Wormald Peter John, Boustred R Niell, Le Tong, Hawke Lianne, Sacks Raymond
Department of Surgery-Otolaryngology, Head and Neck Surgery, The University of Adelaide and Flinders University, Adelaide, South Australia, Australia.
Am J Rhinol. 2006 Jan-Feb;20(1):7-10.
The aim of this study was to determine whether there was any benefit or detrimental consequences of placing a hyaluronic acid pack (Merogel) into the middle meatus after endoscopic sinus surgery (ESS).
A randomized controlled blinded study was performed in 42 patients with chronic sinusitis undergoing ESS. The patients were randomized to receive Merogel on one side and no packing on the other side. Patients were assessed at 2, 4, and 6-8 weeks after surgery and the presence of synechia, edema, and infection was noted with the observer blinded to the side that had received the Merogel.
At 2 weeks the side packed with Merogel had 35% synechiae, 83% edema, and 30% mucopurulent discharge and on the control side the figures were similar with 22.5% synechiae, 83% edema, and 28% mucopurulent discharge. In both groups these figures improved over the observation period but percentages in the groups remained similar. At no time point was the difference between the packed and unpacked sides statistically significant for any of the measures when assessed with Fisher's exact test.
Merogel nasal packing has no significant beneficial or detrimental effect in terms of synechia, edema, or infection when placed in the middle meatus after ESS.
本研究的目的是确定在内镜鼻窦手术（ESS）后将透明质酸填充材料（Merogel）置于中鼻道是否有任何益处或不良后果。
对42例接受ESS的慢性鼻窦炎患者进行了一项随机对照双盲研究。患者被随机分为一侧接受Merogel填充而另一侧不进行填塞。在术后2周、4周和6 - 8周对患者进行评估，由对接受Merogel填充的一侧不知情的观察者记录粘连、水肿和感染的情况。
在2周时，填充Merogel的一侧有35%的粘连、83%的水肿和30%的黏液脓性分泌物，而对照侧的相应数据分别为22.5%的粘连、83%的水肿和28%的黏液脓性分泌物。在两组中，这些数据在观察期内均有所改善，但两组的百分比仍相似。当用Fisher精确检验评估时，在任何时间点，填充侧和未填充侧在任何一项指标上的差异均无统计学意义。
ESS后将Merogel鼻腔填塞物置于中鼻道时，在粘连、水肿或感染方面没有显著的有益或有害影响。
