Hyaluronic acid for post sinus surgery care: systematic review and meta-analysis.
BACKGROUND
Wound healing after endoscopic sinus surgery may result in adhesion formation. Hyaluronic acid may prevent synechiae development. A systematic review was performed to evaluate the current evidence on the clinical efficacy of hyaluronic acid applied to the nasal cavity after sinus surgery.


METHODS
Studies using hyaluronic acid as an adjunct treatment following endoscopic sinus surgery for chronic rhinosinusitis were identified. The primary outcome was adhesion formation rates. A meta-analysis was performed on adhesion event frequency. Secondary outcome measures included other endoscopic findings and patient-reported outcomes.


RESULTS
Thirteen studies (501 patients) met the selection criteria. A meta-analysis of adhesion formation frequency on endoscopy demonstrated a lower risk ratio in the hyaluronic acid intervention group (42 out of 283 cases) compared to the control group (81 out of 282) of 0.52 (95 per cent confidence interval = 0.37-0.72). Hyaluronic acid use was not associated with any significant adverse events.


CONCLUSIONS
Hyaluronic acid appears to be clinically safe and well tolerated, and may be useful in the early stages after sinus surgery to limit adhesion rate. Further research, including larger randomised controlled trials, is required to evaluate patient- and clinician-reported outcomes of hyaluronic acid post sinus surgery.
Otolaryngology - Head and Neck Surgery,Flinders Medical Centre and Flinders University,Bedford Park,Australia.
E
E
Fong
Otolaryngology - Head and Neck Surgery,Flinders Medical Centre and Flinders University,Bedford Park,Australia.
M
M
Garcia
Otolaryngology - Head and Neck Surgery,Flinders Medical Centre and Flinders University,Bedford Park,Australia.
C M
CM
Woods
Otolaryngology - Head and Neck Surgery,Flinders Medical Centre and Flinders University,Bedford Park,Australia.
E
E
Ooi
D002908:Chronic Disease; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D009296:Nasal Cavity; D009298:Nasal Polyps / Q000150:complications / Q000601:surgery*; D011182:Postoperative Care; D012220:Rhinitis / Q000150:complications / Q000601:surgery*; D012852:Sinusitis / Q000150:complications / Q000601:surgery*; D000267:Tissue Adhesions / Q000517:prevention & control*; D055675:Viscosupplements / Q000627:therapeutic use*; D014945:Wound Healing
D055675:Viscosupplements; D006820:Hyaluronic Acid
Drug Therapy; Hyaluronic Acid; Quality Of Life; Rhinitis; Surgery