BIODEGRADABLE NASAL TAMPONADE DURING ENDONASAL ENDOSCOPIC DACRYOCYSTORHINOSTOMY

Aim. To analyze the efficacy of novel biodegradable Nasopore® nasal dressing for bleeding prevention in postoperative period after endonasal endoscopic dacryocystorhinostomy.

Patients and methods. Two cohorts of patients who underwent endonasal endoscopic dacryocystorhinostomy were analyzed. In these patients, the area of rhinostoma was plugged with biodegradable Nasopore® or non-biodegradable Merocel® nasal dressing to prevent bleeding. 37 women and 9 men (mean age 56 years) underwent the surgery which was performed under anesthetic using standard technology and endoscopic instruments. Nasopore® and Merocel® were used in 20 and 26 cases, respectively. Re-bleeding rate and the presence of post-operative discomfort were assessed. Specifics of nasal mucosa regeneration, formation of granulations, synechiae, and membranes in the area of nasolacrimal anastamosis were noted.

Results. Efficacy of nasal dressing was assessed in the first week after the surgery. In group 1 (Nasopore®), no nasal bleeding was observed and no re-tamponade was required. In group 2 (Merocel®), nasal bleeding occurred in 10 cases (38.4%) after nasal dressing removal, and re-tamponade was performed in 8 patients (30.8%). Main disadvantage of Merocel® is the «sawing» effect due to the pore texture of its surface. This property resulted in the bleeding after nasal dressing removal. None of group 1 patients complained of severe discomfort while 19% of group 2 patients experienced significant discomfort.

Conclusions. Biodegradable Nasopore® nasal dressing use in endonasal endoscopic dacryocystorhinostomy prevents recurrent post-operative nasal bleedings, decreases patient discomfort, provides better anatomical and functional outcomes and improves quality of life and medical social rehabilitation. 

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