Effects of topical hyaluronic acid (Sepragel®/Hylan B) on mucosal healing after endoscopic sinus surgery

Abstract:

Objective: To investigate the effects of hyaluronic acid (HA) (Sepragel® Hylan B; Genzyme Co., Cambridge, MA, USA) on the mucosal healing of patients who undergone functional endoscopic sinus surgery (FESS) for chronic rhinosinusitis and/or nasal polyposis.

Methods: A total of thirty-six patients were included in the study. Patients had received topical administration of HA soaked sponges to the middle meatus on one side of their nasal cavities intra-operatively at the end of the procedures. Other side of the middle meatus was free of any treatment or packing to create a control group. Postoperative endoscopic examination was performed at the 1st, 4th and 12th weeks in order to score mucosal findings regarding synechiae, mucosal hypertrophy and polyp formation on both sides. Mucosal findings were scored from 0 to 3 points (0: lesion free, 1: mild, 2: moderate, 3: severe).

Results: Average scores of the mucosal cavities were compared and it was found to be significantly low for the HA administered mucosa (p<0.05). Synechia formation and mucosal hypertrophy at the 1st, 4th and 12th weeks were significantly low for the Hylan B group compared to the control group (p<0.05 for both findings).

Conclusion: Topical HA has preventive effects on synechia formation and mucosal hypertrophy.