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Silastic splints reduce middle meatal adhesions after endoscopic sinus surgery.

Campbell J Baguley1, Nicholas W Stow, Erik K Weitzel

  • 1North Shore Hospital, and Department of Surgery, The University of Auckland, Auckland, New Zealand.

American Journal of Rhinology & Allergy
|November 22, 2012
PubMed
Summary

Silastic splints placed after endoscopic sinus surgery reduce adhesions but increase early discomfort. Long-term outcomes were not significantly improved, indicating a trade-off between adhesion prevention and early side effects.

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Area of Science:

  • Otolaryngology
  • Surgical Innovation
  • Nasal Surgery Outcomes

Background:

  • Post-endoscopic sinus surgery (ESS) adhesions can lead to surgical failure.
  • Various surgical spacers have been explored to improve healing.
  • The efficacy of middle meatal silastic splints in preventing adhesions and improving outcomes requires investigation.

Purpose of the Study:

  • To determine if thin silastic splints in the middle meatus reduce adhesion formation after ESS.
  • To assess if reduced adhesions improve early postoperative patient outcomes.
  • To evaluate the impact of silastic splints on symptom scores and ethmoid cavity grading.

Main Methods:

  • Randomized controlled trial with 42 chronic rhinosinusitis patients undergoing ESS.
  • Silastic splints placed unilaterally in the middle meatus, removed after 2 weeks.

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  • Blinded assessment of symptom scores, ethmoid cavity grading, and adhesions at 6 and 12 weeks.

    • Main Results:

    • Splinted sides showed significantly higher nasal obstruction and discomfort in the first 2 weeks.
    • No adhesions were observed at 12 weeks in splinted sides, versus 9/33 in nonsplinted sides.
    • No significant differences in symptom or ethmoid cavity scores at 6 or 12 weeks between splinted and nonsplinted sides.

    Conclusions:

    • Middle meatal silastic splints effectively reduce adhesions following ESS.
    • However, splints increase early postoperative nasal obstruction and discomfort.
    • The use of silastic splints did not significantly alter symptom or ethmoid cavity scores at 12 weeks.