Advantages of Glove Finger–coated Polyvinyl Acetate Pack in Endoscopic Sinus Surgery

Background This study investigated the efficacy of glove finger–coated polyvinyl acetate (PA) pack on hemostasis, pain levels, and wound healing after endoscopic sinus surgery (ESS). Methods A prospective, randomized, double-blinded controlled study was performed in 30 patients who underwent bilateral ESS for chronic rhinosinusitis. Fifteen patients (control group) had both nasal cavities packed with PA pack (Merocel; Medtronic Xomed, Jacksonville, FL) and another 15 subjects (experimental group) had their nasal cavities packed with PA in a glove finger. Pain levels were assessed by patients on a visual analog scale 12 hours after surgery and at the time of packing removal. The amount of bleeding on removal were quantified by weighing it after removal. Lund-Kennedy score and synechiae formation were assessed at 4, 8, and 12 weeks after surgery. The use of analgesics and oral steroid was compared between the two groups. Results The experimental group showed lower levels of pain and lessened bleeding during packing removal than the control group. There were no differences in pain levels at 12 hours after surgery, use of analgesics and oral steroid between the two groups. One (6%) of each group had postoperative bleeding and required additional packing for hemostasis. Lower Lund-Kennedy score at postoperative 4 weeks was documented in the experimental group. In addition, two (13%) control subjects developed a synechiae between the middle turbinate and the lateral wall. Conclusion PA packing in a glove finger is advantageous in terms of pain, bleeding on packing removal, and postoperative wound healing, compared with PA pack only.