title: Comparison of calcium alginate and carboxymethyl cellulose for nasal packing after endoscopic sinus surgery: a prospective, randomised, controlled single-blinded trial.
abstract: OBJECTIVE
  Calcium alginate is a biodegradable gel-transforming agent widely used for nasal packing. It can reduce pain and improve comfort. However, few randomised controlled trials have compared the efficacy of calcium alginate nasal packing with that of other biodegradable gel-transforming materials.
  
  
  METHODS
  Prospective, randomised, single-blinded controlled study.
  
  
  METHODS
  Yonsei University Severance Hospital, a tertiary academic medical centre.
  
  
  METHODS
  Twenty-seven patients (54 nostrils) with chronic rhinosinusitis who were scheduled for bilateral endoscopic sinus surgery were enrolled. After surgery, one nostril was packed with calcium alginate and the other with carboxymethyl cellulose. Only patients with an intersinus chronic rhinosinusitis severity score difference of ≤1 were included.
  
  
  METHODS
  Visual analogue scale (VAS) scores for postoperative pain, discomfort from nasal discharge and pain during packing removal were analysed. Two independent rhinologists who were blinded to the assessments separately scored adhesions, oedema and infection by endoscopic digital photography at 1, 4 and 8 weeks postoperatively.
  
  
  RESULTS
  There were no significant differences in VAS scores for postoperative pain, discomfort from nasal discharge or pain during packing removal between calcium alginate packings and carboxymethyl cellulose packings. Inter-rater variability of adhesion, oedema and infection scores was acceptable. Adhesion severity and oedema scores at 4 weeks were significantly lower with calcium alginate packing than with carboxymethyl cellulose. Infection severity scores also tended to be lower with calcium alginate than with carboxymethyl cellulose, but the difference was not significant.
  
  
  CONCLUSIONS
  Calcium alginate nasal packing is associated with reduced severity of oedema and adhesions after endoscopic sinus surgery.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.
authors.forename: D-Y
authors.identifier: http://orcid.org/0000-0001-9969-3051
authors.initials: DY
authors.lastname: Park
authors.affiliation: Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: H J
authors.initials: HJ
authors.lastname: Chung
authors.affiliation: Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: N S
authors.initials: NS
authors.lastname: Sim
authors.affiliation: Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: K H
authors.initials: KH
authors.lastname: Jo
authors.affiliation: Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: D H
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea.|The Airway Mucus Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: C-H
authors.initials: CH
authors.lastname: Kim
authors.affiliation: Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea.|The Airway Mucus Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: J-H
authors.initials: JH
authors.lastname: Yoon
mesh_terms: D000328:Adult; D000368:Aged; D000464:Alginates / Q000494:pharmacology*; D002266:Carboxymethylcellulose Sodium / Q000494:pharmacology*; D004724:Endoscopy; D005260:Female; D020723:Glucuronic Acid / Q000494:pharmacology; D006603:Hexuronic Acids / Q000494:pharmacology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D012220:Rhinitis / Q000601:surgery*; D016037:Single-Blind Method; D012852:Sinusitis / Q000601:surgery*; D013630:Tampons, Surgical; D016896:Treatment Outcome
chemical_list: D000464:Alginates; D006603:Hexuronic Acids; D020723:Glucuronic Acid; D002266:Carboxymethylcellulose Sodium