CMC packing in functional endoscopic sinus surgery

BACKGROUND: Functional endoscopic sinus surgery (FESS) has become the treatment of choice for patients with medically resistant chronic rhinosinusitis (CRS and nasal polyposis). Nasal packing is usually placed after the surgery to minimize mucosal bleeding and support the wound healing process. Both the packing itself and its removal are often associated with pain and discomfort.

OBJECTIVE: To evaluate the effect of carboxymethylcellulose (CMC) nasal packing on patient comfort following FESS.

METHODS: Forty consecutive patients underwent bilateral FESS. One side of the nasal cavity was packed with CMC (mesh or gel) and the opposite side was not packed, the sides having been randomly selected. Postoperatively, patients were given visual analog scales to rate nasal airway obstruction and headache/pressure separately for the right and left sides. They also rated sleep disturbance and general well-being.

RESULTS: No significant differences were found between the CMC-packed side and the unpacked side with regard to patient comfort. No significant differences were found between CMC mesh and CMC gel.

CONCLUSION: Based on the presented data concerning patient comfort, CMC appears to be an ideal packing material following FESS. However, there is no other study revealing an identical study design focusing on other resorbable packing material. As a consequence, other available resorbable packing material should be investigated to find the ideal packing material following FESS, if packing is required.