Comparison of Calcium Alginate and Polyurethane Foam Used as Nasal Packings after Endonasal Dacryocystorhinostomy

Seonghee Choi; Yuri Seo; Jae Sang Ko; Young Jin Song; Jin Sook Yoon

doi:10.3341/jkos.2018.59.3.197

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Choi, Seo, Ko, Song, and Yoon: Comparison of Calcium Alginate and Polyurethane Foam Used as Nasal Packings after Endonasal Dacryocystorhinostomy

Original Article

J Korean Ophthalmol Soc 2018;59(3):197-202.

Published online: 7 September 2018

DOI: https://doi.org/10.3341/jkos.2018.59.3.197

Comparison of Calcium Alginate and Polyurethane Foam Used as Nasal Packings after Endonasal Dacryocystorhinostomy

Seonghee Choi, MD, Yuri Seo, MD, Jae Sang Ko, MD, Young Jin Song, MD, Jin Sook Yoon, MD, PhD

The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea

Address reprint requests to Jin Sook Yoon, MD, PhD Department of Ophthalmology, Severance Hospital, #50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea Tel: 82-2-2228-3570, Fax: 82-2-312-0541, E-mail: yoonjs@yuhs.ac

Received 16 November 2017 Revised 25 December 2017 Accepted 20 February 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To compare the effectiveness of calcium alginate (Algi-pack®)and polyurethane foam (Nasopore®), two types of absorbable packing used for nasal packing after endonasal dacryocystorhinostomy.

Methods

We performed a retrospective chart review of 128 eyes of patients who underwent endonasal dacryocystorhinostomy from January 2008 to July 2016. Algi-pack® was used to pack 42 eyes and Nasopore® in 86 eyes. We compared the two groups in terms of pain on postoperative day 2; the re-bleeding frequency within 1 week; anatomical and functional success rates 3 months after surgery; and the frequencies of postoperative complications including synechiae, granulomas, and membrane formation at 3 months postoperatively.

Results

There was no significant difference between the Algi-pack^® and Nasopore^® groups in terms of postoperative pain or re-bleeding rate (pain: 73.8% vs. 83.7%, p = 0.38; re-bleeding: 4.8% vs. 5.8%, p = 0.058). There was no significant between-group difference in terms of the formation of synechiae, granulomas, or membranes to 3 months postoperatively (granulomas: 33.3% vs. 29.1%, p = 0.62; synechiae: 1.2% vs. 4.8%, p = 0.21; membranes: 19.0% vs. 12.8%, p = 0.35). The functional and anatomical success rates evaluated 3 months after surgery also did not differ significantly between the two groups (anatomical success: 100% vs. 97.7%, p = 0.32; functional success: 100% vs. 95.3%, p = 0.16).

Conclusions

Algi-pack® and Nasopore® equivalently suppressed bleeding after endonasal dacryocystorhinostomy and did not differentially affect the surgical success rate or the frequency of postoperative complications.

Keywords: Calcium alginate, Endoscopic dacryocystorhinostomy, Nasal packing

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Figure 1.

Calcium alginate (Algi-pack®). (A) Photograph of Algi-pack before insertion into the nasal cavity. (B) Clinical photographs demonstrating changes in Algi-pack® during postoperative follow-up. POD = postoperative day.

Figure 2.

Comparison of re-bleeding that required re-packing within postoperative day 7. (A) There was no significant difference in re-bleeding within postoperative day 7 between Algi-pack® and Nasopore® groups. (B) There was no significant difference in re-bleeding between the group on antiplatelets and the group not on antiplatelets.

Figure 3.

Comparison of visual analogue scale (VAS) results for postoperative pain on postoperative day 2. There was no significant difference in pain on postoperative day 2 between Algi-pack® and Nasopore® groups.

Table 1.

Demographics and clinical data of subjects enrolled in this study

	Algi-pack®	Nasopore®	p-value
No. of eyes	42	86
Age (years)	61.5 ± 10.9	59.2 ± 10.9	0.10
Gender (M/F)	8/34 (19.0/81.0)	17/69 (19.8/80.2)	0.92
Aspirin medication	5 (11.9)	13 (15.1)	0.62
DM	5 (11.9)	10 (11.6)	0.96
HTN	16 (38.1)	22 (25.6)	0.15
Canalicular stenosis	16/26 (38.1)	24/62 (27.9)	0.24

Values are presented as mean ± SD or n (%) unless otherwise indicated. Independent r-test for the comparision of age, otherwise Pearson's chi-square and Fisher exact test was used.

SD = standard deviation; M/F = male/female; DM = diabetes mellitus; HTN = hypertension.

Table 2.

Comparison of anatomical and functional success rates between Algi-pack® and Nasopore® groups

	Algi-pack®	Nasopore®	p-value
	(n = 42)	(n = 86)
Anatomical success after 3 months (Assessed by fluorescein dye)	42 (100)	84 (97.7)	0.32
Functional success after 3 months (Assessed by Munk score) Postoperative nasal findings after 3 months	42 (100)	82 (95.3)	0.16
Granulation formation	14 (33.3)	25 (29.1)	0.62
Synechiae formation	2 (1.2)	1 (4.8)	0.21
Membrane formation	8 (19.0)	11 (12.8)	0.35

Values are presented as number (%) unless otherwise indicated. p-values less than 0.05 were considered significantly. Pearson's chi-square and Fischer exact test were used. Postoperative nasal findings were assessed using a nasal endoscope, and any granulation, synechiae, and membrane formation within 1-2 mm of the nasal ostium were identified in postoperative 3 months.

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