Clinical Results of Anti-adhesion Adjuvants after Endonasal Dacryocystorhinostomy
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Purpose: Various absorbable anti-adhesion agents have been used to prevent postoperative synechia formation after endonasal surgery. The purpose of this study was to evaluate the anti-adhesion effects of HyFence and Mediclore after endonasal dacryocystorhinostomy (DCR) compared to a mixed solution of hyaluronic acid and sodium carboxymethylcellulose (Guardix-Sol). Methods: In this retrospective study, endonasal DCR and silicone tube intubation were performed on 198 eyes of 151 patients. Three different anti-adhesion adjuvants were applied to the osteotomy site in the nasal cavity after standard endonasal DCR procedures. The subjects were classified into three respective groups: group A (71 eyes, Guardix-Sol 1.5 g), group B (89 eyes, HyFence 1.5 mL), and group C (38 eyes, Mediclore 1 cc). The three groups were evaluated by asking patients about subjective symptoms and by performing lacrimal irrigation tests and endoscopic examinations. Results: There were no statistically significant differences in age, sex, timing of tube removal, or follow-up period among the three groups. There were no statistically significant differences in success rates among the three groups (p = 0.990, 91.5% [65 / 71], 92.1% [82 / 89], and 92.1% [35 / 38], respectively). Conclusions: HyFence and Mediclore are safe and effective adjunctive modalities following endonasal DCR compared to Guardix-Sol. Therefore, these agents can be considered good alternatives to Guardix-Sol to increase the success rate of endonasal DCR in treating patients with poor prognosis.
Abstract
Purpose: Various absorbable anti-adhesion agents have been used to prevent postoperative synechia formation after endonasal surgery. The purpose of this study was to evaluate the anti-adhesion effects of HyFence and Mediclore after endonasal dacryocystorhinostomy (DCR) compared to a mixed solution of hyaluronic acid and sodium carboxymethylcellulose (Guardix-Sol). Methods: In this retrospective study, endonasal DCR and silicone tube intubation were performed on 198 eyes of 151 patients. Three different anti-adhesion adjuvants were applied to the osteotomy site in the nasal cavity after standard endonasal DCR procedures. The subjects were classified into three respective groups: group A (71 eyes, Guardix-Sol 1.5 g), group B (89 eyes, HyFence 1.5 mL), and group C (38 eyes, Mediclore 1 cc). The three groups were evaluated by asking patients about subjective symptoms and by performing lacrimal irrigation tests and endoscopic examinations. Results: There were no statistically significant differences in age, sex, timing of tube removal, or follow-up period among the three groups. There were no statistically significant differences in success rates among the three groups (p = 0.990, 91.5% [65 / 71], 92.1% [82 / 89], and 92.1% [35 / 38], respectively). Conclusions: HyFence and Mediclore are safe and effective adjunctive modalities following endonasal DCR compared to Guardix-Sol. Therefore, these agents can be considered good alternatives to Guardix-Sol to increase the success rate of endonasal DCR in treating patients with poor prognosis.
참고문헌 (15)
- McDonogh M, "Endoscopic transnasal dacryocystorhinostomy", J Laryngol Otol, 103, pp.585~587 (1989)
- Zilelioglu G, "Adjunctive use of mitomycin C on endoscopic lacrimal surgery", Br J Ophthalmol, 82, pp.63~66 (1998)
- 최영재, "비강내 누낭비강문합술시 시행한 양막충전술의 단기 임상 결과", 대한안과학회지, 49(3), pp.384~389 (2008), 대한안과학회
- Cukurova I, "Endoscopic dacryocystorhinostomy: outcomes using mucosal f lap preserving technique", Eur Arch Otorhinolaryngol, 270, pp.1661~1666 (2013)
- Onerci M, "Long-term results and reasons for failure of intranasal endoscopic dacryocystorhinostomy", Acta Otolaryngol, 120, pp.319~322 (2000)
- Kim JH, "Antiadhesive effect of the mixed solution of sodium hyaluronate and sodium carboxymethylcellulose after endoscopic sinus surgery", Am J Rhinol, 21, pp.95~99 (2007)
- 장철, "A Randomized, Multi-Center, Single Blind, Active-Controlled, Matched Pairs Clinical Study to Evaluate Prevention of Adhesion Formation and Safety of HyFence in Patients After Endoscopic Sinus Surgery", Clinical and Experimental Otorhinolaryngology, 7(1), pp.30~35 (2014), 대한이비인후과학회[DOI]
- Song KJ, "Anti-adhesive effect of a thermosensitive poloxamer applied after the removal of nasal packing in endoscopic sinus surgery: a randomised multicentre clinical trial", Clin Otolaryngol, 38, pp.225~230 (2013)
- Elkins TE, "Adhesion prevention by solutions of sodium carboxymethylcellulose in the rat. I", Fertil Steril, 41, pp.926~928 (1984)
- 오태훈, "비내시경 누낭비강연결술에서 히알루론산나트륨과 카르복시메틸셀룰로오스나트륨 혼합액의 효과", 대한안과학회지, 51(2), pp.159~163 (2010), 대한안과학회
- Kimmelman CP, "Sepragel sinus (hylan B) as a postsurgical dressing for endoscopic sinus surgery", Otolaryngol Head Neck Surg, 125, pp.603~608 (2001)
- Gago LA, "Seprafilm (modified hyaluronic acid and carboxymethylcellulose) acts as a physical barrier", Fertil Steril, 80, pp.612~616 (2003)
- 권성욱, "가토에서 히알루론산나트륨과 카르복시메틸셀룰로오스나트륨 혼합액이 술 후 유착에 미치는 영향", 대한안과학회지, 50(1), pp.145~150 (2009), 대한안과학회
- Kwon SK, "Prevention of anterior glottis web with hyaluronic acid derivatives in rabbit model", Laryngoscope, 126, pp.2320~2324 (2016)
- Ferland R, "Evaluation of a sprayable polyethylene glycol adhesion barrier in a porcine efficacy model", Hum Reprod, 16, pp.2718~2723 (2001)