Department of ENT-HNS, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
Rhinology. 2019 Aug 1;57(4):287-292. doi: 10.4193/Rhin19.004.
Steroids have been proven to be beneficial in improving post-operative outcomes following sinus surgery. The ideal mode of delivery is to increase local concentration in the sinuses with minimal systemic side effects. In this study, we used triamcinolone soaked polyvinyl alcohol packs immediately following sinus surgery, and assessed the effects on post-operative outcomes.
This was a prospective, interventional, and comparative study. Following endoscopic sinus surgery, a polyvinyl alcohol pack was placed in both nasal cavities and 4 ml triamcinolone was infiltrated in one side and 4 ml of normal saline was infiltrated in the other. The pack was removed on the second post-operative day and nasal cavities and paranasal sinuses were evaluated using a flexible endoscope in the third post-operative week using Lund-Kennedy and Peri-operative sinus endoscopic scores.
There was a reduction in the average Lund-Kennedy score and Peri-operative sinus endoscopy score in the treatment site compared to the control site which was statistically significant. There was a greater reduction in crusting, oedema and scarring in the treatment site compared to the control site. However, only the reduction in oedema was statistically significant.
Triamcinolone soaked polyvinyl alcohol pack following endoscopic sinus surgery improves post-operative outcomes.
类固醇已被证明可改善鼻窦手术后的术后结果。理想的给药方式是在鼻窦中增加局部浓度，同时最小化全身副作用。在这项研究中，我们在鼻窦手术后立即使用曲安奈德浸泡的聚乙烯醇包，并评估其对术后结果的影响。
这是一项前瞻性、干预性和对照研究。在鼻内镜鼻窦手术后，将聚乙烯醇包置于两个鼻腔中，一侧浸润 4 毫升曲安奈德，另一侧浸润 4 毫升生理盐水。在术后第二天取出包，在术后第三周使用可弯曲的内窥镜评估鼻腔和鼻窦，并使用 Lund-Kennedy 和围手术期鼻窦内窥镜评分进行评估。
与对照组相比，治疗部位的平均 Lund-Kennedy 评分和围手术期鼻窦内窥镜评分均有所降低，具有统计学意义。治疗部位的结痂、水肿和瘢痕形成减少得更多，但只有水肿减少具有统计学意义。
鼻内镜鼻窦手术后使用曲安奈德浸泡的聚乙烯醇包可改善术后结果。
