Department of Otolaryngology-Head and Neck Surgery, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey.
Otolaryngol Head Neck Surg. 2010 Mar;142(3):394-9. doi: 10.1016/j.otohns.2009.11.036.
Our objective was to determine the efficacy of fibrin glue to prevent complications and nasal mucociliary clearance (MCC) after septoplasty compared with a nonabsorbable packing requiring removal (polyvinyl alcohol [PVA] sponge).
Prospective clinical trial with planned data collection.
The study was conducted at Haydarpasa Numune Education and Research Hospital.
A total of 44 patients, who had septoplasty operations, were included in the study. We evaluated postoperative pain, sleep disturbance on the night of surgery, bleeding, septal hematoma, synechia, infection, and MCC values in the fibrin glue and PVA sponge groups.
The pain scores in the fibrin glue group were significantly lower than in the PVA sponge group (P < 0.01). A statistically significant difference was noted in the number of patients who had mild bleeding in favor of the fibrin glue group (P < 0.05). In the fibrin glue group, 95.7 percent of patients reported that they had normal sleep; in the PVA sponge group, only 23.8 percent of patients reported normal sleep (P < 0.01). In the fibrin glue group, a significant decrease was noted in postoperative MCC values compared with preoperative values (P < 0.01). However, in the PVA sponge group, a significant increase was noted in postoperative clearance values compared with preoperative values (P < 0.01).
In our series of patients, we have seen no gross complications from fibrin glue usage. Fibrin glue can be readily used in septoplasty; it requires no special treatment, has an adequate hemostatic effect, and appears to promote the regeneration of mucociliary activity of the injured mucosa postoperatively.
我们的目的是确定纤维蛋白胶在预防鼻中隔成形术后并发症和鼻腔黏液清除率（MCC）方面的疗效，与需要取出的不可吸收填塞物（聚乙烯醇[PVA]海绵）相比。
有计划数据收集的前瞻性临床试验。
该研究在 Haydarpasa Numune 教育和研究医院进行。
共纳入 44 例接受鼻中隔成形术的患者。我们评估了纤维蛋白胶组和 PVA 海绵组术后疼痛、手术当晚睡眠障碍、出血、鼻中隔血肿、粘连、感染和 MCC 值。
纤维蛋白胶组的疼痛评分明显低于 PVA 海绵组（P<0.01）。纤维蛋白胶组轻度出血患者明显多于 PVA 海绵组（P<0.05）。在纤维蛋白胶组，95.7%的患者报告睡眠正常；在 PVA 海绵组，只有 23.8%的患者报告睡眠正常（P<0.01）。与术前相比，纤维蛋白胶组术后 MCC 值明显降低（P<0.01）。然而，在 PVA 海绵组，术后清除值明显高于术前（P<0.01）。
在我们的患者系列中，我们没有看到纤维蛋白胶使用的明显严重并发症。纤维蛋白胶可在鼻中隔成形术中轻易使用；它不需要特殊处理，具有足够的止血效果，并在术后似乎促进受损黏膜的黏液纤毛活动再生。
