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Double-blind, randomised controlled trial on the efficacy of saline nasal irrigation with sodium hyaluronate after endoscopic sinus surgery

Published online by Cambridge University Press:  10 April 2019

F Mozzanica ,
A Preti ,
R Gera ,
C Bulgheroni ,
A Cardella ,
A Albera ,
F Collurà ,
N Mevio ,
A Dragonetti  and
A Schindler
...Show all authors
F Mozzanica
Affiliation:
Department of Clinical Sciences and Community Health, San Giuseppe Hospital, IRCCS Multimedica, University of Milan, Italy
A Preti*
Affiliation:
Department of Clinical Sciences and Community Health, San Giuseppe Hospital, IRCCS Multimedica, University of Milan, Italy Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
R Gera
Affiliation:
Department of Clinical Sciences and Community Health, San Giuseppe Hospital, IRCCS Multimedica, University of Milan, Italy
C Bulgheroni
Affiliation:
Department of Otolaryngology, Desio Hospital, Monza, Italy
A Cardella
Affiliation:
Department of Clinical Sciences and Community Health, San Giuseppe Hospital, IRCCS Multimedica, University of Milan, Italy
A Albera
Affiliation:
Department of Clinical Sciences and Community Health, San Giuseppe Hospital, IRCCS Multimedica, University of Milan, Italy
F Collurà
Affiliation:
Department of Clinical Sciences and Community Health, San Giuseppe Hospital, IRCCS Multimedica, University of Milan, Italy
N Mevio
Affiliation:
Department of Otolaryngology, Niguarda Hospital, Milan, Italy
A Dragonetti
Affiliation:
Department of Otolaryngology, Niguarda Hospital, Milan, Italy
A Schindler
Affiliation:
Department of Biochemical and Clinical Sciences, Sacco Hospital, University of Milan, Italy
U Milanesi
Affiliation:
Department of Otolaryngology, Desio Hospital, Monza, Italy
F Ottaviani
Affiliation:
Department of Clinical Sciences and Community Health, San Giuseppe Hospital, IRCCS Multimedica, University of Milan, Italy
*
Author for correspondence: Dr Andrea Preti, Department of Clinical Sciences and Community Health, Ospedale San Giuseppe, IRCCS Multimedica, University of Milan, Milan, Italy E-mail: [email protected] Fax: +39 0285 994 472
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Abstract

Objective

There is a growing interest in sodium hyaluronate for the clinical management of patients who undergo functional endoscopic sinus surgery for chronic rhinosinusitis, because of the mucosal regenerative properties of this macromolecule. However, its role in post-operative care is still debated. This study aimed to evaluate the effect of sodium hyaluronate administered via nasal irrigation with saline, in the post-operative period, after functional endoscopic sinus surgery.

Methods

A multicentric, prospective, randomised, double-blind, parallel group study was conducted on 56 consecutive patients who underwent functional endoscopic sinus surgery for chronic rhinosinusitis without polyps. Group 1 received the standard therapy of normal saline; group 2 received saline plus sodium hyaluronate.

Results

Both objective and subjective measurements, in terms of endoscopic appearance and patient-reported satisfaction, were significantly better in group 2 compared to group 1.

Conclusion

Sodium hyaluronate may be a useful adjunct to nasal saline irrigation in the early post-operative period following functional endoscopic sinus surgery.

Keywords

SinusitisSurgeryNoseSodium Hyaluronate
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 4 , April 2019 , pp. 300 - 308
Copyright
Copyright © JLO (1984) Limited, 2019 

