Effects of nonabsorbable packing in middle meatus after sinus surgery.
OBJECTIVE
The aim of this study was to evaluate the effects of a nonabsorbable packing (NAP) in the middle meatus (MM) for 5 days after sinus surgery.


METHODS
A randomized, partly blinded, controlled clinical trial.


METHODS
Sixty-one patients (M/F = 30/31, mean age 42, range 18-72) with chronic or acute recurrent rhinosinusitis were included. Fifty-nine underwent surgery. Thirty-one had NAP in the MM for 5 days, and 28 served as controls with daily saline irrigations postoperatively. Primary outcome variables were nasal congestion, nasal pain, and headache the first 2 weeks rated on visual analogue scales (VAS; 0-100) and the amount of postoperative bleeding recorded on an ordinal scale (1-4). Secondary outcome variable was the extent of adhesions in MM 10 to 14 weeks after surgery judged by blinded evaluation of endoscopic video recordings.


RESULTS
Fifty-eight patients completed a diary. No significant differences in primary outcome variables between the groups were found. Nasal congestion decreased most the first 5 to 7 days postoperatively. Removal of the NAP caused little pain (mean 23 on VAS). Temporary bleeding occurred in three patients. Bilateral adhesions were observed in 10 control patients but in none with NAP. Unilateral adhesions were found in nine control patients and in seven with NAP (exact P < .001).


CONCLUSIONS
NAP in the MM for 5 days significantly reduced the extent of adhesions in MM compared with saline irrigation alone. NAP did not cause additional discomfort.
Department of Otolaryngology, Head and Neck Surgery, St. Olav University Hospital of Trondheim, Trondheim, Norway. vegard.bugten@ntnu.no
Vegard
V
Bugten
Ståle
S
Nordgård
Eirik
E
Skogvoll
Sverre
S
Steinsvåg
D000293:Adolescent; D000328:Adult; D000368:Aged; D001458:Bandages; D004724:Endoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity; D013506:Otologic Surgical Procedures / Q000379:methods*; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000517:prevention & control*; D012016:Reference Values; D012220:Rhinitis / Q000175:diagnosis / Q000601:surgery*; D012307:Risk Factors; D016037:Single-Blind Method; D012852:Sinusitis / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome