Skip to main content
Log in

Control of bleeding following functional endoscopic sinus surgery using carboxy-methylated cellulose packing

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

Abstract

The aim of this study is to evaluate the haemostatic effect of carboxy-methylated cellulose (CMC) nasal packing following functional endoscopic sinus surgery (FESS). The design includes an investigator-initiated, randomized, single-blinded, controlled, prospective clinical study. A bilateral FESS procedure was performed on 41 patients. At the end of the operation, one side was randomly filled with CMC nasal packing, the other side remained without packing. The patients were blinded to the side of nasal packing and were postoperatively examined on the 1st day, after 2 and 4 weeks and the extent of the postoperative bleeding was quantified with a clinical grading system. Even though there were slightly more postoperative bleedings reported for the non-packed sides as compared to the CMC-packed sides, these differences were at no point statistically significant within the monitored postoperative period of 4 weeks. In the examined collective, the CMC packing investigated did not statistically prove to have an effect on bleeding control in this study design.

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.

Fig. 1

Similar content being viewed by others

References

  1. Fokkens W, Lund V, Bachert C et al (2005) EAACI position paper on rhinosinusitis and nasal polyps executive summary. Allergy 60:583–601. doi:10.1111/j.1398-9995.2005.00830.x

    Article  CAS  PubMed  Google Scholar 

  2. Bugten V, Nordgard S, Skogvoll E et al (2006) Effects of nonabsorbable packing in middle meatus after sinus surgery. Laryngoscope 116:83–88. doi:10.1097/01.mlg.0000184581.67185.6e

    Article  PubMed  Google Scholar 

  3. Eliashar R, Gross M, Wohlgelernter J et al (2006) Packing in endoscopic sinus surgery: is it really required? Otolaryngol Head Neck Surg 134:276–279. doi:10.1016/j.otohns.2005.10.012

    Article  PubMed  Google Scholar 

  4. Orlandi RR, Lanza DC (2004) Is nasal packing necessary following endoscopic sinus surgery? Laryngoscope 114:1541–1544. doi:10.1097/00005537-200409000-00007

    Article  PubMed  Google Scholar 

  5. Beule AG, Weber RK, Kaftan H et al (2004) Ubersicht: Art und Wirkung gelaufiger Nasentamponaden. Laryngorhinootologie 83:534–551. doi:10.1055/s-2004-825695

    Article  CAS  PubMed  Google Scholar 

  6. Weber R, Keerl R, Hochapfel F et al (2001) Packing in endonasal surgery. Am J Otolaryngol 22:306–320. doi:10.1053/ajot.2001.26499

    Article  PubMed  Google Scholar 

  7. Weitzel EK, Wormald PJ (2008) A scientific review of middle meatal packing/stents. Am J Rhinol 22:302–307. doi:10.2500/ajr.2008.22.3171

    Article  PubMed  Google Scholar 

  8. Chandra RK, Kern RC (2004) Advantages and disadvantages of topical packing in endoscopic sinus surgery. Curr Opin Otolaryngol Head Neck Surg 12:21–26. doi:10.1097/00020840-200402000-00007

    Article  PubMed  Google Scholar 

  9. Wormald PJ, Boustred RN, Le T et al (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 

  10. Nilssen EL, Wardrop P, El-Hakim H et al (2002) A randomized control trial of post-operative care following endoscopic sinus surgery: debridement versus no debridement. J Laryngol Otol 116:108–111. doi:10.1258/0022215021910041

    Article  CAS  PubMed  Google Scholar 

  11. Stammberger H, Hosemann W, Draf W (1997) Anatomische Terminologie und Nomenklatur fur die Nasennebenhohlenchirurgie. Laryngorhinootologie 76:435–449

    Article  CAS  PubMed  Google Scholar 

  12. Stammberger H, Posawetz W (1990) Functional endoscopic sinus surgery, concept, indications and results of the Messerklinger technique. Eur Arch Otorhinolaryngol 247:63–76. doi:10.1007/BF00183169

    Article  CAS  PubMed  Google Scholar 

  13. Boezaart AP, van der Merwe J, Coetzee A (1995) Comparison of sodium nitroprusside- and esmolol-induced controlled hypotension for functional endoscopic sinus surgery. Can J Anaesth 42:373–376

    Article  CAS  PubMed  Google Scholar 

  14. Leunig A (2006) Vermeidung von und Umgang mit Blutungen wahrend endoskopischer Nasennebenhohlenchirurgie. Laryngorhinootologie 85:249–252. doi:10.1055/s-2006-939824

    Article  CAS  PubMed  Google Scholar 

  15. 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 

  16. Bogris K, Stavropoulos N, Sylligardakis N et al (2005) Haemostasis and chemoprophylasis using a specific nasal packing after rhinosurgery. Ann Ital Chir 76:189–193 discussion 193

    PubMed  Google Scholar 

  17. Chandra RK, Conley DB, Kern RC (2003) The effect of FloSeal on mucosal healing after endoscopic sinus surgery: a comparison with thrombin-soaked gelatin foam. Am J Rhinol 17:51–55

    PubMed  Google Scholar 

  18. Gall RM, Witterick IJ, Shargill NS et al (2002) Control of bleeding in endoscopic sinus surgery: use of a novel gelatin-based hemostatic agent. J Otolaryngol 31:271–274. doi:10.2310/7070.2002.29810

    Article  PubMed  Google Scholar 

  19. Vaiman M, Eviatar E, Shlamkovich N et al (2005) Use of fibrin glue as a hemostatic in endoscopic sinus surgery. Ann Otol Rhinol Laryngol 114:237–241

    Article  PubMed  Google Scholar 

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

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Konrad G. Kastl.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kastl, K.G., Betz, C.S., Siedek, V. et al. Control of bleeding following functional endoscopic sinus surgery using carboxy-methylated cellulose packing. Eur Arch Otorhinolaryngol 266, 1239–1243 (2009). https://doi.org/10.1007/s00405-008-0881-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-008-0881-8

Keywords

Navigation