Please use this identifier to cite or link to this item: https://hdl.handle.net/1/1920
Title: Efficacy of Absorbable Steroid-Impregnated Nasal Packing in Functional Endoscopic Sinus Surgery for Chronic Rhinosinusitis: A Systematic Review
Authors: Shashinder, Singh ;Ryan, Peter J ;Zhang, Michael 
Affliation: Central Coast Local Health District
Gosford Hospital
Issue Date: Jan-2021
Source: 131(8):1704-1714
Journal title: Laryngoscope
Department: Otolaryngology–Head & Neck Surgery
Abstract: OBJECTIVE: To evaluate the efficacy of absorbable steroid-impregnated nasal packing on postoperative outcomes following functional endoscopic sinus surgery (FESS) for chronic rhinosinusitis (CRS). METHODS: A systematic review of the literature was conducted as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Twelve databases (including Journals@Ovid, Embase®, Medline®, EBM Reviews and Joanna Briggs Institute EBP Database) were searched using relevant keywords and expanded with corresponding MeSH/Emtree terms. Results were narrowed to English articles assessing the efficacy of absorbable packing impregnated with steroids post-production placed at time of surgery under general anesthetic, with hollow-lumen devices and devices inserted in-office excluded. RESULTS: Eight studies met criteria and were included in this review. Five evaluated the efficacy of the intervention in only CRS with nasal polyposis (CRSwNP) patients, two included all subtypes of CRS, and one included only CRS without nasal polyposis (CRSsNP). Of the eight studies, four studied the efficacy of Nasopore®, three studied bioabsorbable gels, and one studied bioabsorbable calcium alginate. Four studies applied triamcinolone as the operative steroid, with the other studies utilizing betamethasone, budesonide, mometasone, and dexamethasone. Seven studies demonstrated statistically significant improvements in endoscopic outcomes using validated scoring scales, albeit at differing timepoints. The one study which included only CRSsNP patients failed to find a significant difference. CONCLUSION: Steroid-impregnated nasal packing appears to have positive effects on postoperative endoscopic outcomes in CRSwNP patients undergoing FESS. Additional research is needed to evaluate the efficacy of these interventions in more recently defined subtypes of CRS, and whether these interventions differ in their efficacy in eosinophilic and non-eosinophilic CRS. Laryngoscope, 2021.
URI: https://elibrary.cclhd.health.nsw.gov.au/cclhdjspui/handle/1/1920
DOI: 10.1002/lary.29350
Pubmed: https://pubmed.ncbi.nlm.nih.gov/33393665/
ISSN: 0023-852x
Publicaton type: Journal Article
Keywords: Surgery
Study or Trial: Reviews/Systematic Reviews
Appears in Collections:Health Service Research

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