Randomized, controlled, study of absorbable nasal packing on outcomes of surgical treatment of rhinosinusitis with polyposis

Background: The aim of this study was to establish the effect of absorbable dressing on postoperative discomfort and mucosal healing after sinus surgery. A prospective, randomized, controlled, blinded study was performed. Methods: Patients 18-80 years old undergoing sinus surgery were enrolled in the study. Each patient's ethmoid cavities were randomized to receive either absorbable dressing or the standard nonabsorbable sinus packs. Therefore, patients served as their own control. Preoperative CT scan and intraoperative endoscopic photographs were used for staging within the Lund-Mackay system. The procedure was performed as indicated by extent of disease. The remaining absorbable dressing was removed at 2 weeks by endoscopic suctioning in the clinic. Patients completed questionnaires regarding sinus symptoms and discomfort. Postoperative endoscopic appearance was graded by a single rhinologist. Length of follow-up was 6 months. Results: Thirty-five patients were randomized. There were no significant adverse events in either group. Patients' symptom scores improved at 2 weeks and at 1 and 3 months when compared with preoperation. Both groups had similar preoperative grade of disease and extent of surgery. Endoscopic appearance of the absorbable cavity showed a trend toward improvement at 2 weeks (p < 0.05). Endoscopic appearance showed a similar trend toward improvement at 1, 3, and 6 months in the absorbable group (NS). Twenty-seven patients had a strong preference for a particular nasal packing of which 16 of 27 (59.3%) patients preferred the absorbable dressing. Conclusion: The absorbable dressing showed a trend toward positive effect on early wound healing and in late results. Strong patient preference was indicated for the absorbable dressing over standard sponges.