Effects of Silver Nitrate Cauterization on Middle Turbinate Synechia after Endoscopic Sinus Surgery

Abstract

Objective This study aimed to examine the efficacy of silver nitrate cauterization of the middle turbinate (MT) for hindering postoperative middle meatal synechia formation after endoscopic sinus surgery (ESS). Study Design Prospective, controlled, and single-blinded. Settings Tertiary referral center. Subjects and Methods For this study, 38 patients undergoing bilateral ESS due to nasal polyposis were recruited. Following ESS, silver nitrate cauterization of the lateral side of the left MT was performed in all cases. The noncauterized opposite right sides served as controls. All patients received the standard ESS protocol, intraoperative middle meatal packing, and postoperative management. The main outcome measured was the formation of partial or complete MT synechia at the end of 6-month assessment, performed by a blinded observer. Results At the end of the 6-month follow-up period, MT synechia formation was observed in 7 of the right sides (7 of 38, 18.4%) and none in any left sides. The rate of synechia formation was significantly higher in the controls when compared with the silver nitrate–cauterized sides ( P < .001). Conclusion The results of this study suggest that silver nitrate cauterization of the MT is a practical and efficient method to eliminate middle meatal synechia after ESS.