Effectiveness of Hyaluronic Acid Nasal Drops in Post Functional Endoscopic Sinus Surgery
DOI:
https://doi.org/10.21776/ub.jkb.2022.032.01.5Keywords:
FESS, clinical symptoms, endoscopic features, hyaluronic acidAbstract
Functional Endoscopic Sinus Surgery (FESS) is commonly performed on patients with chronic rhinosinusitis (CRS) that has not improved through medical treatment. Hyaluronic acid (HA) has a vital role in wound healing and mucosa repair. This study aimed to determine the effectiveness of nasal drops using HA on clinical symptom scores, quality of life, and endoscopic features in post-FESS patients. This study was conducted with a pre- and post-test randomized control group design in 50 CRS patients undergoing FESS (25 males, 25 females, aged 18 to 55 years) at Dr. Kariadi General Hospital Medical Center Semarang from May to November 2019. The treatment group received additional HA therapy, while the control group only received standard therapy. Subjects were assessed with clinical symptom scores, quality of life, and endoscopic features before and after treatment. The statistical analysis was performed between the control and treatment groups using the Mann-Whitney test. There were significant differences between the control and treatment groups on clinical symptom scores (nasal congestion p = 0.001, runny nose p = 0.027) and endoscopic features (edema p = 0.001, secret p = 0.001, crusts p = 0.001). The therapy in post-FESS patients was using nasal drops, the treatment group was given HA, and the control group was given a placebo. Nasal drops using HA in the treatment group show improvement in clinical symptom scores of nasal congestion and runny nose, as well as the endoscopic appearance of edema, secret, and crusts.
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References
Epstein VA, Lanza DC. The diagnosis of rhinosinusitis. In: Kennedy DW, Hwang PH, editors. Rhinology diseases of the nose, sinuses, and skull base. New York: Thieme Medical Publishers; 2012. p. 110–25.
Fokkens Wytske J., Lund Valerie J., Mullol Joachim, Bachert Claus, Alobid Isam, Baroody Fuad, et al. 2012_Fokkens_EPOS 2012 European position paper on rhinosinusitis and nasal polyps. Eur Position Pap Rhinosinusitis Nasal Polyps . 2012;1–12.
Psaltis 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(10):2216–23.
Suh J, Chiu A. Medical management of chronic sinusitis. In: Johnson J, Rosen C, editors. Bailey’s head and neck surgery otolaryngology. fifth. Philadelphia: Lippincot williams and wilkins; 2014. p. 586–92.
Chan Y. The nose, acute and chronic sinusitis. In: Lee K, editor. Essential otolaryngology head and neck surgery. tenth. United States of America: McGraw-Hill; 2012. p. 397-415.
Ryan M. Chronic rhinosinusitis with nasal polyposis. In: Johnso J, Rosen C, editors. Bailey’s head and neck surgery otolaryngology. fifth. Philadelphia: Lippincot williams and wilkins; 2014. p. 525–34.
Cantone E, Iengo M. Effect of sodium hyaluronate added to topical corticosteroids in chronic rhinosinusitis with nasal polyposis. Am J Rhinol Allergy. 2016;30(5):340–3.
Gelardi M, Guglielmi AVN, 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(3):103–8.
Kurniasih C, Ratnawati LM. Distribusi penderita rinosinusitis kronis yang menjalani pembedahan di RSUP Sanglah Denpasar Periode Tahun 2014 – 2016. Medicina (B Aires). 2019;50(1):133–7.
Shusterman D. Toxicology of nasal irritants. Curr Allergy Asthma Rep. 2003;3(3):258–65.
Guo S, DiPietro LA. Critical review in oral biology & medicine: Factors affecting wound healing. J Dent Res. 2010;89(3):219–29.
Galluzzi F, Pignataro L, Maddalone M, Garavello W. Recurrences of surgery for antrochoanal polyps in children: A systematic review. Int J Pediatr Otorhinolaryngol [Internet]. 2018;106(October 2017):26–30. Available from: https://doi.org/10.1016/j.ijporl.2017.12.035
Cooper M, Cheng T, Truong T, Kuchibhatla M, Hachem RA, Jang DW. Factors Associated with Revision Surgery after Balloon Sinuplasty. Otolaryngol - Head Neck Surg (United States). 2019;160(4):734–9.
Safitri W, Pawarti DR, Ahadiah TH. Efektivitas salin hipertonik terhadap waktu transpor mukosiliar dan skor gejala hidung penderita rinitis alergi. Oto Rhino Laryngol Indones. 2018;47(2):123.
Boztepe OF, Gün T, Demir M, Gür ÖE, Ozel D, Doğru H. A novel predictive marker for the recurrence of nasal polyposis following endoscopic sinus surgery. Eur Arch Oto-Rhino-Laryngology. 2016;273(6):1439–44.
Casalino-Matsuda SM, Monzon ME, Day AJ, Forteza RM. Hyaluronan fragments/CD44 mediate oxidative stress-induced MUC5B up-regulation in airway epithelium. Am J Respir Cell Mol Biol. 2009;40(3):277–85.
Mehle ME, Schreiber CP. Sinus headache, migraine, and the otolaryngologist. Otolaryngol - Head Neck Surg. 2005;133(4):489–96.
Bassiouni A, Naidoo Y, Wormald PJ. When FESS fails: The inflammatory load hypothesis in refractory chronic rhinosinusitis. Laryngoscope. 2012;122(2):460–6.
Lee JT, Kennedy DW, Palmer JN, Feldman M, Chiu AG. The incidence of concurrent osteitis in patients with chronic rhinosinusitis: A clinicopathological study. Am J Rhinol. 2006;20(3):278–82.
Bassiouni A, Chen PG, Wormald PJ. Mucosal remodeling and reversibility in chronic rhinosinusitis. Curr Opin Allergy Clin Immunol. 2013;13(1):4–12.
Castelnuovo P, Tajana G, Terranova P, Digilio E, Bignami M, Macchi A. From modeling to remodeling of upper airways: Centrality of hyaluronan (hyaluronic acid). Int J Immunopathol Pharmacol. 2016;29(2):160–7.
Cassano M, Russo GM, Granieri C, Cassano P. Cytofunctional changes in nasal ciliated cells in patients treated with hyaluronate after nasal surgery. Am J Rhinol Allergy. 2016;30(2):83–8.
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