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KMID : 1195620230160020148
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Clinical and Experimental Otorhinolaryngology
2023 Volume.16 No. 2 p.148 ~ p.158
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Efficacy of Steroid-Impregnated Spacers After Endoscopic Sinus Surgery in Chronic Rhinosinusitis: A Systematic Review and Meta-Analysis
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Hwang Se-Hwan
Kim Sung-Won
Mohammed Abdullah Basurrah
Kim Do-Hyun
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Abstract
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Objectives. The aim of this study was to compare the effect of steroid-impregnated spacers to that of conventional manage-ment after endoscopic sinus surgery (ESS) in patients with chronic rhinosinusitis (CRS).
Methods. Six databases were searched from inception until November 2022. Sixteen studies were found that comparedthe improvement of chronic sinusitis-related symptoms and postoperative outcomes between a steroid-impregnatedspacer group and a control group (non-steroid-impregnated spacers). The Cochrane risk of bias tool (for randomizedcontrolled studies) and the Newcastle-Ottawa Scale (for non-randomized controlled studies) were used to assess thequality of the works included.
Results. Regarding the endoscopic findings, the degree of mucosal edema, ethmoid inflammation, crust formation at 2?3 monthspostoperatively, nasal discharge, polyposis, and scarring/synechia were significantly lower in the steroid-impregnatedspacer group. The steroid-impregnated spacer group also showed significantly lower Lund?Kennedy scores and peri-operative sinus endoscopy scores than the control group at 2?3 weeks postoperatively. Furthermore, the steroid-im-pregnated spacer group had lower rates of adhesions, middle turbinate lateralization, polypoid changes, the need fororal steroid use, the need for postoperative therapeutic interventions, and lysis of adhesions than controls. However,no significant between-group differences were found in short-term (2?3 weeks postoperatively) endoscopic findingsregarding nasal discharge, postoperative crusting, polyposis, or scarring/synechia.
Conclusion. Steroid-impregnated nasal packing reduced the rates of postoperative intervention and recurrent polyposisand inflammation in CRS patients undergoing ESS.
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KEYWORD
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Sinusitis, Operative Surgical Procedures, Nose, Steroids, Stents
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