title: Polyhydrated ionogen enhances postoperative sinonasal ciliated remucosalization.
abstract: BACKGROUND
  Mucosalization of the sinonasal cavity following surgery is critical for successful outcomes. Recently a novel anti-protease compound, polyhydrated-ionogen (PHI) with Mg(2+)/Br(-), demonstrated improved dermal wound healing. We set out to investigate the effect of PHI Mg(2+)/Br(-) on sinus remucosalization following surgery.
  
  
  METHODS
  A total of 24 rabbits underwent bilateral medial-wall maxillary mucosal stripping followed by placement of an indwelling irrigation catheter. In a randomized fashion 1 side received 3 cc normal saline (NS) daily, while the contralateral side received PHI Mg(2+)/Br(-). Following a 14-day therapeutic trial, remucosalization was assessed by hematoxylin and eosin (H&E) staining and immunohistochemistry for β-tubulin, a marker of cilia. A semiquantitative grading of ciliated remucosalization was applied with a chi-square test used to compare distributions for each treatment.
  
  
  RESULTS
  H&E staining comparison demonstrated NS treated sinuses (n = 24) had substantial bare areas with predominant ciliation scores under 30%. The PHI Mg(2+)/Br(-)-treated group (n = 24) achieved a statistically significant improvement in reciliation (>60%) when compared with NS (p < 0.01). These results were confirmed with Type IV β-tubulin staining (p < 0.01).
  
  
  CONCLUSIONS
  Poor postsurgical sinonasal mucosa healing results in adverse clinical outcomes. In a rabbit model of sinonasal mucosal healing, daily irrigation for 14 days with PHI Mg(2+)/Br(-)-enhanced ciliated remucosalization compared to saline.
authors.affiliation: Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA 19104, USA.
authors.forename: David
authors.initials: D
authors.lastname: DePoortere
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Kofonow
authors.forename: Alexander G
authors.initials: AG
authors.lastname: Chiu
authors.forename: Noam A
authors.initials: NA
authors.lastname: Cohen
mesh_terms: D000818:Animals; D001965:Bromides / Q000494:pharmacology*; D002923:Cilia / Q000187:drug effects; D002951:Citrates / Q000494:pharmacology; D007150:Immunohistochemistry; D008274:Magnesium / Q000494:pharmacology*; D009079:Mucociliary Clearance / Q000187:drug effects; D009296:Nasal Cavity / Q000187:drug effects; D009297:Nasal Mucosa / Q000187:drug effects* / Q000601:surgery; D010256:Paranasal Sinuses / Q000187:drug effects* / Q000601:surgery; D011817:Rabbits; D011897:Random Allocation; D012413:Rubidium / Q000494:pharmacology*; D014945:Wound Healing / Q000187:drug effects; D015032:Zinc / Q000494:pharmacology*
chemical_list: D001965:Bromides; D002951:Citrates; C523779:PHI-5 formulation; D008274:Magnesium; D015032:Zinc; D012413:Rubidium