title: Nasal mucosa healing after endoscopic sinus surgery in chronic rhinosinusitis of elderly patients: role of topic alpha-tocopherol acetate.
abstract: BACKGROUND
  Chronic rhinosinusitis (CRS) in European country ranges in elderly patients from 4.5 to 12% of population and has a significant effect on quality of life. In these patients, rhinosinusitis is linked to immune functions changes with age and to mucosal paraphysiological alterations such as crusting formations with atrophic epithelium, variations of nasal airflow and modifications of the mucociliary clearance. Failure of medical treatments leads to surgery in patients with persistent symptoms and radiographic signs of CRS. The choice of appropriate post-surgical topic treatments is important for healing time and for preventing mucosal complications such as synechiae, crusting formation and atrophy with secondary bacterial and fungal infections.
  
  
  OBJECTIVE
  Defining the effects of topic alpha-tocopherol acetate administration on nasal mucosa healing after endoscopic sinus surgery in CRS of elderly patients.
  
  
  METHODS
  In this study were included 32 patients, mean age 68.6, who underwent FESS because affected by CRS not responsive to medical treatments. After surgical treatment, we distinguish two groups basing on local nasal therapy.
  
  
  RESULTS
  We investigated, in the postoperative time, the role of alpha-tocopherol acetate compared to gomenol oil. Follow-up was performed at 7-15 days and 1-3 months after surgery. We evaluated mucosal restoration using Rhinoscopy Sum Score and quality of life using Nasal Six Items Symptom Questionnaire. We observed a faster healing time and less recurrence of complications in patients who underwent topic treatment with alpha-tocopherol acetate.
  
  
  CONCLUSIONS
  In our research, we observed that alpha-tocopherol acetate has no contraindications and side effects.
  
  
  CONCLUSIONS
  Our study showed the effectiveness of alpha-tocopherol acetate topic treatment in elderly patients affected by CRS after FESS, in improving and speeding up the process of restoring the sinonasal mucosa, compared to another topic medication.
authors.affiliation: Department of Anesthesiologic, Surgical and Emergency Sciences, Otolaryngology, Head and Neck Surgery Unit, Second University of Naples, Naples, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Testa
authors.affiliation: Department of Anesthesiologic, Surgical and Emergency Sciences, Otolaryngology, Head and Neck Surgery Unit, Second University of Naples, Naples, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Marcuccio
authors.affiliation: Department of Medicine and Health Sciences "V Tiberio", University of Molise, Via F. De Santis, 86100, Campobasso, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Panin
authors.affiliation: Department of Cardiothoracic and Respiratory Sciences, Second University of Naples, A.O. Dei Colli - Monaldi Hospital, Naples, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Bianco
authors.affiliation: Department of Sport Sciences and Wellness, University of Naples "Parthenope", Naples, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Tafuri
authors.affiliation: Department of Anesthesiologic, Surgical and Emergency Sciences, Otolaryngology, Head and Neck Surgery Unit, Second University of Naples, Naples, Italy.
authors.forename: Francesco Zappoli
authors.initials: FZ
authors.lastname: Thyrion
authors.affiliation: Department of Anesthesiologic, Surgical and Emergency Sciences, Otolaryngology, Head and Neck Surgery Unit, Second University of Naples, Naples, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Nunziata
authors.affiliation: Department of Anesthesiologic, Surgical and Emergency Sciences, Otolaryngology, Head and Neck Surgery Unit, Second University of Naples, Naples, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Piombino
authors.affiliation: Department of Medicine and Health Sciences "V Tiberio", University of Molise, Via F. De Santis, 86100, Campobasso, Italy. germano.guerra@unimol.it.
authors.forename: Germano
authors.identifier: http://orcid.org/0000-0002-4342-962X
authors.initials: G
authors.lastname: Guerra
authors.affiliation: Department of Anesthesiologic, Surgical and Emergency Sciences, Otolaryngology, Head and Neck Surgery Unit, Second University of Naples, Naples, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Motta
mesh_terms: D000287:Administration, Topical; D000368:Aged; D000975:Antioxidants / Q000008:administration & dosage; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D009297:Nasal Mucosa / Q000187:drug effects; D057605:Natural Orifice Endoscopic Surgery / Q000009:adverse effects / Q000379:methods; D010256:Paranasal Sinuses / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications / Q000517:prevention & control*; D011788:Quality of Life; D012220:Rhinitis / Q000503:physiopathology / Q000523:psychology / Q000601:surgery; D012852:Sinusitis / Q000503:physiopathology / Q000523:psychology / Q000601:surgery; D016896:Treatment Outcome; D024502:alpha-Tocopherol / Q000008:administration & dosage*
chemical_list: D000975:Antioxidants; D024502:alpha-Tocopherol
keywords: Alpha-tocopherol acetate; Chronic rhinosinusitis (CRS); Functional endoscopic sinonasal surgery (FESS); Nasal mucosa; Rhinoscopy Sum Score (RSS)