Ottoviano et al. present a prospective double-blinded RCT to assess the effect of a nasal gel containing silver sucrose octasulfate (Silsos Gel) on wound healing after endoscopic sinus surgery. The placebo used was a glycol gel. Thirty-four consecutive patients were included in the study. Exclusion criteria included those with previous sinus surgery or auto-immune disease. Endoscopic biopsies of the anterior ethmoid mucosa were taken at the time of surgery and 90 days postoperatively. Patients were assigned to the treatment gel or placebo, two sprays into each nostril BD for one month postoperatively. Patients were reviewed at 15, 30 and 90 days postoperatively. The Silsos gel group experienced a more rapid improvement as judged by Lund-Kennedy and SNOT-22 assessment, especially in the first 15-30 days postoperatively. The endoscopic appearance was also improved at day 90 postoperatively as compared to the placebo group. Histologically, there were fewer cells with abnormal cilliary morphology in the treatment group as compared to the placebo group at 90 days postop. This study suggests that Silsos gel should be considered as an adjunct in the postoperative management of patients undergoing endoscopic sinus surgery in order to increase the rate of mucosal healing.
A spoonful of sugar… helps the operated sinuses calm down?
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