Skip to main content
Log in

Clinical benefits of polyurethane nasal packing in endoscopic sinus surgery

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

The benefits of nasal packing after endoscopic sinus surgery (ESS) are still debated in the literature. Our aims were to evaluate the efficacy, and the clinical effects of a totally degradable nasal dressing used after ESS. Thirty patients with chronic rhinosinusitis with nasal polyps were enrolled in a prospective, randomized, double-blind, controlled study. Every patient underwent ESS and a polyurethane nasal dressing was used in one nasal fossa and the contralateral fossa was left unpacked. The extent of mucosal edema, crust formation, bleeding tendency, presence of synechiae, amount of nasal discharge, and the patency of the ostiomeatal complex (OMC) was evaluated during nasal endoscopy on the first, fourth, and twelfth postoperative weeks. All clinical findings were statistically analyzed. Endoscopy showed a significant improvement in the patency of the OMC on the side with resorbable material at 4 weeks after surgery. Follow-up at week 12 showed that in addition to the OMC patency scores, synechia formation and nasal discharge were also significantly improved in the packed fossa. Polyurethane packing is an effective alternative for nasal packing following functional endoscopic sinus surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Eliashar R, Gross M, Wohlgelernter J, Sichel JY (2006) Packing in endoscopic sinus surgery: is it really required? Otolaryngol Head Neck Surg 134:276–279

    Article  PubMed  Google Scholar 

  2. Orlandi RR, Lanza DC (2004) Is nasal packing necessary following endoscopic sinus surgery? Laryngoscope 114:1541–1544

    Article  PubMed  Google Scholar 

  3. Weitzel EK, Wormald PJ (2008) A scientific review of middle meatal packing/stents. Am J Rhinol 22:302–307

    Article  PubMed  Google Scholar 

  4. von Schoenberg M, Robinson P, Ryan R (1993) Nasal packing after routine nasal surgery-is it justified? J Laryngol Otol 107:902–905

    Article  Google Scholar 

  5. Samad I, Stevens HE, Maloney A (1992) The efficacy of nasal septal surgery. J Otolaryngol 21:88–91

    CAS  PubMed  Google Scholar 

  6. Pomerantz J, Dutton JM (2005) Platelet gel for endoscopic sinus surgery. Ann Otol Rhinol Laryngol 114:699–704

    Article  PubMed  Google Scholar 

  7. Vaiman M, Eviatar E, Segal S (2002) The use of fibrin glue as haemostatic in endonasal operations: a prospective, randomized study. Rhinology 40:185–188

    PubMed  Google Scholar 

  8. Vaiman M, Eviatar E, Segal S (2002) Effectiveness of second-generation fibrin glue in endonasal operation. Otolaryngol Head Neck Surg 126:388–391

    Article  PubMed  Google Scholar 

  9. Shaw CL, Dymock RB, Cowin A, Wormald PJ (2000) Effect of packing on nasal mucosa of sheep. J Laryngol Otol 114:506–509

    CAS  PubMed  Google Scholar 

  10. Lund VJ, Mackay IS (1993) Staging in rhinosinusitis. Rhinology 107:183–184

    Google Scholar 

  11. Stammberger H, Posawetz W (1990) Functional endoscopic sinus surgery. Concept, indications and results of the Messerklinger technique. Eur Arch Otorhinolaryngol 247:63–76

    Article  CAS  PubMed  Google Scholar 

  12. Berlucchi M, Castelnuovo P, Vincenzi A, Morra B, Pasquini E (2009) Endoscopic outcomes of resorbable nasal packing after functional endoscopic sinus surgery: a multicenter prospective randomized controlled study. Eur Arch Otorhinolaryngol 266:839–845

    Article  PubMed  Google Scholar 

  13. Jee HW, Chul HL, Chae SR, Jeong-Whun K (2012) Comparison between Gelfoam packing and no packing after endoscopic sinus surgery in the same patients. Eur Arch Otorhinolaryngol 269:897–903

    Article  Google Scholar 

  14. Athanasiadis T, Beule AG, Wormald PJ (2007) Effects of topical antifibrinolytics in endoscopic sinus surgery: a pilot randomized controlled trial. Am J Rhinol 21:737–742

    Article  PubMed  Google Scholar 

  15. Wormald PJ, Boustred RN, Le T, Hawke L, Sacks R (2006) A prospective single-blind randomized controlled study of use of hyaluronic acid nasal packs in patients after endoscopic sinus surgery. Am J Rhinol 20:7–10

    PubMed  Google Scholar 

  16. Weber R, Keerl R, Hochapfel F et al (2001) Packing in endonasal surgery. Am J Otolaryngol 22:306–320

    Article  PubMed  Google Scholar 

  17. Weber R, Keerl R, Hochapfel F, Draf W (2000) Packing and stents in endonasal surgery. Rhinology 38:49–62

    CAS  PubMed  Google Scholar 

  18. Okushi T et al (2012) Evaluation of symptoms and QOL with calcium alginate versus chitin-coated gauze for middle meatus packing after endoscopic sinus surgery. Auris Nasus Larynx 39:31–37

