Clinical Trial Investigates TAA Dressing Following Sinus Surgery

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a condition where the lining of the nose and sinuses become inflamed and swollen, leading to the growth of small, non-cancerous growths called nasal polyps. Endoscopic sinus surgery (ESS) is a common treatment for this condition, but sometimes polyps can recur even after surgery.

Researchers wanted to investigate whether a type of dressing, called triamcinolone acetonide (TAA)-impregnated Gelfoam nasal pack, could help reduce the recurrence of nasal polyps following surgery.

The study was a randomized, double-blinded, placebo-controlled trial, which means that neither the patients nor the researchers knew which nostril received the TAA dressing and which received the placebo (saline-impregnated dressing). A total of 104 patients with bilateral CRSwNP who underwent ESS were included in the study.

The researchers used a validated scoring system called Perioperative Sinus Endoscopy (POSE) to evaluate the participants' condition at 1, 3, 6, 12, and 18 months after the surgery. They found that the treatment side of the eosinophilic CRSwNP (EosCRSwNP) group, which is a type of CRSwNP with high levels of a type of white blood cell called eosinophils, had significantly better endoscopic scores than the contralateral control side in all follow-up visits except for the first postoperative month. No significant difference was detected between the TAA(triamcinolone acetonide) and saline-treated nostrils in the non-eosinophilic CRSwNP (nonEosCRSwNP) subgroup during the follow-up period.

Moreover, the study found that the treatment side of the EosCRSwNP group had a better clinical response than the saline-treated side in terms of the total POSE scores, middle turbinate synechia, middle meatal narrowing, ethmoid polypoid changes, ethmoid polyposis, ethmoid cavity secretions, and sphenoid severity at the end of the study period.

Conclusion

The study found that TAA-soaked Gelfoam dressing following bilateral ESS was effective in treating CRSwNP, particularly for the eosinophilic endotype of the disease. This dressing could potentially help reduce the recurrence of nasal polyps following surgery and improve the quality of life of patients with CRSwNP. However, further research is needed to confirm these findings and determine the long-term efficacy and safety of TAA-soaked Gelfoam dressing.
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