Department of Otorhinolaryngology and Head and Neck Surgery, Eye & ENT Hospital, Shanghai Key Clinical Disciplines of Otorhinolaryngology, Fudan University, Shanghai, PR China.
Int Forum Allergy Rhinol. 2018 Nov;8(11):1233-1241. doi: 10.1002/alr.22213. Epub 2018 Oct 3.
Postoperative care is an important factor affecting the outcome of endoscopic sinus surgery (ESS) in patients with chronic rhinosinusitis (CRS). The aim of this study was to test the effect of mometasone furoate (MF)-soaked biodegradable nasal dressings (BNDs) on endoscopic appearance in CRS patients with nasal polyps (CRSwNP) after ESS.
This study was a prospective, randomized, double-blinded, placebo-controlled study. A total of 64 CRSwNP patients with bilateral ESS were enrolled and randomly given 4 mL or 8 mL of MF-soaked BNDs (NasoPore) in 1 nasal cavity and the same amount of normal saline-soaked BNDs in the contralateral side. The BNDs were removed on the 7th or 14th postoperative day. Perioperative sinus endoscopy (POSE) and Lund-Kennedy scores were collected, on the 7th or 14th postoperative days and at 1, 2, and 3 postoperative months.
The POSE and Lund-Kennedy scores showed that in the 4-mL, 1-week group, no significant differences between the sides treated with MF-soaked BNDs and the normal saline-soaked control were observed at any postoperative visits. In the 4-mL, 2-week group, significant differences were found at the 2-week and 1-month postoperative visits but not at the 2-month and 3-month visits. In the 8-mL, 1-week group, significant differences were found at the 1-week, 1-month, and 2-month postoperative visits but not at the 3-month visit. In the 8-mL, 2-week group, significant differences were found at all postoperative visits.
This study reveals that MF-impregnated BNDs improve the endoscopic appearance in the healing process of CRSwNP after ESS.
术后护理是影响慢性鼻-鼻窦炎（CRS）患者内镜鼻窦手术（ESS）结局的重要因素。本研究旨在测试糠酸莫米松（MF）浸渍的可生物降解鼻内填塞（BND）对 ESS 后鼻息肉（CRSwNP）患者内镜外观的影响。
这是一项前瞻性、随机、双盲、安慰剂对照研究。共纳入 64 例双侧 ESS 的 CRSwNP 患者，随机接受单侧鼻腔 4 mL 或 8 mL MF 浸渍 BND（NasoPore），对侧鼻腔给予等量生理盐水浸渍 BND。术后第 7 天或第 14 天取出 BND。收集术后第 7 天或第 14 天以及术后第 1、2、3 个月的围手术期鼻窦内镜（POSE）和 Lund-Kennedy 评分。
POSE 和 Lund-Kennedy 评分显示，在 4-mL、1 周组中，MF 浸渍 BND 治疗侧与生理盐水对照组在任何术后访视时均无显著差异。在 4-mL、2 周组中，在术后第 2 周和 1 个月访视时发现显著差异，但在术后第 2 个月和 3 个月访视时未发现显著差异。在 8-mL、1 周组中，在术后第 1 周、1 个月和 2 个月访视时发现显著差异，但在术后第 3 个月访视时未发现显著差异。在 8-mL、2 周组中，在所有术后访视时均发现显著差异。
本研究表明，MF 浸渍的 BND 可改善 ESS 后 CRSwNP 愈合过程中的内镜外观。
