title: Biodegradable nasal packings for endoscopic sinonasal surgery: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To assess biodegradable nasal packing effectiveness for improving postoperative symptoms and mucosal healing after endoscopic sinonasal surgery as compared with conventional/non-packing groups.
  
  
  METHODS
  Relevant articles were searched on PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials. We included randomized controlled trials (RCTs) that compared biodegradable packings with conventional packings or no packing, reporting postoperative symptoms and/or mucosal healing outcomes.
  
  
  RESULTS
  This review included 19 studies, of which 11 compared biodegradable packings with conventional packings. Meta-analysis found that biodegradable packings significantly improved postoperative symptoms: bleeding at removal, pain at removal, pain in situ, and nasal blockage. Mucosal healing outcomes were inconsistent within studies, with no data could be pooled. Eight studies compared biodegradable packings with non-packing group. Postoperative symptom data in this comparison could not be pooled: A protective or equal effect on postoperative bleeding was reported in different studies; no difference was reported in pain status and nasal blockage. As for mucosal healing, meta-analysis showed that two arms of comparison had similar effect on synechiae, edema, infection and granulation at each time point.
  
  
  CONCLUSIONS
  The limiting evidence suggests that biodegradable nasal packings are statistically better than conventional packings in postoperative symptoms, and probably comparable to non-packing group, as in this comparison we could not carry out meta-analysis. No beneficial or detrimental effect on postoperative mucosal healing could be determined based on existing evidence.
authors.affiliation: Department of Otorhinolaryngology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Maoxiao
authors.initials: M
authors.lastname: Yan
authors.affiliation: Department of Otorhinolaryngology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Dandan
authors.initials: D
authors.lastname: Zheng
authors.affiliation: Department of Otorhinolaryngology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Li
authors.affiliation: Clinical Research Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Qiaoli
authors.initials: Q
authors.lastname: Zheng
authors.affiliation: Department of Otorhinolaryngology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Jia
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Otorhinolaryngology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Beibei
authors.initials: B
authors.lastname: Yang
mesh_terms: D004724:Endoscopy / Q000295:instrumentation*; D006801:Humans; D015508:Nasal Obstruction / Q000209:etiology / Q000628:therapy; D059747:Nasal Surgical Procedures / Q000295:instrumentation*; D010256:Paranasal Sinuses / Q000601:surgery*; D011182:Postoperative Care / Q000295:instrumentation* / Q000379:methods; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000628:therapy; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D014945:Wound Healing