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© Borgis - New Medicine 4/2011, s. 120-121
*Lechosław P. Chmielik, Anna Gorzelnik, Mieczysław Chmielik
Assessment of influence of packing used in postoperative period for children that underwent pediatric endoscopic sinus surgery
Department of Pediatric Otolaryngology, Medical University of Warsaw, Poland
Head of Department: Prof. Mieczysław Chmielik, MD, PhD
Summary
Introduction. One of the most common complication after pediatric functional endoscopic sinus surgery are nasal cavity adhesions. Apart from treatment methods applied, the medical packing used after surgery may have an influence on the above mentioned adhesions. The basic medical packing used for years in otolaryngology is gauze seton. This packing has applications in both otosurgery and rhinosurgery. In recent years alternative methods of nasal cavities tamponing have appeared, including gel packings with carboxymethylcellulose.
Aim. The aim of this study is to compare the effects of using seton with carboxymethylcellulose for patients that underwent pediatric endoscopic sinus surgery.
Patients and methods. The prevalence of adhesion and infections during the postoperative period after PESS were analyzed in 170 children that underwent surgery in ENT Clinic at Medical University of Warsaw between 2007 and 2011. The inclusion criteria for the analyzed group were diagnosed chronic nasosinusitis and sinusitis, as well as undergoing Pediatric Endoscopic Sinus Surgery. Children who had the Balloon Sinuplasty method operation previously were excluded from the trial examination group. The patients were divided into two groups – those to whom seton was administrated and those for whom gel packing was used.
Conclusions. The differences in the process of healing while using gel and seton packing were presented.
Functional endoscopic surgery is the fundamental method of treating chronic rhinitis and sinusitis with stenosis of the physiological sinus ostium. The surgery success depends not only on the surgery technique but also on the patient preparation and the postoperative period, including the medical packing which was used. The traditional packing used in the nasal cavity area is seton. In recent years alternative methods of nasal cavities tamponing have appeared, including gel packings with carboxymethylcellulose.
Functional endoscopic nasal sinuses endoscopy is a safe method and local or general complications are rare. One of the most common local complications are internasal adhesions and epistaxis.
The objective of our study was to investigate the influence of the medical packing used on the prevalence of the indicated types of complications.
PATIENTS AND METHODS
Retrospective research of 175 patients (96 boys, 79 girls) was conducted. Conservative treatment of chronic rhinitis and sinusitis did not bring satisfactory effects for the studied patients, so surgical procedure was performed. Children suffering from chronic sinusitis with stenosis of the physiological sinus ostium were qualified for surgical treatment. Their condition was confirmed by computed tomography of sinuses after at least 8 weeks of lasting symptoms.

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Piśmiennictwo
1. Chmielik M et al.: Operacje endoskopowe zatok (mini FESS) u dzieci. Otorynolaryngologia 2004; supl. 1, 38-41 2. Chmielik M et al.: Funkcjonalna chirurgia endoskopowa zatok u dzieci. Otolaryngologia Polska 1999; LIII, supl. 29: 9-11. 3. American Academy of Pediatrics, Subcommittee on Management of Sinusitis and Committee on Quality Improvement, Clinical practice guidelines: management of sinusitis. Pediatrics 2001; 108, pp. 798-808. 4. Rettinger G, Gjuric M: Osteoplastic endonasal approach to the maxillary sinus. Rhinology 1994; 32 (1): 42-44 5. Huang HM et al.: Normalization of maxillary sinus mucosa after functional endoscopic sinus surgery in pediatric chronic sinusitis. Int J of Pediatr Otorhinolaryngol 2005; 69(9): 1219-1223. 6. Leung Alexander KC, Kellner James D: Acute sinusitis in children: Diagnosis and management. Journal of Pediatric Health Care 2004; 18, pp. 72-76. 7. Chmielik M, Brożek E: Nasal and sinus diseases in children – surgical treatment. New Medicine 2002; 2: 55-57. 8. Bernal-Sprekelsen M et al.: Pediatric endoscopic sinus surgery (PES): Review of indications. Rev Laryngol Otol Rhinol 2003. 9. Clement P et al.: Management of rhinosinusitis. Int J Pediatr Otorhinolaryngol 1999; 49 (supl). 10. Wigand ME: Transnasale, Endoskopischer Chirurgie der Nasennebenhohlen bie chronischer sinusitis. II Die Endonasale Kieferhohlen-Operation. HNO 1981; 29.
otrzymano: 2011-09-28
zaakceptowano do druku: 2011-10-19

Adres do korespondencji:
*Lechosław P. Chmielik
Klinika Otolaryngologii Dziecięcej WUM
ul. Marszałkowska 24, 00-576 Warszawa
tel./fax: +48 22 628 05 84
e-mail: laryngologia@litewska.edu.pl

New Medicine 4/2011
Strona internetowa czasopisma New Medicine