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Microporous polysaccharide hemospheres do not increase synechiae after sinus surgery: randomized controlled study
Jastin L Antisdel1, Jackie L Matijasec, Jonathan Y Ting
1Department of Otolaryngology-Head and Neck Surgery, Saint Louis University, Saint Louis, Missouri, USA.
Background:
Many surgeons use absorbable packing materials after endoscopic sinus surgery (ESS). Despite their popularity, some of these agents have been shown to contribute to synechiae formation. Microporous polysaccharide hemospheres (MPH) is a plant-based hemostatic powder that does not interfere with regenerating sinus mucosa in the animal model. The goal of this study was to examine the impact of MPH on healing and synechiae formation after ESS in human subjects.
Methods:
A prospective, randomized, controlled, double-blind study was performed. Forty consenting adult patients with chronic sinusitis requiring symmetric ESS were randomized to receive MPH unilaterally at the conclusion of surgery. The opposite side was untreated. Standard postoperative care was performed bilaterally. Outcomes measured included blinded observer ratings for synechiae formation, edema, and infection. Each side was examined endoscopically and scored at postoperative days 7, 14, and 30.
Results:
Twenty men and 20 women with an average age of 48.2 years were included. There were no complications and all patients were discharged home the same day. There was no significant difference in synechiae formation at any point postoperatively. The rate of synechiae formation was determined to be 10% (4/40) on the MPH-treated side versus 7.5% (3/40) on the untreated side (p = 0.7639). In addition, there were no significant differences observed in edema (p = 0.7480) or infection (p = 0.5533).
Conclusion:
The use of MPH after sinus surgery does not increase synechiae formation and does not appear to deleteriously affect the healing of postoperative sinus cavities.
Insights
Microporous polysaccharide hemospheres (MPH) did not increase synechiae formation after endoscopic sinus surgery (ESS). This plant-based hemostatic powder appears safe for healing sinus cavities post-surgery.
Area of Science:
- Otolaryngology
- Surgical Innovation
- Wound Healing
Background:
- Absorbable packing materials are common after endoscopic sinus surgery (ESS).
- Some packing agents may promote synechiae formation (nasal adhesions).
- Microporous polysaccharide hemospheres (MPH) is a plant-based hemostatic agent with no adverse effects on sinus mucosa in animal models.
Purpose of the Study:
- To evaluate the impact of MPH on healing and synechiae formation following ESS in human subjects.
- To assess the safety and efficacy of MPH as a post-operative packing agent.
Main Methods:
- Prospective, randomized, controlled, double-blind study.
- Forty adult patients undergoing ESS received MPH unilaterally; the contralateral side served as untreated control.
- Outcomes including synechiae, edema, and infection were assessed via endoscopy at 7, 14, and 30 days postoperatively.
Main Results:
- No significant difference in synechiae formation between MPH-treated (10%) and untreated (7.5%) sides (p=0.7639).
- No significant differences observed in postoperative edema (p=0.7480) or infection rates (p=0.5533).
- No complications reported; all patients discharged same-day.
Conclusions:
- Microporous polysaccharide hemospheres (MPH) do not increase synechiae formation after ESS.
- MPH does not appear to negatively impact the healing of postoperative sinus cavities.
- MPH is a safe and potentially effective option for post-ESS packing.