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Effects of Meropack in the middle meatus after functional endoscopic sinus surgery in children with chronic sinusitis.
Int J Pediatr Otorhinolaryngol. 2008 Oct; 72(10):1535-40.IJ

Abstract

OBJECTIVES

The aim of the study was to evaluate the effects and morbidities of Meropack, an absorbable hyaluronic acid packing material, placed in the middle meatus after endoscopic sinus surgery in children with chronic sinusitis.

METHODS

Sixty consecutive children with similar degrees of bilateral chronic sinusitis were enrolled in the study. Meropack was randomly inserted into one side of the middle meatus, while the opposite sinus was not packed after functional endoscopic sinus surgery. Patients were investigated 3, 8, and 12 weeks after surgery. The effects and morbidities of nasal dressings in the middle meatus were evaluated with respect to six distinct parameters: blood loss during surgery, postoperative hemorrhage, synechiae, granulation tissue, infection, and patency of the maxillary sinus ostia.

RESULTS

Mean blood loss of packed and unpacked sinuses did not significantly differ (p > 0.05). Twenty-nine (15 packed, 14 unpacked) of the 120 sinuses underwent resection of the lateral wall of concha bullosa. Four of 14 unpacked sinuses had postoperative hemorrhaging, while the 15 packed sinuses did not (p < 0.05). The mean synechiae scores at the first follow-up visit for the Meropack filled and unpacked sinuses differed significantly (p < 0.05). For the 8- and 12-week follow-up visits, severity of adhesions, granulation tissue formation, infection rate, and patency of the maxillary sinus ostia did not differ significantly between the Meropack filled sinuses and the unpacked sinuses (p > 0.05 for all).

CONCLUSION

Meropack dressings effectively prevented postoperative hemorrhage, but did not significantly reduced synechiae after endoscopic sinus surgery. Therefore, we recommend that Meropack packing is not necessary for routine use following pediatric functional endoscopic sinus surgery (FESS). However, it should be reserved for children who are predisposed to develop postoperative hemorrhages or adhesions, such as resection of the concha bullosa, traumatic surgery with the creation of large raw surfaces on the middle turbinate, and revision surgery with preexisting adhesions.

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Authors+Show Affiliations

Hu KH
Department of Otorhinolaryngology-Head and Neck Surgery, Keelung Hospital, Department of Health, Keelung, Taiwan.
Lin KN
No affiliation info available
Li WT
No affiliation info available
Huang HM
No affiliation info available

MeSH

Adjuvants, ImmunologicAdolescentBlood Loss, SurgicalChildChronic DiseaseEndoscopyGelatin Sponge, AbsorbableGranulation TissueHumansHyaluronic AcidParanasal SinusesPostoperative HemorrhageSeverity of Illness IndexSinusitisTreatment Outcome

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

18752856

Citation

Hu, Ko-Hsin, et al. "Effects of Meropack in the Middle Meatus After Functional Endoscopic Sinus Surgery in Children With Chronic Sinusitis." International Journal of Pediatric Otorhinolaryngology, vol. 72, no. 10, 2008, pp. 1535-40.
Hu KH, Lin KN, Li WT, et al. Effects of Meropack in the middle meatus after functional endoscopic sinus surgery in children with chronic sinusitis. Int J Pediatr Otorhinolaryngol. 2008;72(10):1535-40.
Hu, K. H., Lin, K. N., Li, W. T., & Huang, H. M. (2008). Effects of Meropack in the middle meatus after functional endoscopic sinus surgery in children with chronic sinusitis. International Journal of Pediatric Otorhinolaryngology, 72(10), 1535-40. https://doi.org/10.1016/j.ijporl.2008.07.006
Hu KH, et al. Effects of Meropack in the Middle Meatus After Functional Endoscopic Sinus Surgery in Children With Chronic Sinusitis. Int J Pediatr Otorhinolaryngol. 2008;72(10):1535-40. PubMed PMID: 18752856.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of Meropack in the middle meatus after functional endoscopic sinus surgery in children with chronic sinusitis. AU - Hu,Ko-Hsin, AU - Lin,Kai-Nan, AU - Li,Wen-Tyng, AU - Huang,Hung-Meng, Y1 - 2008/08/26/ PY - 2008/05/29/received PY - 2008/07/11/revised PY - 2008/07/14/accepted PY - 2008/8/30/pubmed PY - 2009/1/30/medline PY - 2008/8/30/entrez SP - 1535 EP - 40 JF - International journal of pediatric otorhinolaryngology JO - Int J Pediatr Otorhinolaryngol VL - 72 IS - 10 N2 - OBJECTIVES: The aim of the study was to evaluate the effects and morbidities of Meropack, an absorbable hyaluronic acid packing material, placed in the middle meatus after endoscopic sinus surgery in children with chronic sinusitis. METHODS: Sixty consecutive children with similar degrees of bilateral chronic sinusitis were enrolled in the study. Meropack was randomly inserted into one side of the middle meatus, while the opposite sinus was not packed after functional endoscopic sinus surgery. Patients were investigated 3, 8, and 12 weeks after surgery. The effects and morbidities of nasal dressings in the middle meatus were evaluated with respect to six distinct parameters: blood loss during surgery, postoperative hemorrhage, synechiae, granulation tissue, infection, and patency of the maxillary sinus ostia. RESULTS: Mean blood loss of packed and unpacked sinuses did not significantly differ (p > 0.05). Twenty-nine (15 packed, 14 unpacked) of the 120 sinuses underwent resection of the lateral wall of concha bullosa. Four of 14 unpacked sinuses had postoperative hemorrhaging, while the 15 packed sinuses did not (p < 0.05). The mean synechiae scores at the first follow-up visit for the Meropack filled and unpacked sinuses differed significantly (p < 0.05). For the 8- and 12-week follow-up visits, severity of adhesions, granulation tissue formation, infection rate, and patency of the maxillary sinus ostia did not differ significantly between the Meropack filled sinuses and the unpacked sinuses (p > 0.05 for all). CONCLUSION: Meropack dressings effectively prevented postoperative hemorrhage, but did not significantly reduced synechiae after endoscopic sinus surgery. Therefore, we recommend that Meropack packing is not necessary for routine use following pediatric functional endoscopic sinus surgery (FESS). However, it should be reserved for children who are predisposed to develop postoperative hemorrhages or adhesions, such as resection of the concha bullosa, traumatic surgery with the creation of large raw surfaces on the middle turbinate, and revision surgery with preexisting adhesions. SN - 0165-5876 UR - https://www.unboundmedicine.com/medline/citation/18752856/Effects_of_Meropack_in_the_middle_meatus_after_functional_endoscopic_sinus_surgery_in_children_with_chronic_sinusitis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-5876(08)00320-0 DB - PRIME DP - Unbound Medicine ER -