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Hyaluronic acid for post sinus surgery care: systematic review and meta-analysis

Published online by Cambridge University Press:  06 February 2017

E Fong ,
M Garcia ,
C M Woods  and
E Ooi
E Fong*
Affiliation:
Otolaryngology – Head and Neck Surgery, Flinders Medical Centre and Flinders University, Bedford Park, Australia Ears, Nose and Throat Department, Princess Alexandra Hospital, Woolloongabba, Australia
M Garcia
Affiliation:
Otolaryngology – Head and Neck Surgery, Flinders Medical Centre and Flinders University, Bedford Park, Australia
C M Woods
Affiliation:
Otolaryngology – Head and Neck Surgery, Flinders Medical Centre and Flinders University, Bedford Park, Australia
E Ooi
Affiliation:
Otolaryngology – Head and Neck Surgery, Flinders Medical Centre and Flinders University, Bedford Park, Australia
*
Address for correspondence: Dr Eric Fong, ENT Department, Flinders Medical Centre, Flinders Drive, Bedford Park, SA 5042, Australia Fax: +61 8 8204 7524 E-mail: [email protected]
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Abstract

Background:

Wound healing after endoscopic sinus surgery may result in adhesion formation. Hyaluronic acid may prevent synechiae development. A systematic review was performed to evaluate the current evidence on the clinical efficacy of hyaluronic acid applied to the nasal cavity after sinus surgery.

Methods:

Studies using hyaluronic acid as an adjunct treatment following endoscopic sinus surgery for chronic rhinosinusitis were identified. The primary outcome was adhesion formation rates. A meta-analysis was performed on adhesion event frequency. Secondary outcome measures included other endoscopic findings and patient-reported outcomes.

Results:

Thirteen studies (501 patients) met the selection criteria. A meta-analysis of adhesion formation frequency on endoscopy demonstrated a lower risk ratio in the hyaluronic acid intervention group (42 out of 283 cases) compared to the control group (81 out of 282) of 0.52 (95 per cent confidence interval = 0.37–0.72). Hyaluronic acid use was not associated with any significant adverse events.

Conclusion:

Hyaluronic acid appears to be clinically safe and well tolerated, and may be useful in the early stages after sinus surgery to limit adhesion rate. Further research, including larger randomised controlled trials, is required to evaluate patient- and clinician-reported outcomes of hyaluronic acid post sinus surgery.

Keywords

RhinitisSurgeryQuality Of LifeDrug TherapyHyaluronic Acid
Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 131 , Supplement S1 , January 2017 , pp. S2 - S11
Copyright
Copyright © JLO (1984) Limited 2017 

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Footnotes

Presented at the Australian Society of Otolaryngology – Head and Neck Surgery 65th Annual Scientific Meeting, 7–9 March 2015, Sydney, Australia.

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