Dal Teoman, Bahar Seçil
Otolaryngology Department, Vehbi Koç Foundation American Hospital, Istanbul, Turkey.
Eur Arch Otorhinolaryngol. 2017 Sep;274(9):3397-3402. doi: 10.1007/s00405-017-4638-0. Epub 2017 Jun 24.
In endoscopic sinus surgery (ESS) synechiae formation and ostial stenosis are frequently encountered. This is not uncommon after frontal recess and ostium interventions due to the narrow recess and difficult anatomy of the region. The goal of this study is to evaluate the efficacy of the new cross-linked hyaluronan gel-PureRegen Gel Sinus-on wound healing and synechiae prevention in endoscopic frontal sinus surgery. The study consists of two groups of patients who underwent ESS, including frontal sinus surgery. In the study group of 37 patients, PureRegen Gel Sinus was applied to both the frontal recess and ostium at the end of the procedure. The control group consisted of 28 patients. In this group, nasal dressing material was not applied at the end of surgery-neither to the frontal recess nor to the ostium. Postoperatively, epithelization was found to be significantly better at 2 and 4 weeks in the study group when compared with the findings in patients where no postoperative dressing was applied. In the eighth week, there was no significant difference found between the two groups in terms of epithelization. Synechiae formation was significantly lower in the PureRegen Gel Sinus group than the control group at all 2, 4 and 8 weeks postoperative evaluations. The effects of PureRegen Gel Sinus on wound healing, especially in reepithelization, have shown to occur earlier in the postoperative period. Rapid reepithelization and control of infection related granulation tissue formation with antibiotics in the early postoperative period may explain the low stenosis rate in frontal sinus ostia in PureRegen Gel Sinus applied patients.
在内镜鼻窦手术（ESS）中，粘连形成和开口狭窄经常出现。由于额隐窝狭窄且该区域解剖结构复杂，在额隐窝和开口处进行干预后出现这种情况并不罕见。本研究的目的是评估新型交联透明质酸凝胶——PureRegen Gel Sinus在鼻内镜额窦手术中对伤口愈合和预防粘连的疗效。该研究包括两组接受ESS（包括额窦手术）的患者。在37例患者的研究组中，手术结束时在额隐窝和开口处均应用了PureRegen Gel Sinus。对照组由28例患者组成。在该组中，手术结束时未在额隐窝和开口处应用鼻敷料材料。术后发现，与未进行术后敷料处理的患者相比，研究组在2周和4周时上皮化明显更好。在第8周时，两组在上皮化方面未发现显著差异。在术后2周、4周和8周的所有评估中，PureRegen Gel Sinus组的粘连形成明显低于对照组。PureRegen Gel Sinus对伤口愈合的影响，尤其是在上皮再形成方面，已显示在术后早期出现得更早。术后早期快速上皮再形成以及用抗生素控制感染相关的肉芽组织形成，可能解释了应用PureRegen Gel Sinus的患者额窦开口狭窄率较低的原因。
