Efficacy of Absorbable Steroid-Impregnated Nasal Packing in Functional Endoscopic Sinus Surgery for Chronic Rhinosinusitis: A Systematic Review.

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Tytuł:: Efficacy of Absorbable Steroid-Impregnated Nasal Packing in Functional Endoscopic Sinus Surgery for Chronic Rhinosinusitis: A Systematic Review.
Autorzy:: Zhang M; Department of Otolaryngology, Head & Neck Surgery, Gosford Hospital, NSW Health-Central Coast Local Health District, Gosford, New South Wales, Australia.; School of Medicine and Public Health-Faculty of Health and Medicine, The University of Newcastle, Newcastle, New South Wales, Australia.
Ryan PJ; Department of Otolaryngology, Head & Neck Surgery, Gosford Hospital, NSW Health-Central Coast Local Health District, Gosford, New South Wales, Australia.
Shashinder S; Department of Otolaryngology, Head & Neck Surgery, Gosford Hospital, NSW Health-Central Coast Local Health District, Gosford, New South Wales, Australia.; School of Medicine and Public Health-Faculty of Health and Medicine, The University of Newcastle, Newcastle, New South Wales, Australia.
Źródło:: The Laryngoscope [Laryngoscope] 2021 Aug; Vol. 131 (8), pp. 1704-1714. Date of Electronic Publication: 2021 Jan 04.
Typ publikacji:: Comparative Study; Journal Article; Systematic Review
Język:: English
Imprint Name(s):: Publication: <2009- >: Philadelphia, PA : Wiley-Blackwell
Original Publication: St. Louis, Mo. : [s.n., 1896-
MeSH Terms:: Compression Bandages/*adverse effects
Endoscopy/*methods
Paranasal Sinuses/*surgery
Rhinitis/*surgery
Sinusitis/*surgery
Steroids/*pharmacology
Triamcinolone/*pharmacology
Chronic Disease ; Compression Bandages/statistics & numerical data ; Databases, Factual ; Humans ; Nasal Polyps/surgery ; Postoperative Period ; Prospective Studies ; Randomized Controlled Trials as Topic ; Research Design/standards ; Rhinitis/complications ; Sinusitis/complications ; Steroids/therapeutic use ; Treatment Outcome ; Triamcinolone/therapeutic use
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Contributed Indexing:: Keywords: Functional endoscopic sinus surgery; chronic rhinosinusitis; steroid-impregnated absorbable nasal packing
Substance Nomenclature:: 0 (Steroids)
1ZK20VI6TY (Triamcinolone)
Entry Date(s):: Date Created: 20210104 Date Completed: 20210726 Latest Revision: 20210726
Update Code:: 20240105
DOI:: 10.1002/lary.29350
PMID:: 33393665
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Objective: To evaluate the efficacy of absorbable steroid-impregnated nasal packing on postoperative outcomes following functional endoscopic sinus surgery (FESS) for chronic rhinosinusitis (CRS).
Methods: A systematic review of the literature was conducted as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Twelve databases (including Journals@Ovid, Embase®, Medline®, EBM Reviews and Joanna Briggs Institute EBP Database) were searched using relevant keywords and expanded with corresponding MeSH/Emtree terms. Results were narrowed to English articles assessing the efficacy of absorbable packing impregnated with steroids post-production placed at time of surgery under general anesthetic, with hollow-lumen devices and devices inserted in-office excluded.
Results: Eight studies met criteria and were included in this review. Five evaluated the efficacy of the intervention in only CRS with nasal polyposis (CRSwNP) patients, two included all subtypes of CRS, and one included only CRS without nasal polyposis (CRSsNP). Of the eight studies, four studied the efficacy of Nasopore®, three studied bioabsorbable gels, and one studied bioabsorbable calcium alginate. Four studies applied triamcinolone as the operative steroid, with the other studies utilizing betamethasone, budesonide, mometasone, and dexamethasone. Seven studies demonstrated statistically significant improvements in endoscopic outcomes using validated scoring scales, albeit at differing timepoints. The one study which included only CRSsNP patients failed to find a significant difference.
Conclusion: Steroid-impregnated nasal packing appears to have positive effects on postoperative endoscopic outcomes in CRSwNP patients undergoing FESS. Additional research is needed to evaluate the efficacy of these interventions in more recently defined subtypes of CRS, and whether these interventions differ in their efficacy in eosinophilic and non-eosinophilic CRS. Laryngoscope, 131:1704-1714, 2021.
(© 2021 The American Laryngological, Rhinological and Otological Society, Inc.)

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