title: The effects of topical agents on paranasal sinus mucosa healing: a rabbit study.
abstract: BACKGROUND
  Numerous topical agents have been used intraoperatively to enhance postoperative mucosal healing or reduce scar formation. However, the histological effects of many of these treatments have not been well described. This study investigates the impact of topical mometasone furoate, acitretin, lactoferrin, and Silastic sheet (Medtronic) on sinus mucosal healing in a rabbit model.
  
  
  METHODS
  Forty-eight New Zealand white rabbits underwent defined, localized stripping of a bilateral region of maxillary sinus mucosa. One of 6 treatments was placed in 1 maxillary sinus, and the treatment carrier was applied contralaterally (0.1% mometasone furoate, 0.25% and 0.5% acitretin, lactoferrin, Silastic, and no treatment; n = 8 each group). Rabbits were euthanized after 2 weeks and histological sections were examined with light microscopy.
  
  
  RESULTS
  Treatment with acitretin 0.25% and 0.5% improved cilial recovery by 0.9 ± 0.5 (p = 0.003) and 0.5 ± 0.5 (p < 0.05), respectively. Acitretin 0.25% treatment also significantly reduced collagen in healing mucosa (5.1% ± 4.8%, p = 0.04). Conversely, rabbits treated with mometasone furoate 0.1% were more likely to have reduced cilial and goblet cell recovery. Intergroup comparisons demonstrated a significant improvement in cilial recovery scores with both acitretin doses compared with mometasone furoate (p < 0.05) and less collagen deposition in rabbits treated with placebo gel over Silastic (p < 0.05). Mucosa directly underlying a blood clot had a lower cilia score and impaired epithelial recovery (p < 0.001).
  
  
  CONCLUSIONS
  Intraoperatively applied agents have the potential to significantly affect wound healing. Acitretin improved cilial recovery and reduced collagen deposition.
authors: Department of Surgery, The University of Auckland, Auckland, New Zealand.
authors: Ravi
authors: R
authors: Jain
authors: Raymond
authors: R
authors: Kim
authors: Sharon
authors: S
authors: Waldvogel-Thurlow
authors: Peter
authors: P
authors: Hwang
authors: Jillian
authors: J
authors: Cornish
authors: Richard
authors: R
authors: Douglas
mesh_terms: D017255:Acitretin / Q000627:therapeutic use; D000287:Administration, Topical; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D003094:Collagen / Q000378:metabolism; D003879:Dermatologic Agents / Q000627:therapeutic use*; D004129:Dimethylpolysiloxanes / Q000627:therapeutic use; D007430:Intraoperative Care; D007781:Lactoferrin / Q000627:therapeutic use; D023421:Models, Animal; D000068656:Mometasone Furoate / Q000627:therapeutic use; D009297:Nasal Mucosa / Q000187:drug effects* / Q000502:physiology / Q000601:surgery; D010256:Paranasal Sinuses / Q000187:drug effects*; D011817:Rabbits; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D000893:Anti-Inflammatory Agents; D003879:Dermatologic Agents; D004129:Dimethylpolysiloxanes; D000068656:Mometasone Furoate; C013830:baysilon; D003094:Collagen; D007781:Lactoferrin; D017255:Acitretin
keywords: Silastic; cilia; corticosteroids; intranasal surgery; lactoferrin; paranasal sinuses; retinoids; sinusitis; wound healing