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Open AccessArticle

Effect of a Chitosan-Based Biodegradable Middle Meatal Dressing after Endoscopic Sinus Surgery: A Prospective Randomized Comparative Study

Department of Otolaryngology, St Elizabeth's Medical Center, 736 Cambridge Street, SMC-8 Brighton, MA 02135, USA
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Academic Editor: Claudina A. Pérez Novo
Sinusitis 2016, 1(1), 3-12; https://doi.org/10.3390/sinusitis1010003
Received: 10 October 2015 / Accepted: 7 November 2015 / Published: 25 November 2015
(This article belongs to the Special Issue Chronic Rhinosinusitis: Clinical and Immunological Research)
Introduction: The use of biomaterials to improve wound healing after endoscopic sinus surgery (ESS) is not new. Many types of resorbable and non-resorbable materials have been tried as a middle meatal (MM) dressing, spacer, or stent to prevent lateralization of the middle turbinate, formation of synechia, granulation tissue, adhesions and scarring. The FDA has recently approved Chitosan-based nasal dressing/spacers which have optimal wound healing characteristics, including hemostatic and bacteriostatic properties. Herein, we compare a new chitosan-based biomaterial to a popular fully synthetic resorbable dressing in patients undergoing ESS. Materials and Methods: A prospective randomized controlled study was performed comparing a new Chitosan-based bioresorbable nasal dressing (Posi-Sep X) against a previously studied and well known fully synthetic polyurethane-based control (Nasopore). Post-operative outcome metrics included the degree of crusting, amount of retained implant, patient comfort, wound healing, epistaxis, and post-operative infection at two weeks. Results: Thirty-five patients were enrolled and a total seventy implants were placed (n = 70) at the completion of ESS. The results show a statistically significant difference between the Chitosan-based product and the control with respect to wound healing, degree of crusting, and resorption profile. In addition, the Chitosan-based dressing had a markedly lower requirement for post-operative debridement, and a lower incidence of epistaxis and infection, which corresponds to superior patient comfort. Conclusion: Our study is consistent with the biomaterials literature regarding the potential advantages of Chitosan-based MM dressings after ESS regarding improved wound healing, biocompatibility, and patient comfort. View Full-Text
Keywords: chitosan; biodegradable; middle meatal dressing; middle meatal spacer; endoscopic sinus surgery; NasoPore™; Posi-Sep X™; sinus stent chitosan; biodegradable; middle meatal dressing; middle meatal spacer; endoscopic sinus surgery; NasoPore™; Posi-Sep X™; sinus stent
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Hsu, K.; Ericksen, M.; Catalano, P. Effect of a Chitosan-Based Biodegradable Middle Meatal Dressing after Endoscopic Sinus Surgery: A Prospective Randomized Comparative Study. Sinusitis 2016, 1, 3-12.

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