Fibrin tissue adhesive versus nasal packing in endoscopic nasal surgery: a systematic review and meta-analysis

Faculty of Biology, Medicine and Health, The University of Manchester, United Kingdom. Faculty of Biology, Medicine and Health, The University of Manchester, United Kingdom. Faculty of Biology, Medicine and Health, The University of Manchester, United Kingdom. Faculty of Biology, Medicine and Health, The University of Manchester, United Kingdom. Faculty of Biology, Medicine and Health, The University of Manchester, United Kingdom.

Rhinology. 2018
Abstract
BACKGROUND It has been proposed that fibrin tissue adhesive (FTA) can act as an effective alternative to nasal packing in managing the postoperative symptoms of endoscopic nasal surgery. METHODOLOGY MEDLINE, Embase, Cochrane Library, The Cumulative Index to Nursing and Allied Health Literature and ClinicalTrials.gov were searched for randomised controlled trials comparing FTA with nasal packing in endoscopic nasal surgery. The primary outcome of interest was bleeding; secondary outcomes included pain, nasal obstruction, infection, adhesions and the formation of granulation tissue. All trials underwent a risk of bias assessment, and a meta-analysis was performed using a random effects model. RESULTS 315 studies were found, of which four were eligible for inclusion (n = 152). Bleeding was reported in all, with the meta-analysis favouring the packing group, although this was not significant. Nasal obstruction and granulation severity were significantly lower in the FTA group, however, no difference was noted for the outcomes of pain, infection or adhesions. CONCLUSION Our results indicate minor advantages for using FTA over nasal packing. Unfortunately, the included studies show significant heterogeneity and risk of bias. Based on the available evidence, clinicians must balance the higher cost of FTA against the limited advantages for the patient.
Study details
Study Design : Systematic Review
Language : English
Credits : Bibliographic data from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine