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Effects of nasal lavage with and without mupirocin after endoscopic endonasal skull base surgery: a randomised, controlled study

Published online by Cambridge University Press:  27 November 2019

B H K Ng ,
I P Tang ,
P Narayanan ,
R Raman  and
R L Carrau
B H K Ng
Affiliation:
Otorhinolaryngology – Head and Neck Surgery Department, Faculty of Medicine, University of Malaya, Malaysia Otorhinolaryngology – Head and Neck Surgery Department, Faculty of Medicine and Health Sciences, University Malaysia Sarawak, Malaysia Otorhinolaryngology – Head and Neck Surgery Department, Sarawak General Hospital, Malaysia
I P Tang*
Affiliation:
Otorhinolaryngology – Head and Neck Surgery Department, Faculty of Medicine and Health Sciences, University Malaysia Sarawak, Malaysia Otorhinolaryngology – Head and Neck Surgery Department, Sarawak General Hospital, Malaysia
P Narayanan
Affiliation:
Otorhinolaryngology – Head and Neck Surgery Department, Faculty of Medicine, University of Malaya, Malaysia
R Raman
Affiliation:
Otorhinolaryngology – Head and Neck Surgery Department, Faculty of Medicine, University of Malaya, Malaysia
R L Carrau
Affiliation:
Otorhinolaryngology – Head and Neck Surgery Department, Ohio State University Wexner Medical Center, Columbus, Ohio, USA
*
Author for correspondence: Dr Ing Ping Tang, Otorhinolaryngology – Head and Neck Surgery Department, Faculty of Medicine and Health Sciences, University Malaysia Sarawak (‘UNIMAS’), Jalan Datuk Mohd Musa, 94300Kota Samarahan, Sarawak, Malaysia E-mail: [email protected]
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Abstract

Background

Nasal lavage with mupirocin has the potential to reduce sinonasal morbidity in endoscopic endonasal approaches for skull base surgery.

Objective

To evaluate the effects of nasal lavage with and without mupirocin after endoscopic endonasal skull base surgery.

Methods

A pilot randomised, controlled trial was conducted on 20 adult patients who had undergone endoscopic endonasal approaches for skull base lesions. These patients were randomly assigned to cohorts using nasal lavages with mupirocin or without mupirocin. Patients were assessed in the out-patient clinic, one week and one month after surgery, using the 22-item Sino-Nasal Outcome Test questionnaire and nasal endoscopy.

Results

Patients in the mupirocin nasal lavage group had lower nasal endoscopy scores post-operatively, and a statistically significant larger difference in nasal endoscopy scores at one month compared to one week. The mupirocin nasal lavage group also showed better Sino-Nasal Outcome Test scores at one month compared to the group without mupirocin.

Conclusion

Nasal lavage with mupirocin seems to yield better outcomes regarding patients’ symptoms and endoscopic findings.

Keywords

Endoscopic Surgical ProcedureMinimally Invasive SurgerySkull BaseNasal LavageMupirocin
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 12 , December 2019 , pp. 1059 - 1063
Copyright
Copyright © JLO (1984) Limited, 2019

