Combination of Merocel sponge with Lipopolysaccharide to establish rat rhinosinusitis model

Abstract Objective The study aimed to investigate the feasibility of establishing rhinosinusitis model in rats combinated with Lipopolysaccharide (LPS) and merocel sponge. Methods SD (Sprague Dawley) rats that underwent nasal obstruction using Merocel sponge packing, rats with LPS instillation alone, and rats with both nasal obstruction and LPS instillation were used to establish rat models of rhinosinusitis. After the models were established, the nasal symptoms of rats were recorded, the histopathological examination and Transmission Electron Microscopy (TME) of the sinus tissue were performed and the levels of Tumor Necrosis Factor-α (TNF-α), Interleukin-6 (IL-6) in the blood were also analyzed. The expressions of Aquaporin-5 (AQP5), Occludin, Toll-Like Receptor-4 (TLR4), Medullary differentiation factor 88 (MyD88) and phosphorylated (p)-p65 protein were detected by Western blot to evaluate the effect and mechanism of the experimental models. Results We found that compared with the control group and LPS group, the sinusitis symptom scores in the Merocel sponge combined with LPS group were significantly increased; the respiratory epithelia of the maxillary sinus were degenerated, cilia were detached, and even inflammatory cell infiltration occurred; the levels of TNF-α and IL-6 were increased; the expression of AQP5 and Occludin protein was decreased; and the expressions of TLR4, MyD88, and p-p65 protein were increased. Conclusion For the first time, we successfully established a rat rhinosinusitis model using Merocel sponge with LPS and explored the possible mechanism of LPS action.

A-prospective-study-comparing-the-outcomes-of-nasal-septal-clip-versus-merocel-application-after-nasal-septal-corrective-surgery

Nasal splint application is an important step of septal corrective surgeries to keep the septum in midline after the surgery. Septal clip is most commonly used. In our study we have compared the use of nasal septal clip and Merocel application post surgery and the morbidities associated with it.

Comparative Study of Effect of Mitomycin-C and Merocel Packing on Ostial Patency in Primary Endoscopic Dacryocystorhinostomy.

Background: To compare the post operative ostial patency at the rhinostomy site in the patients undergoing the primary endoscopic dacryocystorhinostomy, using Mitomycin-C application and Merocel packing. Methods: The patients visiting the Otorhinolaryngology out patients department at the tertiary referral hospital were included in this study. The study was prospective in nature and comprised of 50 patients suffering from primary dacryocystitis. Endonasal endoscopic dacryocystorhinostomy was done in the patients suffering from the chronic dacryocystitis with postsaccular obstruction of lacrimal system. The patients were divided in two equal groups containing 25 patients in each group. In first group (Group- A) Mitomycin-C (0.5 mg/ml for 15 min) was locally applied at the rhinostomy site and nasal cavity was packed with bactigras after the surgery, whereas in the second group, nasal cavity was packed with Merocel after reposition of the flap without application of any drug. Follow up was done every week in the first month, then monthly till the six months after the surgery. The post operative results were compared in terms of ostial patency at the rhinostomy site at one month, three months and six months of follow up. The surgical technique used remained same throughout the period of study. Results: The post operative ostial patency of rhinostomy stoma was better in the group of the patients undergoing application of Mytomycin-C at the rhinostomy site as compared to the packing of the nasal cavity with Merocel. The difference between both the groups was statistically significant. The rhinostomy created was free from synachiae and granulation tissue formation on follow up examination in the group of the patients having application of Mitomycin-C at the time of surgery. Ultimately the ostial patency was better in the patients having application of Mitomycin-C. Conclusion: Mitomycin-C has statistically significant beneficial effect in the maintenance of ostial patency after primary endonasal endoscopic dacryocystorhinostomy as compared to the merocel packing alone after the surgery.

