<p>Chronic rhinosinusitis is a common long term condition affecting millions across the globe. Treatment can be conservative or surgical with functional endoscopic sinus surgery (FESS) being one of the keystone treatments for this condition. Post-operatively, the nasal cavity is packed for various reasons, including to alleviate bleeding and to aid in wound healing. Non-absorbable packing is commonly utilized for packing but studies have shown that removal may not be well tolerated. Absorbable nasal dressings were hence developed. However, there is insufficient evidence with regards to the relative effectiveness of these respective packings. This meta-analysis was conducted according to PRISMA guidelines. A literature search was done on Pubmed, Web of Science, Embase. 12 randomized controlled trials comparing absorbable versus non absorbable packing were included in this meta-analysis evaluating 10 post-operative outcomes. Study quality of RCTs was analyzed using the Cochrane risk-of-bias 2 tool (RoB 2). Data analysis was done using Review Manager Version 5.3 (Cochrane Collaboration). Meta-analysis showed that absorbable nasal dressings had significant long-term reduction of synechiae (OR 5.71, 95% CI [1.55–21.10], <i>p</i> = 0.009) better re-epithelization (OR 3.32, 95% CI [1.33–8.30], <i>p</i> = 0.01) and reduced nasal blockage symptoms (Mean Difference -0.53, 95% CI [-0.82, -0.24], <i>p</i> = 0.0003). Qualitative review shows shorter time to hemostasis for absorbable nasal dressings. The consideration of using absorbable over non-absorbable packing is a decade-long debate in post-FESS patients. Current data shows that absorbable nasal dressings outperform their non-absorbable counterparts.</p>

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Post-operative outcomes of absorbable versus non-absorbable sinus packing after functional endoscopic sinus surgery: a systematic review and meta-analysis

  • Branden Qi Yu Chua,
  • Vanessa Wei Shan Chong,
  • Thomas Zheng Jie Teng,
  • Tze Choong Charn

摘要

Chronic rhinosinusitis is a common long term condition affecting millions across the globe. Treatment can be conservative or surgical with functional endoscopic sinus surgery (FESS) being one of the keystone treatments for this condition. Post-operatively, the nasal cavity is packed for various reasons, including to alleviate bleeding and to aid in wound healing. Non-absorbable packing is commonly utilized for packing but studies have shown that removal may not be well tolerated. Absorbable nasal dressings were hence developed. However, there is insufficient evidence with regards to the relative effectiveness of these respective packings. This meta-analysis was conducted according to PRISMA guidelines. A literature search was done on Pubmed, Web of Science, Embase. 12 randomized controlled trials comparing absorbable versus non absorbable packing were included in this meta-analysis evaluating 10 post-operative outcomes. Study quality of RCTs was analyzed using the Cochrane risk-of-bias 2 tool (RoB 2). Data analysis was done using Review Manager Version 5.3 (Cochrane Collaboration). Meta-analysis showed that absorbable nasal dressings had significant long-term reduction of synechiae (OR 5.71, 95% CI [1.55–21.10], p = 0.009) better re-epithelization (OR 3.32, 95% CI [1.33–8.30], p = 0.01) and reduced nasal blockage symptoms (Mean Difference -0.53, 95% CI [-0.82, -0.24], p = 0.0003). Qualitative review shows shorter time to hemostasis for absorbable nasal dressings. The consideration of using absorbable over non-absorbable packing is a decade-long debate in post-FESS patients. Current data shows that absorbable nasal dressings outperform their non-absorbable counterparts.