    Article  PubMed  Google Scholar 

  19. Catalano PJ, Roffman EJ (2003) Evaluation of middle meatal stenting after minimally invasive sinus techniques (MIST). Otolaryngol Head Neck Surg 128:875–881

    Article  PubMed  Google Scholar 

  20. Woodworth BA, Chandra RK, LeBenger JD, Ilie B, Schlosser RJ (2009) A gelatin-thrombin matrix for hemostasis after endoscopic sinus surgery. Am J Otolaryngol 199230:49–53

    Article  Google Scholar 

  21. Vaiman M, Sarfaty S, Shlamkovich N, Segal S, Eviatar E (2005) Fibrin sealant: alternative to nasal packing in endonasal operations. A prospective randomized study. Isr Med Assoc J 7:571–574

    PubMed  Google Scholar 

  22. Baumann A, Caversaccio M (2003) Hemostasis in endoscopic sinus surgery using a specific gelatin-thrombin based agent (FloSeal). Rhinology 41:244–249

    PubMed  Google Scholar 

  23. Valentine R, Athanasiadis T, Moratti S, Hanton L, Robinson S, Wormald PJ (2010) The efficacy of a novel chitosan gel on hemostasis and wound healing after endoscopic sinus surgery. Am J Rhinol Allergy 24:70–75

    Article  PubMed  Google Scholar 

  24. Karkos PD, Thinakararajan T, Goodyear P, Srinivasan VR (2007) Day-case endoscopic sinus surgery using dissolvable haemostatic nasal packs: a pilot study. Eur Arch Otorhinolaryngol 264:1171–1174

    Article  CAS  PubMed  Google Scholar 

  25. Antisdel JL, West-Denning JL, Sindwani R (2009) Effect of microporous polysaccharide hemospheres (MPH) on bleeding after endoscopic sinus surgery: randomized controlled study. Otolaryngol Head Neck Surg 141:353–357

    Article  PubMed  Google Scholar 

  26. Kastl KG, Reichert M, Scheithauer MO et al (2014) Patient comfort following FESS and Nasopore® packing, a double blind, prospective, randomized trial. Rhinology 52:60–65

    CAS  PubMed  Google Scholar 

  27. Catalano PJ, Payne S, Thong M (2011) Clinical evaluation of a fully synthetic middle meatal stent for safety and tolerability. Otolaryngol Head Neck Surg 144:452–456

    Article  PubMed  Google Scholar 

  28. Verim A, Seneldir L, Naiboglu B, Karaca CT, Kulekci S, Toros SZ, Oysu C (2014) Role of nasal packing in surgical outcome for chronic rhinosinusitis with polyposis. Laryngoscope. 124:1529–1535. doi:10.1002/lary.24543

    Article  PubMed  Google Scholar 

  29. Burduk PK, Wierzchowska M, Grzeskowiak B, Kazmierczak W, Wawprzyniak K (2016) Clinical outcome and patient satisfaction using biodegradable (NasoPore) and non-biodegradable packing, a double-blind, prospective, randomized study. Braz J Otorhinolaryngol. doi:10.1016/j.bjorl

    Google Scholar 

  30. Yilmaz MS, Guven M, Elicora SS, Kaymaz R (2013) An evaluation of biodegradable synthetic polyurethane foam in patients following septoplasty: a prospective randomized trial. Otolaryngol Head Neck Surg 148:140–144

    Article  PubMed  Google Scholar 

  31. More Y, Willen S, Catalano P (2011) Management of early nasal polyposis using a steroid-impregnated nasal dressing. Int Forum Allergy Rhinol 1:401–404

    Article  PubMed  Google Scholar 

  32. Wang YP, Wang MC, Chen YC, Leu YS, Lin HC, Lee KS (2011) The effects of Vaseline gauze strip, Merocel, and Nasopore on the formation of synechiae and excessive granulation tissue in the middle meatus and the incidence of major postoperative bleeding after endoscopic sinus surgery. J Chin Med Assoc 74:16–21

    Article  PubMed  Google Scholar 

  33. Shoman N, Gherian H, Flamer D, Javer A (2009) Prospective, double-blind, randomized trial evaluating patient satisfaction, bleeding, and wound healing using biodegradable synthetic polyurethane foam (nasopore) as a middle meatal spacer in functional endoscopic sinus surgery. J Otolaryngol Head Neck Surg 38:112–118

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Zalan Piski.

Ethics declarations

Conflict of interest

No conflict of interest.

Ethical statement

The study protocol was approved by the Ethics Committee of the Medical School—University of Pécs. (No. 4588/2012).

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Piski, Z., Gerlinger, I., Nepp, N. et al. Clinical benefits of polyurethane nasal packing in endoscopic sinus surgery. Eur Arch Otorhinolaryngol 274, 1449–1454 (2017). https://doi.org/10.1007/s00405-016-4354-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-016-4354-1

Keywords

Navigation