Endoscopic sinus surgery may be complicated by
bleeding, formation of synechia, and
infection. This study investigated the application of
autologous fibrin tissue adhesive during endoscopic sinus surgery in an attempt to avoid packing, to decrease complications, and to improve healing.
Fibrin tissue adhesive from pooled human blood is a
hemostatic and bacteriostatic agent.
Autologous fibrin tissue adhesive avoids the potential infectious and immunologic risks of the pooled blood product. Twelve patients undergoing bilateral endoscopic sinus surgery participated in the study. Phlebotomy and preparation of the adhesive were performed during the procedure.
Fibrin tissue adhesive was applied to only one side, with the contralateral side used as a control.
Bacitracin ointment was applied to the adhesive-treated side, and packing coated with
bacitracin was placed on the contralateral side. Patients were observed for a minimum of 3 months, and results were documented with photographic and video recordings. A uniformly high degree of patient satisfaction was achieved because of the elimination of packing and a sensation of increased nasal airway patency on the
fibrin-treated side.
Fibrin tissue adhesive provided hemostasis, decreased crusting, accelerated mucosal healing, and diminished synechia.
Autologous fibrin tissue adhesive is beneficial in endoscopic sinus surgery, and its application should be considered, especially when the risk of
hemorrhage or synechia is increased.