Clinical Effect of the Mixed Solution of Sodium Hyaluronate and Sodium Carboxymethylcellulose After Endonasal Dacryocystorhinostomy

ABSTRACT

PURPOSE: To evaluate the effects of a mixed solution of sodium hyaluronate and sodium carboxymethylcellulose (HACMC, Guardix-sol(R)) for reducing postoperative adhesion after endonasal dacryocystorhinostomy. METHODS: Endonasal dacryocystorhinostomy was performed on 58 patients with obstructions of the nasolacrimal system. We divided the 58 patients into two groups. At the completion of endonasal dacryocystorhinostomy, HACMC was applied to the operative site in the experimental group (n=26) and normal saline was applied in the control group (n=32). For the evaluation of clinical effectsand postoperative adhesion, subjective symptom score evaluations, lacrimal irrigation tests, fluorescein disappearance tests, and endoscopic examinations were performed at 1 week, 1 month, 3 months, and 6 months postoperatively. RESULTS: The HACMC-treated patients showed better results than the control patients for subjective symptom scores, lacrimal irrigation tests, and fluorescein disappearance tests, but these differences were not statistically significant. Upon endoscopic examination, the HACMC group revealed lower incidence of adhesion at 1 week after surgery and lower severity of adhesion throughout the period of observation (p<0.05). CONCLUSIONS: The application of a mixed solution of HACMC may effectively reduce postoperative adhesion after endonasal dacryocystorhinostomy.