title: Absorbable Steroid-Impregnated Spacer After Endoscopic Sinus Surgery to Reduce Synechiae Formation.
abstract: OBJECTIVE
  Middle meatal synechiae formation after endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS) leads to higher rates of revision surgery. We aimed to determine if there are different rates of postoperative synechiae following ESS for CRS between patients who received a nonabsorbable spacer (NAS) placed in the ethmoid cavity versus patients who had a steroid-impregnated absorbable spacer (AS) placed at the middle meatal entry.
  
  
  METHODS
  We conducted a retrospective cohort study of patients who underwent ESS for CRS at a single tertiary referral center from October 2009 to October 2013. We collected data on synechiae formation between the middle turbinate and lateral nasal wall within 1 month of surgery and postoperative epistaxis.
  
  
  RESULTS
  One hundred forty-six patients with 252 nasal cavities (52.0%) received steroid-impregnated AS, and 128 patients with 233 nasal cavities (48.0%) received NAS. Synechiae formation occurred in 2.0% of cavities with AS and 5.6% of cavities with NAS, but this difference was not statistically significant (OR = 0.34, P = .052). One patient in each cohort had significant postoperative epistaxis requiring additional nasal packing (P > .99).
  
  
  CONCLUSIONS
  Steroid-impregnated absorbable spacers had statistically insignificant reduction in postoperative synechiae formation when compared to nonabsorbable spacers. Low rates of postoperative epistaxis were observed regardless of the type of spacer used.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, University of Toronto, ON, Canada jasonji.xu@mail.utoronto.ca.
authors.forename: Jason J
authors.initials: JJ
authors.lastname: Xu
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, University of Toronto, ON, Canada.
authors.forename: Gian-Marco
authors.initials: GM
authors.lastname: Busato
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, St. Michael's Hospital, Toronto, ON, Canada.
authors.forename: Carmen
authors.initials: C
authors.lastname: McKnight
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, University of Toronto, ON, Canada Department of Otolaryngology-Head and Neck Surgery, St. Michael's Hospital, Toronto, ON, Canada.
authors.forename: John M
authors.initials: JM
authors.lastname: Lee
mesh_terms: D000328:Adult; D002908:Chronic Disease; D004724:Endoscopy / Q000009:adverse effects*; D005260:Female; D005557:Formaldehyde / Q000008:administration & dosage; D005938:Glucocorticoids / Q000008:administration & dosage*; D006490:Hemostatics / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000473:pathology*; D010256:Paranasal Sinuses / Q000601:surgery*; D011142:Polyvinyl Alcohol / Q000008:administration & dosage; D011241:Prednisone / Q000008:administration & dosage*; D012086:Reoperation; D012189:Retrospective Studies; D012220:Rhinitis / Q000601:surgery*; D012852:Sinusitis / Q000601:surgery*; D000267:Tissue Adhesions / Q000517:prevention & control; D014221:Triamcinolone / Q000008:administration & dosage
chemical_list: D005938:Glucocorticoids; D006490:Hemostatics; D005557:Formaldehyde; D014221:Triamcinolone; C027490:polyvinyl alcohol formaldehyde foam; D011142:Polyvinyl Alcohol; D011241:Prednisone
keywords: chronic rhinosinusitis; endoscopic sinus surgery; otolaryngology; rhinology; sinusitis