Lee Eun Jung, Hwang Hye Jin, Jung Chan Min, Kim Min Ki, Kim Kyung-Su
Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Korea.
Eur Arch Otorhinolaryngol. 2017 Jan;274(1):181-188. doi: 10.1007/s00405-016-4186-z. Epub 2016 Jul 4.
The purpose of the study was to evaluate the effect of a solid mixture of sodium hyaluronate and carboxymethylcellulose (S-HA/CMC) for the prevention of adhesions after iatrogenic mucosal injury in murine nasal cavities. We introduced iatrogenic adhesions into the bilateral nasal cavities of 20 male Sprague-Dawley rats. S-HA/CMC was applied to the left nasal cavity, while no packing was placed in the right nasal cavity as a control. At 1, 2, and 4 weeks post-procedure, we examined the number of adhesions, the ratio of the longest cross-sectional length of adhesion to septal cartilage length (RAC), and the degree of fibrosis. S-HA/CMC significantly reduced the number of adhesions when compared to the control group in total (p = 0.031), but not at each individual time point. The S-HA/CMC group showed significantly shorter RAC than the control group in total (p = 0.044), but not at each individual time point. The total fibrosis score was less severe in the S-HA/CMC group than in the control group (p < 0.001), with a significant difference between the two groups at the second week (p = 0.001). Therefore, in an animal model, S-HA/CMC can prevent post-injury mucosal adhesions suggesting a potential for clinical applications in endoscopic sinus surgery. Further clinical trials are needed to determine the safety and efficacy of S-HA/CMC as nasal packing after endoscopic sinus surgery.
本研究的目的是评估透明质酸钠与羧甲基纤维素的固体混合物（S-HA/CMC）对预防小鼠鼻腔医源性黏膜损伤后粘连的效果。我们将医源性粘连引入20只雄性Sprague-Dawley大鼠的双侧鼻腔。将S-HA/CMC应用于左侧鼻腔，而右侧鼻腔不进行填塞作为对照。在术后1周、2周和4周，我们检查粘连数量、粘连最长横截面长度与鼻中隔软骨长度的比值（RAC）以及纤维化程度。与对照组相比，S-HA/CMC总体上显著减少了粘连数量（p = 0.031），但在每个单独时间点并非如此。S-HA/CMC组的RAC总体上显著短于对照组（p = 0.044），但在每个单独时间点并非如此。S-HA/CMC组的总纤维化评分比对照组轻（p < 0.001），两组在第二周有显著差异（p = 0.001）。因此，在动物模型中，S-HA/CMC可预防损伤后黏膜粘连，提示其在内镜鼻窦手术中具有临床应用潜力。需要进一步的临床试验来确定S-HA/CMC作为内镜鼻窦手术后鼻腔填塞物的安全性和有效性。
