title: Role of nasal packing in surgical outcome for chronic rhinosinusitis with polyposis.
abstract: OBJECTIVE
  To analyze the differences between biodegradable and nondegradable nasal dressings with regard to their effects on wound healing in the short and medium term and on surgical outcomes in the long term, after endoscopic sinus surgery (ESS).
  
  
  METHODS
  A prospective, randomized, partly blinded, controlled trial.
  
  
  METHODS
  A total of 56 patients undergoing bilateral ESS for chronic rhinosinusitis with polyposis were enrolled and randomized to receive biodegradable (Nasopore; Stryker, Hamilton, ON, Canada) on one side and nondegradable packing (Merocel; Medtronic Xomed, Minneapolis, MN) on the opposite side. Postoperative morbidities (pain, bleeding, facial edema, nasal blockage) related to dressings were assessed on postoperative day 6. Wound healing (edema, crusting, secretions, synechia, granulation tissue formation, and percentage re-epithelialization) were evaluated at 2 weeks, 1 month, 3 months, and 6 months using modified Lund-Kennedy scores. Long-term assessment at 12 months was done using validated Lund-Kennedy scores.
  
  
  RESULTS
  Morbidities related to nondegradable packing were significantly higher than with degradable packing (Wilcoxon signed rank test, P<.01). Pain, bleeding, nasal blockage, and facial edema were significantly less with absorbable packing. No statistically significant difference was found between sinonasal cavities packed with biodegradable or nondegradable materials with regard to healing scores and percentage of re-epithelialization at 2 weeks, 1 month, 3 months, 6 months, and surgical outcomes at 1 year (P>.05). However, healing at 6 months was correlated with the preoperative Lund-Mackay radiology and surgery scores (Spearman's rho correlation test, P<.05 and P<.01, respectively).
  
  
  CONCLUSIONS
  No significant healing or surgical outcome differences were found between biodegradable and nondegradable packing. However pain, bleeding, nasal blockage, and facial edema were lower with biodegradable packing.
  
  
  METHODS
  1b.
authors.affiliation: Department of Otorhinolaryngology/Head and Neck Surgery, Haydarpaşa Numune Educational and Research Hospital, Istanbul, Turkey.
authors.forename: Ayşegül
authors.initials: A
authors.lastname: Verim
authors.forename: Lütfü
authors.initials: L
authors.lastname: Seneldir
authors.forename: Bariş
authors.initials: B
authors.lastname: Naiboğlu
authors.forename: Çiğdem Tepe
authors.initials: ÇT
authors.lastname: Karaca
authors.forename: Semra
authors.initials: S
authors.lastname: Külekçi
authors.forename: Sema Zer
authors.initials: SZ
authors.lastname: Toros
authors.forename: Çağatay
authors.initials: Ç
authors.lastname: Oysu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001458:Bandages; D002908:Chronic Disease; D004724:Endoscopy / Q000379:methods*; D004844:Epistaxis / Q000209:etiology / Q000628:therapy*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D005557:Formaldehyde; D006490:Hemostatics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000150:complications / Q000601:surgery*; D011142:Polyvinyl Alcohol; D011182:Postoperative Care / Q000379:methods; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000628:therapy; D011446:Prospective Studies; D012220:Rhinitis / Q000150:complications / Q000601:surgery*; D016037:Single-Blind Method; D012852:Sinusitis / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult
chemical_list: D006490:Hemostatics; D005557:Formaldehyde; C027490:polyvinyl alcohol formaldehyde foam; D011142:Polyvinyl Alcohol
keywords: Nasal dressings; chronic rhinosinusitis; endoscopic sinus surgery outcomes