Effect of recombinant human acidic fibroblast growth factor on nasal mucosal healing after endoscopic sinus surgery

Am J Otolaryngol. 2023 Jul-Aug;44(4):103895. doi: 10.1016/j.amjoto.2023.103895. Epub 2023 Apr 12.

Abstract

Background: Postoperative nasal treatment is an important factor affecting the outcomes of endoscopic sinus surgery (ESS) in patients with chronic rhinosinusitis (CRS). This study aimed to determine the effect of recombinant human acidic fibroblast growth factor (rh-aFGF) on nasal mucosal healing after ESS.

Methods: This study is a prospective, single-blind, and randomized controlled clinical study. Fifty-eight CRS patients with nasal polyps (CRSwNP) with bilateral ESS were enrolled and randomly given 1 mL of budesonide nasal spray and 2 mL of rh-aFGF solution (rh-aFGF group) or 1 mL of budesonide nasal spray and 2 mL of rh-aFGF solvent (budesonide group)-infiltrated Nasopore nasal packing after ESS. Preoperative and postoperative scores for Sino-Nasal Outcome Test (SNOT-22), Visual Analogue Scale (VAS), and Lund-Kennedy were collected and analyzed.

Results: Forty-two patients completed the 12-week follow-up. Postoperative SNOT-22 scores and VAS scores showed no significant differences between the two groups. In terms of the Lund-Kennedy scores, there was a statistically significant difference between the two groups at the 2-, 4-, 8-, and 12-week postoperative visits, but not at the 1-week visit. Twelve weeks after surgery, the nasal mucosa had completely epithelialized in 18 patients in the rh-aFGF group and in 12 patients in the budesonide group (χ2 = 4.200, P = 0.040).

Conclusion: The combined application of rh-aFGF and budesonide significantly improved postoperative endoscopic appearance in the nasal mucosal healing process.

Keywords: Chronic rhinosinusitis; Endoscopic sinus surgery; Nasal packing; Recombinant human acidic fibroblast growth factor; Wound healing.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Budesonide
  • Chronic Disease
  • Endoscopy
  • Fibroblast Growth Factor 1 / pharmacology
  • Fibroblast Growth Factor 1 / therapeutic use
  • Humans
  • Nasal Mucosa
  • Nasal Polyps* / drug therapy
  • Nasal Polyps* / surgery
  • Nasal Sprays
  • Paranasal Sinuses* / surgery
  • Prospective Studies
  • Rhinitis* / drug therapy
  • Rhinitis* / surgery
  • Single-Blind Method
  • Sinusitis* / drug therapy
  • Sinusitis* / surgery
  • Treatment Outcome

Substances

  • Fibroblast Growth Factor 1
  • Nasal Sprays
  • Budesonide