CMC packing in functional endoscopic sinus surgery: does it affect patient comfort?
BACKGROUND
Functional endoscopic sinus surgery (FESS) has become the treatment of choice for patients with medically resistant chronic rhinosinusitis (CRS and nasal polyposis). Nasal packing is usually placed after the surgery to minimize mucosal bleeding and support the wound healing process. Both the packing itself and its removal are often associated with pain and discomfort.


OBJECTIVE
To evaluate the effect of carboxymethylcellulose (CMC) nasal packing on patient comfort following FESS.


METHODS
Forty consecutive patients underwent bilateral FESS. One side of the nasal cavity was packed with CMC (mesh or gel) and the opposite side was not packed, the sides having been randomly selected. Postoperatively, patients were given visual analog scales to rate nasal airway obstruction and headache/pressure separately for the right and left sides. They also rated sleep disturbance and general well-being.


RESULTS
No significant differences were found between the CMC-packed side and the unpacked side with regard to patient comfort. No significant differences were found between CMC mesh and CMC gel.


CONCLUSIONS
Based on the presented data concerning patient comfort, CMC appears to be an ideal packing material following FESS. However, there is no other study revealing an identical study design focusing on other resorbable packing material. As a consequence, other available resorbable packing material should be investigated to find the ideal packing material following FESS, if packing is required.
Leunig
Andreas
A
Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig-Maximilians-University of Munich, Marchioninistr. 15, 81377 Munich, Germany. andreas.leunig@med.uni-muenchen.de
Betz
Christian S
CS
Siedek
Vanessa
V
Kastl
Konrad G
KG
D000328:Adult; D000368:Aged; D001672:Biocompatible Materials / Q000627:therapeutic use*; D002266:Carboxymethylcellulose Sodium / Q000627:therapeutic use*; D004311:Double-Blind Method; D004724:Endoscopy; D005260:Female; D005782:Gels; D006801:Humans; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000473:pathology / Q000601:surgery; D010149:Postoperative Pain / Q000517:prevention & control*; D019106:Postoperative Hemorrhage / Q000517:prevention & control; D012220:Rhinitis / Q000473:pathology / Q000601:surgery*; D012852:Sinusitis / Q000473:pathology / Q000601:surgery*; D013526:Surgical Mesh
D001672:Biocompatible Materials; D005782:Gels; D002266:Carboxymethylcellulose Sodium