Grzeskowiak Blazej, Wierzchowska Malgorzata, Walorek Rafal, Seredyka-Burduk Malgorzata, Wawrzyniak Katarzyna, Burduk Pawel Krzysztof
University Hospital, Department of Otolaryngology and Laryngological Oncology, Bydgoszcz, Poland.
Nicolaus Copernicus University, Faculty of Medicine, Department of Otolaryngology and Laryngological Oncology, Collegium Medicum, Toruń, Poland.
Braz J Otorhinolaryngol. 2019 Jul-Aug;85(4):473-480. doi: 10.1016/j.bjorl.2018.04.002. Epub 2018 May 10.
Endoscopic sinus surgery can lead to crusting or synechiae formation, which can affect the healing process.
The aim of our study was to compare the influence of steroid versus antibiotic versus saline solution impregnated absorbable nasal spacers on postoperative wound healing and patient satisfaction.
Eighty patients, 33 women and 47 men, were enrolled in this study. At the end of the surgery, two pieces of 4cm biodegradable material were applied in each ethmoid cavity. One of them was impregnated with saline solution, while the second one with steroid, or with antibiotic.
We observed statistically significant differences in the Lund-Kennedy score between the control and both treatment groups: for the Antibiotic-group on days 10 and 30 (p=0.009; p=0.009) and for the Steroid-group on day 90 (p=0.008). The extended endoscopic appearance of nasal mucosa indicated statistically significant differences in crust formation on day 10 comparing the steroid and control dressing (p=0.025), in secretion type on days 10 and 30 comparing the antibiotic and control dressing (p=0.003; p=0.016) and additionally for steroid and control on day 90 (p=0.046). On Day 90 we observed statistically significant differences in the absence of mucosal edema in the S-group compared to controls (p=0.007).
The results of this study reveal the significant positive influence of steroid- and antibiotic-impregnated biodegradable nasal packing on the postoperative healing process and patient satisfaction compared to the saline soaked dressing.
鼻内镜鼻窦手术可导致结痂或粘连形成，进而影响愈合过程。
本研究旨在比较类固醇、抗生素及生理盐水浸渍的可吸收鼻腔支撑物对术后伤口愈合及患者满意度的影响。
本研究纳入80例患者，其中女性33例，男性47例。手术结束时，在每个筛窦腔内放置两片4厘米的可生物降解材料。其中一片浸渍生理盐水，另一片浸渍类固醇或抗生素。
我们观察到，对照组与两个治疗组之间的Lund-Kennedy评分存在统计学显著差异：抗生素组在第10天和第30天（p=0.009；p=0.009），类固醇组在第90天（p=0.008）。鼻黏膜的扩展内镜表现显示，在第10天，比较类固醇敷料与对照敷料时，结痂形成存在统计学显著差异（p=0.025）；在第10天和第30天，比较抗生素敷料与对照敷料时，分泌物类型存在统计学显著差异（p=0.003；p=0.016），此外在第90天，比较类固醇敷料与对照敷料时也存在差异（p=0.046）。在第90天，我们观察到，与对照组相比，S组黏膜无水肿存在统计学显著差异（p=0.007）。
本研究结果显示，与生理盐水浸泡的敷料相比，浸渍类固醇和抗生素的可生物降解鼻腔填塞物对术后愈合过程及患者满意度有显著的积极影响。