The Usefulness of Latex-covered Merocel(R) Packing in Septal Surgery

BACKGROUND AND OBJECTIVES: Nasal packing after nasal surgery is commonly practiced. Merocel(R) is one of the most popular packing material, however it can be associated with significant pain and bleeding on its removal. A prospective study was performed to compare the efficacy and patient tolerance of Merocel(R) and newly designed Latex-covered Merocel(R) (LCM). MATERIALS AND METHOD: Sixty patients underwent septoplasty for septal deviation. Following septoplasty, the patients were randomly allocated into two groups of 30 patients each who underwent insertion of either Merocel(R) or LCM. Patients were asked to record pain levels using a visual analogue scale(VAS) before and after packing removal, and number of analgesic injection were recorded. Resistance and amount of bleeding on packing removal were also recorded. RESULTS: Both nasal packs effectively prevented post-operative bleeding. However the VAS score for nasal pain and numbers of analgesic use before and after packing removal were significantly lower in the LCM group. LCM was removed more smoothly causing significantly less amount of bleeding on removal. CONCLUSION: LCM provides good post-operative hemostasis and its removal is less traumatic and painful for the patients, therefore improving patient's comfort.

The Usefulness of Airway Tube Merocel(R) on Treatment of Nasal Bone Fracture

PURPOSE: Nasal packing materials are almost inserted at the end stage of closed reduction of nasal bone for postoperative bleeding control and stabilization of nasal bone. Conventionally, vaseline gauze was used for packing of nasal cavity. These days, Surgeons have tried to apply Merocel(R) into the nasal cavity more easily. It is difficult for patients to continue keeping the nasal packs for more than a week due to breathing difficulty. Moreover, nasal packing itself can also cause headache, dry mouth, stuffiness, etc. METHODS: We performed a prospective study from March 1, 2008 to July 31, 2008. One hundred patients were divided into "Merocel(R) packing group" and "Merocel(R) and Airway Tube Merocel(R) packing group". Using two kinds of materials to each group after closed reduction, we observed and compared the amount of bleeding between two groups. We recorded patient's uncomfortable symptoms which were divided into four groups each 6, 24, 48 hours after nasal packing. RESULTS: The result of the bleeding amount of Air Tube Merocel(R) group after 6 hours of nasal packing is that 3 people belong to mild group, 38 people moderate group, and 9 people severe group. After 6 hours of nasal packing, 11 patients have no complains. 16 patients were mild, 21 patients were moderate, 2 patients were severe. After 24 hours of nasal packing, no complain(18 patients), mild(24 patients), moderate(6 patients), severe(0 patient). After 48 hours of nasal packing, no complain(25 patients), mild(20 patients), moderate(5 patients), severe(0 patient). CONCLUSION: Regarding the amount of bleeding, there are no difference between two groups. In case of Air Tube Merocel(R) group, patient's discomfort is gradually improved after 24 hours of nasal packing, After 48 hours of nasal packing, most of the patients do not experience headache, dry mouth, stuffiness, etc. Therefore, Air Tube Merocel(R) can be useful for bleeding control. Moreover, it helps patients to breathe through nose more easily and reduce discomfort.

Short-Term Clinical Results of Amniotic Membrane Application to Endonasal Dacryocystorhinostomy

PURPOSE: To evaluate the short-term surgical results of Merocel(R) nasal packing wrapped with human amniotic membrane on the internal ostium during endonasal dacryocystorhinostomy (DCR). METHODS: Sixty patients who underwent endonasal DCR to treat nasolacrimal duct obstruction from October 2005 to April 2006 were enrolled in this prospective study. The patients were divided into two groups: 30 patients treated with Merocel(R) packing wrapped with amniotic membrane were assigned to group 1, and the remaining 30 patients were assigned to group 2. During the follow-up period, the authors evaluated surgical wound healing, the incidence of granuloma, and the patency of the internal ostium. RESULTS: Success rates at 6 months after surgery were higher in group 1 than in group 2, but these rates showed no statistically significant difference between the two groups (group 1: 93.3%, group 2: 86.7%, p=0.67). The time for mean wound healing in group 1 was significantly shorter than that in group 2 (group 1: 4.8+/-1.5 weeks, group 2: 7.3+/-1.5 weeks, p< 0.001). The incidence of granuloma in group 1 was lower than that in group 2 at 2 months after surgery (group 1: 13% (4/30), group 2:33% (14/30), p=0.04). However, there was no difference of granuloma formation between the two groups at 6 months postoperatively (group 1: 33% (11/30), group 2: 46% (14/30)). CONCLUSIONS: The authors believe that the use of Merocel(R) packing wrapped with amniotic membrane after endonasal DCR might decrease postoperative inflammation, accelerate wound healing, and decrease granuloma formation in the early postoperative period.