title: Biomaterials in Rhinology.
abstract: BACKGROUND
  Many different kinds of rhinologic biomaterials, both nonabsorbable and absorbable, have been developed over the years to improve outcomes following endoscopic sinus surgery (ESS) for patients with chronic rhinosinusitis. In particular, these products have been designed to prevent postoperative bleeding, optimize the wound healing process, and reduce inflammation. This review evaluates the most recent evidence on biomaterials used in rhinology, focusing on these outcomes after ESS.
  
  
  METHODS
  MEDLINE, Scopus, Google Scholar, and Clinicaltrials.gov.
  
  
  METHODS
  A primary literature search based on the listed databases was performed with combinatorial search terms. Studies were considered for review if they met a set of inclusion and exclusion criteria.
  
  
  CONCLUSIONS
  Some products have performed better than others in clinical trials, although significant heterogeneity among studies does not allow for selection of a clearly superior biomaterial. While nonabsorbable biomaterials are still effective in achieving certain outcomes, newer, absorbable substances may be just as effective and avoid the morbidity associated with nasal packing removal. Steroid-eluting biomaterials have shown promising early results in reducing inflammation and promoting wound healing.
  
  
  CONCLUSIONS
  Certain absorbable biomaterials, such as chitosan gel and fibrin glue, have performed well with respect to postoperative hemostasis and wound healing, although they do not address mucosal inflammation. Steroid delivery systems may play an increasingly important role in reducing disease recurrence after ESS, although more studies are needed to assess long-term outcomes.
authors.affiliation: Division of Otolaryngology, George Washington University, Washington, DC, USA.
authors.forename: Conner J
authors.initials: CJ
authors.lastname: Massey
authors.affiliation: Department of Head and Neck Surgery, University of California, Los Angeles, Los Angeles, California, USA.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Suh
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Connecticut Sinus Center, University of Connecticut, Farmington, Connecticut, USA.
authors.forename: Belachew
authors.initials: B
authors.lastname: Tessema
authors.affiliation: Department of Otology and Laryngology, Harvard Medical School, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.
authors.forename: Stacey T
authors.initials: ST
authors.lastname: Gray
authors.affiliation: Division of Otolaryngology, George Washington University, Washington, DC, USA ameetsingh@alum.mit.edu.
authors.forename: Ameet
authors.initials: A
authors.lastname: Singh
mesh_terms: D001672:Biocompatible Materials; D004724:Endoscopy / Q000379:methods*; D006801:Humans; D011183:Postoperative Complications / Q000517:prevention & control; D012220:Rhinitis / Q000601:surgery*; D012852:Sinusitis / Q000601:surgery*
chemical_list: D001672:Biocompatible Materials
keywords: absorbable packing; biomaterials; chronic rhinosinusitis; drug-eluting stents; endoscopic sinus surgery; hemostasis; nasal packing; removable packing; rhinology; wound healing