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Footnotes

Dr A Preti takes responsibility for the integrity of the content of the paper

References

1Fokkens, WJ, Lund, VJ, Mullol, J, Bachert, C, Alobid, I, Baroody, F et al. EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists. Rhinology 2012;50:1–12Google Scholar
2Low, TH, Woods, CM, Ullah, S, Carney, S. A double-blind randomized controlled trial of normal saline, lactated Ringer's, and hypertonic saline nasal irrigation solution after endoscopic sinus surgery. Am J Rhinol Allergy 2014;28:225–31Google Scholar
3Harvey, RJ, Goddard, JC, Wise, SK, Schlosser, RJ. Effects of endoscopic sinus surgery and delivery device on cadaver sinus irrigation. Otolaryngol Head Neck Surg 2008;139:137–42Google Scholar
4Tomooka, LT, Murphy, C, Davidson, TM. Clinical study and literature review of nasal irrigation. Laryngoscope 2000;110:1189–93Google Scholar
5Wormald, PJ, Cain, T, Oates, L, Hawke, L, Wong, I. A comparative study of three methods of nasal irrigation. Laryngoscope 2004;114:2224–7Google Scholar
6Harvey, R, Hannan, SA, Badia, L, Scadding, G. Nasal saline irrigations for the symptoms of chronic rhinosinusitis. Cochrane Database Syst Rev 2007;(18):CD006394Google Scholar
7Chong, LY, Head, K, Hopkins, C, Philpott, C, Glew, S, Scadding, G et al. Saline irrigation for chronic rhinosinusitis. Cochrane Database Syst Rev 2016;(26):CD011995Google Scholar
8Freeman, SR, Sivayoham, ES, Jepson, K, de Carpentier, J. A preliminary randomized controlled trial evaluating the efficacy of saline douching following endoscopic sinus surgery. Clin Otolaryngol 2008;33:462–5Google Scholar
9Gelardi, M, Guglielmi, AV, De Candia, N, Maffezzoni, E, Berardi, P, Quaranta, N. Effect of sodium hyaluronate on mucociliary clearance after functional endoscopic sinus surgery. Eur Ann Allergy Clin Immunol 2013;45:103–8Google Scholar
10Macchi, A, Terranova, P, Digilio, E, Castelnuovo, P. Hyaluronan plus saline nasal washes in the treatment of rhino-sinusal symptoms in patients undergoing functional endoscopic sinus surgery for rhino-sinusal remodeling. Int J Immunopathol Pharmacol 2013;26:137–45Google Scholar
11Fong, E, Garcia, M, Woods, CM, Ooi, E. Hyaluronic acid for post sinus surgery care: systematic review and meta-analysis. J Laryngol Otol 2017;131:S2–11Google Scholar
12Fraser, JR, Laurent, TC, Laurent, UB. Hyaluronan: its nature, distribution, functions and turnover. J Intern Med 1997;242:27–33Google Scholar
13Lund, VJ, Mackay, IS. Staging in rhinosinusitis. Rhinology 1993;107:183–4Google Scholar
14Lund, VJ, Kennedy, DW. Quantification for staging sinusitis. The Staging and Therapy Group. Ann Otol Rhinol Laryngol Suppl 1995;167:17–21Google Scholar
15Gera, R, Mozzanica, F, Karligkiotis, A, Preti, A, Bandi, F, Gallo, S et al. Lateral lamella of the cribriform plate, a keystone landmark: proposal for a novel classification system. Rhinology 2018;56:65–72Google Scholar
16Mozzanica, F, Preti, A, Gera, R, Gallo, S, Bulgheroni, C, Bandi, F et al. Cross-cultural adaptation and validation of the SNOT-22 into Italian. Eur Arch Otorhinolaryngol 2017;274:887–95Google Scholar
17Mozzanica, F, Urbani, E, Atac, M, Scottà, G, Luciano, K, Bulgheroni, C et al. Reliability and validity of the Italian nose obstruction symptom evaluation (I-NOSE) scale. Eur Arch Otorhinolaryngol 2013;270:3087–94Google Scholar
18Salib, RJ, Talpallikar, S, Uppal, S, Nair, SB. A prospective randomized single-blinded clinical trial comparing the efficacy and tolerability of the nasal douching products Sterimar™ and Sinus Rinse™ following functional endoscopic sinus surgery. Clin Otolaryngol 2013;38:297–305Google Scholar
19Cantone, E, Castagna, G, Sicignano, S, Ferranti, I, Rega, F, Di Rubbo, V et al. Impact of intranasal sodium hyaluronate on the short-term quality of life of patients undergoing functional endoscopic sinus surgery for chronic rhinosinusitis. Int Forum Allergy Rhinol 2014;4:484–7Google Scholar
20Dal, T, Bahar, S. The clinical outcomes of using a new cross-linked hyaluronan gel in endoscopic frontal sinus surgery. Eur Arch Otorhinolaryngol 2017;274:3397–402Google Scholar
21Psaltis, AJ, Li, G, Vaezeafshar, R, Cho, KS, Hwang, PH. Modification of the Lund-Kennedy endoscopic scoring system improves its reliability and correlation with patient-reported outcome measures. Laryngoscope 2014;124:2216–23Google Scholar