Supplementary Files
Keywords
middle meatus
Nasal Surgery
Endoscopic sinus surgery
nasal synechia
How to Cite
Abstract
Objective: To compare the formation of lateral nasal synechiae after endoscopic sinus surgery with and without insertion of a silastic sheet between the middle turbinate and lateral nasal wall.
Methods: This study includes 70 patients of either gender, 20-60 years of age, admitted for elective endoscopic sinus surgery for chronic rhinosinusitis. Patients were divided into two groups. In group S, a silicone sheet was placed between the middle turbinate and the lateral nasal wall. While in group-T, no silicone sheet was placed. All patients were evaluated for the development of lateral nasal synechiae up to the 6th post-operative month.
Results: In group-S, 3 (8.6%) patients developed lateral nasal synechiae, while in group-T, 11 (31.4%) patients developed lateral nasal synechiae. Comparison of both groups showed a p-value of 0.017.
Conclusion: Silastic sheet placement in the middle meatus significantly reduces the formation of lateral nasal synechiae after endoscopic sinus surgery.
References
Fokkens WJ, Lund VJ, Hopkins C, Hellings PW, Kern R, Reitsma S, et al. European position paper on rhinosinusitis and nasal polyps 2020. Rhinology. 2020;58(Suppl S29):1-464. https://doi.org/10.4193/Rhin20.600.
Benjamin MR, Stevens WW, Li N, Bose S, Grammer LC, Kern RC, et al. Clinical characteristics of patients with chronic rhinosinusitis without nasal polyps in an academic setting. J Allergy Clin Immunol Pract. 2019;7(3):1010-1016. https://doi.org/10.1016/j.jaip.2018.10.014.
Korkmaz H, Korkmaz M. Endoscopic sinus surgery- surgical steps with Implications in Intraoperative complications. Mid Blac Sea J Health Sci. 2022;8(2):320-331. https://doi.org/10.19127/mbsjohs.1071048.
Lourijsen ES, Reitsma S, Vleming M, Hannink G, Adriaensen GFJPM, Cornet ME, et al. Endoscopic sinus surgery with medical therapy versus medical therapy for chronic rhinosinusitis with nasal polyps: a multicentre, randomised, controlled trial. Lancet Respir Med. 2022;10(4):337-346. https://doi.org/10.1016/S2213-2600(21)00457-4.
Kim TK, Jeong JY. Deviated nose: Physiological and pathological changes of the nasal cavity. Arch Plast Surg. 2020;47(6):505-515. doi:10.5999/aps.2020.01781.
Stępiński MJ, Banaszewski J. Intranasal synechiae as complications of rhinosurgical treatment-A review of current knowledge. J Clin Med. 2023;12(21):6831. https://doi.org/10.3390/jcm12216831.
Hasan DS, Ali MK, Fadhil AS, Taha MR. Prevention of Middle Meatal Synechia Formation after Endoscopic Sinus Surgery with Different Packing Materials. Iraqi Medical Journal. 2019;65(2):161-166.
Alaryani RA, Alhedaithy RA. Preventive Measures of Middle Turbinate Lateralization After Endoscopic Sinus Surgery: An Updated Review. Cureus. 2021;13(6):e15763. https://doi.org/10.7759/cureus.15763.
Tang DM, Roxbury CR. Management of the middle turbinate during and after sinus surgery. Curr Opin Otolaryngol Head Neck Surg. 2022 ;30(1):40-45. https://doi.org/10.1097/MOO.0000000000000777.
Khatri H, Salati H, Wong E, Bradshaw K, Inthavong K, Sacks R, et al. Modelling the effects of post-FESS middle turbinate synechiae on sinonasal physiology: A computational fluid dynamics study. Auris Nasus Larynx. 2023;50(6):911-920. https://doi.org/10.1016/j.anl.2023.04.003.
Arsalan D, Hassan Syed S, Murtaza G, Qamar Nasir M, Awais Amin M, Ayub Awan A. The frequency of intranasal synechiae formation between nasal septum and lateral nasal wall after endoscopic sinus surgery among patients with sinonasal polyposis. Esculapio - JSIMS . 2023;16(3):70-74. https://doi.org/10.51273/esc20.2516315.
Anchan SV, Shah V, Jalisatgi RR, Naik AS, Sidappa R, Pandurangi AS. A Comparative Study of Interventions of Middle Turbinate Medialization in Endoscopic Sinus Surgery. Indian J Otolaryngol Head Neck Surg. 2022;74(Suppl 2):1706-1712. https://doi.org/10.1007/s12070-021-02861-w.
Khafagy Y, Ghonim M, Elzayat S, Elgendy A. Comparison between the endoscopic scores of bolgerization versus partial resection of the middle turbinate for management of the postoperative lateralization in the early follow-up period after endoscopic frontal sinusotomy: A randomized controlled study. Am J Otolaryngol. 2021;42(5):102998. https://doi.org/10.1016/j.amjoto.2021.102998.
Abdelhamid HI, Awad AMM, Albadea AMA, Khaled IA, El-Anwar MW, El-Ahl MAS. A novel technique with butterfly splint for middle turbinate stabilization in sinus surgery. Eur Arch Otorhinolaryngol. 2024;281(3):1325-1330.
https://doi.org/10.1007/s00405-023-08322-0.
Odat H, Al-Qudah M, Al-Gargaz W. Wedge-shape Merocel Pack After Functional Endoscopic Sinus Surgery: Our Experience With 697 Patients. Med Arch. 2021;75(3):229-233. https://doi.org/10.5455/medarh.2021.75.229-233.
Odat H, Al-Qudah M, Alzoubi F, Bani-Ata M, Hamouri S, Al-Alawneh M, et al. Assessing effects of modification of middle meatal silastic splint after endoscopic sinus surgery for nasal polyps: A randomized controlled study. Ann Med Surg (Lond). 2020;58:172-176. https://doi.org/10.1016/j.amsu.2020.08.047.
Zamaili AM, Kueh YC, Mohamad S, Abdullah B. The impact of middle meatal steroid-eluting implants on the postoperative outcomes of chronic rhinosinusitis: A systematic review and meta-analysis. Eur Ann Otorhinolaryngol Head Neck Dis. 2025;142(1):26-37. https://doi.org/10.1016/j.anorl.2024.02.014
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