female; Follow-Up Studies; Humans; Male; Middle Aged; Nasal Polyps; Otorhinolaryngologic Surgical Procedures; Postoperative Hemorrhage; Prospective Studies; Rhinitis; Sinusitis

Functional endoscopic sinus surgery (FESS) has become the treatment of choice for patients with medically resistant chronic rhinosinusitis (CRS and nasal polyposis). Nasal packing is usually placed after the surgery to minimize mucosal bleeding and support the wound healing process. Both the packing itself and its removal are often associated with pain and discomfort.. To evaluate the effect of carboxymethylcellulose (CMC) nasal packing on patient comfort following FESS.. Forty consecutive patients underwent bilateral FESS. One side of the nasal cavity was packed with CMC (mesh or gel) and the opposite side was not packed, the sides having been randomly selected. Postoperatively, patients were given visual analog scales to rate nasal airway obstruction and headache/pressure separately for the right and left sides. They also rated sleep disturbance and general well-being.. No significant differences were found between the CMC-packed side and the unpacked side with regard to patient comfort. No significant differences were found between CMC mesh and CMC gel.. Based on the presented data concerning patient comfort, CMC appears to be an ideal packing material following FESS. However, there is no other study revealing an identical study design focusing on other resorbable packing material. As a consequence, other available resorbable packing material should be investigated to find the ideal packing material following FESS, if packing is required.

Topics: Adult; Aged; Biocompatible Materials; Carboxymethylcellulose Sodium; Double-Blind Method; Endoscopy; Female; Gels; Humans; Male; Middle Aged; Nasal Polyps; Pain, Postoperative; Postoperative Hemorrhage; Rhinitis; Sinusitis; Surgical Mesh

Aim is to determine the efficacy and pain level associated with the use of dissolvable carboxymethyl cellulose (CMC) foam dressing in functional endoscopic sinus surgery (FESS) in adult patients. In the present prospective study, 60 patients with bilateral chronic rhinosinusitis were included. All patients underwent bilateral FESS. Thirty patients had both nasal cavities packed with dissolvable CMC foam (CMCF) and another 30 patients had their nasal cavities packed with routine nasal packing (RNP) in latex glove fingers. The haemostatic effect of the CMCF was assessed during the recovery period, and pain levels were recorded by the patients on a visual analogue scale 24 h after surgery. The prevalence of postoperative middle meatal synechia formation was assessed 1, 2, 4 and 8 weeks after the operation. Four (13.3%) of the patients packed with CMCF had primary postoperative bleeding during the recovery period and required additional dressing. Bleeding appeared in two (6.7%) patients packed with RNP. The mean level of pain was 0.962 (range 0-4) for patients packed with CMCF but was 5.5 (range 3-9) for patients packed with RNP. Four (6.7%) of 26 CMCF patients and 10 (35.7%) of 28 RNP patients developed a synechia in the middle meatus. We found that dissolvable CMC foam dressing is associated with very low levels of localised pain and with low levels of postoperative bleeding and synechia formation.

Topics: Administration, Intranasal; Adult; Aged; Bandages; Carboxymethylcellulose Sodium; Chronic Disease; Endoscopy; Female; Humans; Male; Middle Aged; Otorhinolaryngologic Surgical Procedures; Pain, Postoperative; Prospective Studies; Rhinitis; Sinusitis; Young Adult