Hwang Chi Sang, Al Sharhan Salma Saud, Kim Bo Ra, Kim Soo In, Kim Jin Woong, Cho Hyung-Ju, Yoon Joo-Heon, Kim Chang-Hoon
Department of Otorhinolaryngology, Seoul, South Korea.
Department of Otorhinolaryngology, Imam Abdulrahman Bin Faisal University and King Fahd Hospital, Dammam, Saudi Arabia.
Laryngoscope. 2018 Feb;128(2):311-316. doi: 10.1002/lary.26871. Epub 2017 Sep 22.
OBJECTIVES/HYPOTHESIS: To evaluate the potential efficacy of steroid-soaked, absorbable calcium alginate nasal packing following endoscopic sinus surgery.
Prospective, randomized, single-blinded, placebo-controlled trial.
Twenty-two patients (44 nostrils) who had chronic rhinosinusitis with polyps underwent bilateral endoscopic sinus surgery. Only those with an intersinus difference in Lund-Mackay severity score of 1 or less were included. In each patient, one randomly selected nostril was packed with calcium alginate soaked with 2 mL of triamcinolone (40 mg/mL) (triamcinolone group), whereas the contralateral nostril received an identical packing soaked in 2 mL of normal saline (saline group). Two independent investigators blinded to the packing allocation scored the surgical field using the validated Perioperative Sinus Endoscopy (POSE) scores 1, 4, and 8 weeks after surgery.
All 44 nostrils were analyzed; the Lund-Mackay scores did not differ significantly between the groups before surgery. Eight weeks after surgery, the total POSE scores were significantly lower in the triamcinolone group (P = .014). The POSE scoring parameters were then compared between groups, and the following variables were significantly different: middle turbinate synechiae with the lateral wall (P = .037), polypoid degeneration of the ethmoid cavity (P = .006), and sphenoid sinus severity (P = .036).
This study demonstrated that steroid-soaked, absorbable nasal packing can be used to enhance wound healing after endoscopic sinus surgery and to prevent polypoid changes in the nasal mucosa.
1b. Laryngoscope, 128:311-316, 2018.
目的/假设：评估内镜鼻窦手术后使用类固醇浸泡的可吸收藻酸钙鼻腔填塞物的潜在疗效。
前瞻性、随机、单盲、安慰剂对照试验。
22例患有慢性鼻窦炎伴息肉的患者（44个鼻孔）接受了双侧内镜鼻窦手术。仅纳入鼻窦间Lund-Mackay严重程度评分差异为1或更小的患者。在每位患者中，随机选择一个鼻孔用浸泡有2毫升曲安奈德（40毫克/毫升）的藻酸钙进行填塞（曲安奈德组），而对侧鼻孔接受浸泡在2毫升生理盐水中的相同填塞物（生理盐水组）。两名对填塞物分配不知情的独立研究者在术后1、4和8周使用经过验证的围手术期鼻窦内窥镜检查（POSE）评分对手术区域进行评分。
对所有44个鼻孔进行了分析；术前两组的Lund-Mackay评分无显著差异。术后8周，曲安奈德组的总POSE评分显著更低（P = 0.014）。然后比较两组之间的POSE评分参数，以下变量有显著差异：中鼻甲与外侧壁粘连（P = 0.037）、筛窦腔息肉样变性（P = 0.006）和蝶窦严重程度（P = 0.036）。
本研究表明，类固醇浸泡的可吸收鼻腔填塞物可用于促进内镜鼻窦手术后的伤口愈合，并预防鼻黏膜息肉样改变。
1b。《喉镜》，2018年，第128卷，第311 - 316页。
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