title: Effectiveness of Synthetic Polyurethane Foam as a Nasal Packing Material in Endoscopic Endonasal Dacryocystorhinostomy.
abstract: OBJECTIVE
  To compare the effects of 2 nasal packing materials, synthetic polyurethane foam (absorbable) and expandable polyvinyl acetate (nonabsorbable), on the surgical success rate and postoperative complications after endoscopic endonasal dacryocystorhinostomy (EDCR).
  
  
  METHODS
  A retrospective medical review of 459 patients (580 eyes) who underwent EDCR for primary acquired nasolacrimal duct obstruction at Korea University Guro Hospitals from January 2009 to February 2014. Surgical success rate (anatomical, functional), postoperative complications (granuloma, synechia, bleeding, and infection) were compared between the 2 groups, absorbable (318 eyes) and nonabsorbable (262 eyes).
  
  
  RESULTS
  The absorbable group showed better results in surgical success rate regarding anatomical (90.5% versus 76.3%, P = 0.00) and functional (89.3% versus 75.9%, P = 0.00). Granulomas developed less frequently in the absorbable group (24.5% versus 38.9%, P = 0.00). Also, bleeding and crust were less frequent in the absorbable group (P = 0.00). Infections were less frequent in the nonabsorbable group (1.52%) compared with the absorbable group (7.86%, P = 0.00). The rate of revision surgery was lower in the absorbable group (7.86% versus 20.9%, P = 0.00). As for the influence of secondary outcomes to the surgical success by multiple logistic regression, granulomas had the largest effect on surgical success either anatomical or functional (odds ratio = 82.393 to anatomical and 44.058 to functional). Synechia had the second largest effect on surgical success (odds ratio = 11.897 to anatomical and 9.605 to functional).
  
  
  CONCLUSIONS
  The authors suggest that using a synthetic polyurethane foam as a nasal packing material is not only a surgical option, but also a crucial and essential procedure in EDCR.
authors.affiliation: *Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea †Department of Ophthalmology, Dongguk University, Ilsan Hospital, Goyang, Korea ‡Department of Ophthalmology, KEPCO Medical Center, Seoul, Korea.
authors.forename: Joonsik
authors.initials: J
authors.lastname: Lee
authors.forename: Hwa
authors.initials: H
authors.lastname: Lee
authors.forename: Hyun Kyu
authors.initials: HK
authors.lastname: Lee
authors.forename: Minwook
authors.initials: M
authors.lastname: Chang
authors.forename: Minsoo
authors.initials: M
authors.lastname: Park
authors.forename: Sehyun
authors.initials: S
authors.lastname: Baek
mesh_terms: D020341:Absorbable Implants; D000328:Adult; D000368:Aged; D001672:Biocompatible Materials / Q000627:therapeutic use*; D003608:Dacryocystorhinostomy / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D004844:Epistaxis / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D005557:Formaldehyde / Q000627:therapeutic use; D006099:Granuloma / Q000517:prevention & control; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009668:Nose Diseases / Q000517:prevention & control; D011140:Polyurethanes / Q000627:therapeutic use*; D011142:Polyvinyl Alcohol / Q000627:therapeutic use; D011145:Polyvinyls / Q000627:therapeutic use; D011183:Postoperative Complications / Q000517:prevention & control; D019106:Postoperative Hemorrhage / Q000517:prevention & control; D012086:Reoperation; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000517:prevention & control; D013630:Tampons, Surgical; D000267:Tissue Adhesions / Q000517:prevention & control; D016896:Treatment Outcome
chemical_list: D001672:Biocompatible Materials; D006490:Hemostatics; D011140:Polyurethanes; D011145:Polyvinyls; D005557:Formaldehyde; C027490:polyvinyl alcohol formaldehyde foam; C013215:polyvinyl acetate; D011142:Polyvinyl Alcohol; C028279:polyurethane foam