Aukema, T.W. (2020) Effects of STB™ wounddressing on nasal wound healing after radiofrequency coblation treatment of the inferior turbinates. A single center, single blind, randomized controlled trial. thesis, Medicine.
Full text available on request.Abstract
Background Nasal obstruction is a problem, with a broad spectrum of etiologies, for which surgical treatment is often applied when conservative treatment fails. Hypertrophy of the inferior turbinates (conchal hypertrophy) is a common cause of nasal obstruction, mostly treated by the use of coblation. This is a frequently used technique in which radiofrequency energy scars the submucosa of the turbinate resulting in shrinkage of the turbinate. Postoperatively, patients are instructed to rinse their nose with saline irrigation three times a day, from 4 to 8 weeks. During this period patients may experience nasal bleeding, crust formation, irritation and/or discomfort. STB™ wounddressing (STB) is an ointment, based on medicinal honey, that is capable of stimulating wound healing in vivo and has an antibacterial effect in vitro. The aim of this study is to assess the effects of STB on nasal wound healing in addition to nasal saline irrigations after coblation treatment of the inferior turbinate. Methods Single center, single blinded, randomized controlled trial, in 56 patients who received bilateral coblation treatment of the inferior turbinates. For 6 weeks, one group was treated with nasal saline irrigations (NSI; control) and one group was treated with nasal saline irrigations in combination with STB (NSI+STB; intervention). The primary endpoint was an overall nasal burden score measured by visual analogue scale (VAS) after 6 weeks follow-up. Nasal crusting, pain, loss of smell, burden of nasal bleeding, burden of secretion and the NL-NOSE were set as secondary endpoints. Differences in pre- and post-peak nasal inspiratory flow (PNIF) scores and nasal endoscopy scores (NES) between groups were assessed. Effect of lateralization was investigated as ancillary analysis. Results Fifty-five patients were eligible for analyses. Twenty-nine patients were randomized to the NSI group (A) and 26 to the NSI+STB group (B). Treatment did not have a significant effect on overall nasal burden (p=0.687), neither was there a difference between treatment groups at six weeks (p=0.181). Treatment did not have a significant effect on crusting (p=0.667), pain (p=0.441), loss of smell (p=0.561), NL-NOSE-scale (p=0.969), nasal bleedings (p=0.758) and secretions (p=0.999). The NSI+STB group showed a trend towards less crusting and pain during the first 2 weeks post-procedure. The NSI group scored significantly better PNIF scores after coblation (p=0.038). Nasal endoscopy did not differ between groups (p=0.320). Lateralization had no significant effect on pain, burden of nasal bleedings and the NL-NOSE scale, but showed a trend towards less pain, less burden of nasal bleedings and better nasal patency. One patient reported STB related headaches as adverse event. Conclusion This study was not able to show that STB™ wounddressing has an added value to nasal saline irrigations after coblation treatment of the inferior turbinates. Merely a small effect on crust forming and pain was found during the first 2 week after ITC-RF. Ointment based on medicinal honey is not valuable as replacement for nasal saline irrigations, but possibly as addition. Lateralization of the inferior turbinates is a meaningful and safe addition to coblation that can be performed under local anesthetics. A larger double blinded randomized trial is needed to assess if ointment based on medicinal honey is more valuable than NSI and indifferent ointments. Trial registration: NL8061 Funding: Dos Medical B.V.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Rinia, drs. A.B. |
| Faculty: | Medical Sciences |
| Date Deposited: | 07 Aug 2023 11:18 |
| Last Modified: | 07 Aug 2023 11:18 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3613 |
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