The postoperative outcomes of patients with chronic rhinosinusitis with nasal polyps by sustained released steroid from
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RHINOLOGY
The postoperative outcomes of patients with chronic rhinosinusitis with nasal polyps by sustained released steroid from hyaluronic acid gel Huankang Zhang1 · Li Hu1 · Wanpeng Li1 · Yuting Lai1 · Jiaying Zhou1 · Dehui Wang1 Received: 30 July 2020 / Accepted: 21 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose The self-crosslinked hyaluronic acid (scHA) and steroids are considered as efficient factors for postoperative management after chronic rhinosinusitis (CRS) nasal surgery. This randomized clinical trial is designed to investigate the efficacy and potential of scHA gel as a topical drug sustained release carrier for steroid of budesonide. Methods The study is performed with 30 patients of chronic rhinosinusitis with nasal polyps (CRSwNP) who underwent functional endoscopic sinus surgery (FESS). The single application of scHA was assessed in the control patient group for postoperative recovery. In the treatment patient group, the combination of scHA/budesonide was applied for postoperative management. The patients are followed up in 2 weeks, 4 weeks and 12 weeks after surgery. Results The combination of scHA/budesonide results in better endoscopic scoring and mucus evaluation than the single scHA application. Conclusion 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. Keywords Self-crosslinked hyaluronic acid · Budesonide · Chronic rhinosinusitis · Functional endoscopic sinus surgery · Topical sustained release
Introduction Chronic rhinosinusitis (CRS), including chronic rhinosinusitis without nasal polyps (CRSsNP) and chronic rhinosinusitis with nasal polyps (CRSwNP), is most commonly treated disease in the otolaryngology departments in hospitals [9]. CRS is attributed to multifactorial causes such as environmental factors and host characteristics [28]. It affects approximately 10–15% of the Western population [22] and 8% of the Chinese population [23]. CRS results in serious health consequences and health-related quality of life [22, 23].
Huankang Zhang and Li Hu contributed equally to this work. * Dehui Wang [email protected] 1
Department of Otolaryngology, Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai 200031, People’s Republic of China
Currently, the functional endoscopic sinus surgery (FESS) is more and more often used to improve the prognosis of CRS patients. FESS on the CRSwNP patients generates greater wound in nasal cavity and is more interesting to be investigated. The postoperative complications such as nasal adhesions is an often cause of endoscopic sinus surgery failure, resulting in poorer outcomes and a higher likelihood of revision surgery [21], with adverse effects on patients’ health-related quality of life scores [14]. Thus, the postoperative management methods are needed to be further investigated. Hyaluronic acid (HA) is a biological material, which
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