Functional Endoscopic Sinus Surgery (FESS) Study

Functional endoscopic sinus surgery (FESS) is often used to improve the prognosis of chronic rhinosinusitis. A study published in the European Archives of Oto-Rhino-Laryngology on September 04, 2020, suggests that the combination of self-crosslinked hyaluronic acid (scHA)/budesonide is effective in the postoperative management of functional endoscopic sinus surgery.

Postoperative complications such as nasal adhesions often cause the failure of endoscopic sinus surgery, resulting in poorer outcomes and a higher likelihood of revision surgery, with adverse effects on patients' health-related quality of life scores. Thus, the postoperative management methods are needed to be further investigated.

Hyaluronic acid has its broad application in:

• ENT surgery
• Gynaecological surgery
• Orthopedical surgery
• General surgery
• Cosmetic surgery

The modulating effect of hyaluronic acid in wound healing and mucosal regeneration has been demonstrated in clinical trials following nasal surgery, in which safety, tolerability, and efficacy of hyaluronic acid were reported. However, the uses of unmodified hyaluronic acid in combination with steroids remain unclear. Therefore, researchers of the Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai, conducted a study to investigate the efficacy and potential of scHA gel as a topical drug sustained-release carrier for the steroid of budesonide.

It was a randomized, controlled trial of 30 chronic rhinosinusitis with nasal polyps patients who underwent functional endoscopic sinus surgery. The control group received the single application of self-crosslinked hyaluronic acid, and the intervention group received the combination of scHA/budesonide. Researchers followed up the patients in 2 weeks, 4 weeks, and 12 weeks after surgery to assess the postoperative recovery.

Upon analysis, researchers found that the combination of scHA/budesonide results in better endoscopic scoring and mucus evaluation than the single self-crosslinked hyaluronic acid application.

The authors concluded, The results indicate that the combination of scHA/budesonide is a valuable treatment for the FESS postoperative management and implies the potential of scHA gel as a topical drug sustained-release scaffold.

For further information: https://doi.org/10.1007/s00405-020-06320-0