Volume 83, Issue 5 (August 2025)
Tehran Univ Med J 2025, 83(5): 324-331 |
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Nasirai E, Bakhshaee M, Rasoulian B, Hamidi Alamdari D, Ketabi K, Roshanzamir I. Effects of using autologous fibrin sealant in functional endoscopic sinus surgery: a randomized controlled clinical trialbackground. Tehran Univ Med J 2025; 83 (5) :324-331
URL: http://tumj.tums.ac.ir/article-1-13615-en.html
URL: http://tumj.tums.ac.ir/article-1-13615-en.html
Ehsan Nasirai1 
, Mehdi Bakhshaee1 , Bashir Rasoulian1 , Daryoush Hamidi Alamdari2 , Kiana Ketabi1 , Imaneh Roshanzamir *3
, Mehdi Bakhshaee1 , Bashir Rasoulian1 , Daryoush Hamidi Alamdari2 , Kiana Ketabi1 , Imaneh Roshanzamir *3
1- Department of Otolaryngology-Head and Neck Surgery, Endoscopic Sinus Surgery Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2- Department of Clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
3- Department of Otolaryngology-Head and Neck Surgery, Endoscopic Sinus Surgery Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. ,Roshanzamiri@mums.ac.ir
2- Department of Clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
3- Department of Otolaryngology-Head and Neck Surgery, Endoscopic Sinus Surgery Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. ,
Abstract: (337 Views)
Background: To improve hemostasis and optimize the healing process, autologous fibrin sealant (FS) has been introduced in selected cases. However, the clinical benefits of FS in sinonasal surgery remain controversial and require further evaluation. This study aimed to investigate the effects of autologous FS on hemostasis, mucosal healing, postoperative clinical outcomes, and recurrence in patients undergoing bilateral FESS, compared with normal saline as the control.
Methods: This randomized clinical trial included 32 patients who underwent bilateral FESS at Ghaem and Imam Reza University Hospitals in Mashhad, Iran, between 2019 and 2021. For each patient, autologous FS was applied to one nasal cavity, while the contralateral cavity received normal saline. Postoperative outcomes including bleeding, crusting, adhesion formation, and infection were assessed at 1 week, 1 month, and 3 months after surgery. In addition, sinonasal symptom burden and endoscopic findings were evaluated using the Sinonasal Outcome Test (SNOT-22) and the Lund-Kennedy endoscopic score, respectively, both recorded preoperatively and three months postoperatively.
Results: Application of autologous FS significantly reduced immediate postoperative bleeding, and no further bleeding events were noted during follow-up. Pain severity was comparable between the two sides. No statistically significant differences were observed in crust formation, adhesion, infection, recurrence, or changes in Lund-Kennedy scores between the FS and control sides (p=0.08, p=0.8, p=0.17, and p=0.14, respectively).
Conclusion: Autologous fibrin sealant reduced early postoperative bleeding without adversely affecting pain control, mucosal healing, or recurrence after FESS. Larger randomized trials with extended follow-up are recommended to determine its definitive clinical value and potential for routine use in surgical practice.
Methods: This randomized clinical trial included 32 patients who underwent bilateral FESS at Ghaem and Imam Reza University Hospitals in Mashhad, Iran, between 2019 and 2021. For each patient, autologous FS was applied to one nasal cavity, while the contralateral cavity received normal saline. Postoperative outcomes including bleeding, crusting, adhesion formation, and infection were assessed at 1 week, 1 month, and 3 months after surgery. In addition, sinonasal symptom burden and endoscopic findings were evaluated using the Sinonasal Outcome Test (SNOT-22) and the Lund-Kennedy endoscopic score, respectively, both recorded preoperatively and three months postoperatively.
Results: Application of autologous FS significantly reduced immediate postoperative bleeding, and no further bleeding events were noted during follow-up. Pain severity was comparable between the two sides. No statistically significant differences were observed in crust formation, adhesion, infection, recurrence, or changes in Lund-Kennedy scores between the FS and control sides (p=0.08, p=0.8, p=0.17, and p=0.14, respectively).
Conclusion: Autologous fibrin sealant reduced early postoperative bleeding without adversely affecting pain control, mucosal healing, or recurrence after FESS. Larger randomized trials with extended follow-up are recommended to determine its definitive clinical value and potential for routine use in surgical practice.
Type of Study: Original Article |
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