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Footnotes

Dr I P Tang takes responsibility for the integrity of the content of the paper

References

1Awad, AJ, Mohyeldin, A, El-Sayed, IH, Aghi, MK.Sinonasal morbidity following endoscopic endonasal skull base surgery. Clin Neurol Neurosurg 2015;130:162–710.1016/j.clineuro.2015.01.004CrossRefGoogle ScholarPubMed
2Balaker, AE, Bergsneider, M, Martin, NA, Wang, MB.Evolution of sinonasal symptoms following endoscopic anterior skull base surgery. Skull Base 2010;20:245–5110.1055/s-0030-1249248CrossRefGoogle ScholarPubMed
3Talbot, AR, Herr, TM, Parsons, DS.Mucociliary clearance and buffered hypertonic saline solution. Laryngoscope 1997;107:500–310.1097/00005537-199704000-00013CrossRefGoogle ScholarPubMed
4Brown, CL, Graham, SM.Nasal irrigations: good or bad? Curr Opin Otolaryngol Head Neck Surg 2004;12:9–1310.1097/00020840-200402000-00004CrossRefGoogle ScholarPubMed
5Hudson, IRB.The efficacy of intranasal mupirocin in the prevention of staphylococcal infections: a review of recent experience. J Hosp Infect 1996;27:81–9810.1016/0195-6701(94)90001-9CrossRefGoogle Scholar
6Sutherland, R, Boon, RJ, Griffin, KE, Masters, PJ, Slocombe, B, White, AR.Antibacterial activity of mupirocin, a new antibiotic for topical use. Antimicrob Agents Chemother 1985;27:495–810.1128/AAC.27.4.495CrossRefGoogle Scholar
7Manoharan, G.Development and validation of a stability-indicating RP-HPLC method for the estimation of mupirocin in bulk and ointment dosage form. Eur J Pharm Med Res 2016;3:470–6Google Scholar
8Uren, B, Psaltis, A, Wormald, PJ.Nasal lavage with mupirocin for the treatment of surgically recalcitrant chronic rhinosinusitis. Laryngoscope 2008;118:1677–8010.1097/MLG.0b013e31817aec47CrossRefGoogle ScholarPubMed
9Lim, M, Citardi, MJ, Leong, JL.Topical antimicrobials in the management of chronic rhinosinusitis: a systemic review. Am J Rhinol 2008;22:381–910.2500/ajr.2008.22.3189CrossRefGoogle Scholar
10Ha, KR, Psaltis, AJ, Butcher, AR, Wormald, PJ, Tan, LW.In vitro activity of mupirocin on clinical isolates of Staphylococcus aureus and its potential implications in chronic rhinosinusitis. Laryngoscope 2008;118:535–4010.1097/MLG.0b013e31815bf2e3CrossRefGoogle ScholarPubMed
11Desrosiers, M, Bendouah, Z, Barbeau, J.Effectiveness of topical antibiotics on Staphylococcus aureus biofilm in vitro. Am J Rhinol 2007;21:149–53CrossRefGoogle ScholarPubMed
12Jervis-Brady, J, Boase, S, Psaltis, A, Foreman, A, Wormald, PJ.A randomized trial of mupirocin sinonasal rinses versus saline in surgically recalcitrant staphylococcal chronic rhinosinusitis. Laryngoscope 2012;122:2148–5310.1002/lary.23486CrossRefGoogle Scholar
13Raz, R, Miron, D, Colodner, R, Staler, Z, Samara, Z, Keness, Y.A 1-year trial of nasal mupirocin in the prevention of recurrent staphylococcal nasal colonization and skin infection. Arch Intern Med 1996;156:1109–1210.1001/archinte.1996.00040041109010CrossRefGoogle ScholarPubMed
14Jervis-Brady, J, Wormald, PJ.Microbiological outcomes following mupirocin nasal washes for symptomatic, Staphylococcus aureus-positive chronic rhinosinusitis following endoscopic sinus surgery. Int Forum Allergy Rhinol 2012;2:111–1510.1002/alr.20106CrossRefGoogle Scholar
15McCoul, ED, Anand, VK, Bedrosian, JC, Schwartz, TH.Endoscopic skull base surgery and its impact on sinonasal-related quality of life. Int Forum Allergy Rhinol 2012;2:174–81CrossRefGoogle ScholarPubMed
16Pant, H, Bhatki, AM, Snyderman, CH, Vescan, AD, Carrau, RL, Gardner, P et al. Quality of life following endonasal skull base surgery. Skull Base 2010;20:35–40CrossRefGoogle ScholarPubMed
17de Almeida, JR, Snyderman, CH, Gardner, PA, Carrau, RL, Vescan, AD.Nasal morbidity following endoscopic skull base surgery: a prospective cohort study. Head Neck 2011;33:547–51CrossRefGoogle ScholarPubMed
18Carr, TF, Hill, JL, Chiu, A, Chang, EH.Alteration in bacterial culture after treatment with topical mupirocin for recalcitrant chronic rhinosinusitis. JAMA Otolaryngol Head Neck Surg 2016;142:138–42CrossRefGoogle ScholarPubMed
19Kauffman, CA, Terpenning, MS, He, X, Zarins, LT, Ramsey, MA, Jorgensen, KA et al. Attempts to eradicate methicillin-resistant Staphylococcus aureus from a long-term-care facility with the use of mupirocin ointment. Am J Med 1993;94:371–8CrossRefGoogle ScholarPubMed