Triamcinolone-impregnated nasal dressing following endoscopic sinus surgery: A randomized, double-blind, placebo-controlled study

Authors

  • David W. J. Côté MD, MPH,

    Corresponding author
    1. Division of Otolaryngology, Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada
    • Chief Resident, c/o Division of Otolaryngology, Head and Neck Surgery, University of Alberta, 1E4 Walter McKenzie Centre, 8440-112 Street NW, Edmonton, Alberta, Canada T6G 2B7
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  • Erin D. Wright MD CM, MEd

    1. Division of Otolaryngology, Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada
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  • This article has been awarded the Shirley Baron Resident Research Award, Western Section, and was presented at the Triological Society Combined Sections Meeting, Orlando, Florida, U.S.A., February 4–7, 2010.

  • Investigator-initiated study with Nasopore dressings donated by Stryker Canada. Stryker Canada had no involvement in study design, protocol, methods, or analysis. The authors have no other funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis:

To evaluate the impact of steroid-impregnated absorbable nasal dressing on wound healing and surgical outcomes after endoscopic sinus surgery (ESS).

Study Design:

A prospective, randomized, double-blinded, placebo-controlled trial.

Methods:

Chronic rhinosinusitis patients with polyposis who were to undergo bilateral endoscopic sinus surgery were recruited and randomized to receive triamcinolone-impregnated bioresorbable dressing (Nasopore; Stryker Canada, Hamilton, Ontario, Canada) in one nasal cavity and saline-impregnated dressing contralaterally. Postoperative healing assessments of edema, crusting, secretions, and scarring were done at postoperative days 7, 14, 28 and at 3 and 6 months using validated Lund-Kennedy and Perioperative Sinus Endoscopy (POSE) scores.

Results:

Analysis of 19 enrolled patients having completed observation shows no significant difference between the cavity scores preoperatively using both the POSE and Lund-Kennedy scores. There was, however, a statistically significant difference at day 7 and 14 in both the Lund-Kennedy (P = .04 and P = .03, respectively) and POSE scores (P = .03 and P = .001, respectively) for the treatment and control groups, and a significant difference was also detected between the groups at 3- and 6-month observations (Lund-Kennedy, P = .007 and P = .02, respectively; POSE, P = .049 and P = .01, respectively).

Conclusions:

Data analysis suggests a significant improvement in early postoperative healing in nasal cavities receiving triamcinolone-impregnated absorbable nasal packing following ESS and is also associated with improved healing up to 6 months postoperatively.

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