European Archives of Oto-Rhino-Laryngology

, Volume 274, Issue 9, pp 3269–3274 | Cite as

Efficacy of chitosan dressing on endoscopic sinus surgery: a systematic review and meta-analysis

  • Jing-chun Zhou
  • Jing-jing Zhang
  • Wei Zhang
  • Zhao-yang Ke
  • Bo Zhang
Review Article


Chitosan dressing might be promising to promote the recovery following endoscopic sinus surgery (ESS). However, the results remain controversial. We conducted a systematic review and meta-analysis to explore the influence of chitosan dressing on ESS. PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the effect of chitosan dressing on endoscopic sinus surgery were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcomes were synechia and hemostasis. Meta-analysis was performed using random-effect model. Four RCTs involving 268 patients were included in the meta-analysis. Overall following ESS, compared with control intervention, chitosan dressing significantly reduced synechia (RR = 0.25; 95% CI 0.13–0.49; P < 0.0001) and promoted hemostasis (RR = 1.70; 95% CI 1.37–2.11; P < 0.00001), but showed no impact on granulations (RR = 1.18; 95% CI 0.72–1.95; P = 0.52), mucosal edema (RR = 0.88; 95% CI 0.60–1.29; P = 0.51), crusting (RR = 0.85; 95% CI 0.48–1.53; P = 0.60), and infection (RR = 0.88; 95% CI 0.51–1.52; P = 0.64). Compared to control intervention, chitosan dressing could significantly decrease edema and improve hemostasis, but had no effect on granulations, mucosal edema, crusting and infection.


Chitosan dressing Synechia Hemostasis Endoscopic sinus surgery Meta-analysis 



This study was supported by Shenzhen Municipal Science and Technology Innovation Committee (No.: CXZZ20140509151403304); Health and Family Planning Commission of Shenzhen Municipality (No.: 201401006).

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Research involving human participants and/or animals

Not applicable.

Informed consent

Not applicable.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Jing-chun Zhou
    • 1
  • Jing-jing Zhang
    • 2
  • Wei Zhang
    • 1
  • Zhao-yang Ke
    • 1
  • Bo Zhang
    • 1
  1. 1.Department of Otorhinolaryngology, Shenzhen People’s HospitalThe Second Clinical Medical College of Jinan UniversityShenzhenChina
  2. 2.Department of OtorhinolaryngologyPeking University Shenzhen HospitalShenzhenChina

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