Taşkın TOKAT, Tolgahan ÇATLI, Mehmet Z ÖZÜER

Effects of topical hyaluronic acid (Sepragel®/Hylan B) on mucosal healing after endoscopic sinus surgery

Topikal hyaluronik asidin (Sepragel®/Hylan B)endoskopik sinüs cerrahisi sonrası mukozal iyilşme üzerindeki etkisi

Objective:To investigate the effects of hyaluronic acid (HA)(Sepragel®Hylan B; Genzyme Co., Cambridge, MA, USA) on themucosal healing of patients who undergone functional endoscopicsinus surgery (FESS) for chronic rhinosinusitis and/or nasal polyposis. Methods:A total of thirty-six patients were included in the study.Patients had received topical administration of HA soaked sponges tothe middle meatus on one side of their nasal cavities intra-operativelyat the end of the procedures. Other side of the middle meatus was freeof any treatment or packing to create a control group. Postoperativeendoscopic examination was performed at the 1st, 4th and 12th weeksin order to score mucosal findings regarding synechiae, mucosal hypertrophy and polyp formation on both sides. Mucosal findings werescored from 0 to 3 points (0: lesion free, 1: mild, 2: moderate, 3: severe). Results: Average scores of the mucosal cavities were compared and itwas found to be significantly low for the HA administered mucosa(p< 0.05). Synechia formation and mucosal hypertrophy at the 1st, 4thand 12th weeks were significantly low for the Hylan B group compared to the control group (p< 0.05 for both findings). Conclusion:Topical HA has preventive effects on synechia formation and mucosal hypertrophy

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1. Bhattacharyya N. Clinical outcomes after endoscopic sinus surgery. Curr Opin Allergy Clin Immunol 2006;6:167–71.

2. Anon JB. Computer-aided endoscopic sinus surgery. Laryngoscope 1998;108:949–61.

3. Valentine R, Wormald PJ. Nasal dressings after endoscopic sinus surgery: what and why? Curr Opin Otolaryngol Head Neck Surg 2010;18:44–8.

4. McMains KC. Safety in endoscopic sinus surgery. Curr Opin Otolaryngol Head Neck Surg 2008;16:247–51.

5. Rombout J, de Vries N. Complications in sinus surgery and new classification proposal. Am J Rhinol 2001;15:363–70.

6. Luong A, Marple BF. Sinus surgery: indications and techniques. Clin Rev Allergy Immunol 2006;30:217–22.

7. Kimmelman CP, Edelstein DR, Cheng HJ. Sepragel sinus (hylan B) as a post-surgical dressing for endoscopic sinus surgery. Otolaryngol Head Neck Surg 2001;125:603–8.

8. Price RD, Berry MG, Navsaria HA. Hyaluronic acid: the scientific and clinical evidence. J Plast Reconstr Aesthet Surg 2007;60: 1110–9.

9. Liu L, Liu Y, Li J, Du G, Chen J. Microbial production of hyaluronic acid: current state, challenges, and perspectives. Microb Cell Fact 2011;10:99.

10. Nishida T, Nakamura M, Mishima H, Otori T. Hyaluronan stimulates corneal epithelial migration. Exp Eye Res 1991;53:753–8.

11. Croce MA, Dyne K, Boraldi F, et al. Hyaluronan affects protein and collagen synthesis by in vitro human skin fibroblasts. Tissue Cell 2001;33:326–31.

12. Ulualp SO. Complications of endoscopic sinus surgery: appropriate management of complications. Curr Opin Otolaryngol Head Neck Surg 2008;16:252-9.

13. Hockstein NG, Bales CB, Palmer JN. Transseptal suture to secure middle meatal spacers. Ear Nose Throat J 2006;85:47–48.

14. Bugten V, Nordgard S, Skogvoll E, Steinsvåg S. Effects of nonabsorbable packing in middle meatus after sinus surgery. Laryngoscope 2006;116:83–8.

15. Friedrich EE, Sun LT, Natesan S, Sun LT, Natesan S, Zamora DO, Christy RJ, Washburn NR. Effects of hyaluronic acid conjugation on anti-TNF-α inhibition of inflammation in burns. J Biomed Mater Res A 2014;102:1527–36.

16. de la Motte CA. Hyaluronan in intestinal homeostasis and inflammation: implications for fibrosis. Am J Physiol Gastrointest Liver Physiol 2011;301:G945–9.

17. Friedman PM, Mafong EA, Kauvar ANB, Geronemus RG. Safety data of injectable nonanimal stabilized hyaluronic acid gel for soft tissue augmentation. Dermatol Surg 2002;28:491–4.

18. Dal Sacco D, Cozzani E, Parodi A, Rebora A. Scar sarcoidosis after hyaluronic acid injection. Int J Dermatol 2005;44:411–2.