Sustained Release Steroid from HA Gel reduces complications after endoscopic sinus surgery

Postoperative complications such as nasal adhesions often cause the failure of endoscopic sinus surgery, resulting in poorer outcomes and a higher likelihood of revision surgery, with adverse effects on patients' health-related quality of life scores. Thus, the postoperative management methods are needed to be further investigated.

Hyaluronic acid has its broad application in ENT surgery, gynaecological surgery, orthopedical surgery, general surgery and cosmetic surgery. The modulating effect of hyaluronic acid in wound healing and mucosal regeneration has been demonstrated in clinical trials following nasal surgery, in which safety, tolerability and efficacy of hyaluronic acid were reported. However, the uses of unmodified hyaluronic acid in combination with steroids remain unclear. Therefore, researchers of the Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai, conducted a study to investigate the efficacy and potential of scHA gel as a topical drug sustained-release carrier for the steroid of budesonide.

It was a randomized, controlled trial of 30 chronic rhinosinusitis with nasal polyps patients who underwent functional endoscopic sinus surgery. The control group received the single application of self-crosslinked hyaluronic acid and, the intervention group received the combination of scHA/budesonide. Researchers followed up the patients in 2 weeks, 4weeks and 12 weeks after surgery to assess the postoperative recovery.

Upon analysis, researchers found that the combination of scHA/budesonide results in better endoscopic scoring and mucus evaluation than the single self-crosslinked hyaluronic acid application.

The authors concluded, "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."

For further information:

https://doi.org/10.1007/s00405-020-06320-0