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

Author(s): Cote DW, Wright ED

Affiliation(s): Division of Otolaryngology, Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada. dcote@post.harvard.edu

Publication date & source: 2010-06, Laryngoscope., 120(6):1269-73.

Publication type: Randomized Controlled Trial

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.