Anti-adhesive effect of solid mixture of sodium hyaluronate/carboxymethylcellulose in murine nasal cavities

Abstract

The purpose of the study was to evaluate the effect of a solid mixture of sodium hyaluronate and carboxymethylcellulose (S-HA/CMC) for the prevention of adhesions after iatrogenic mucosal injury in murine nasal cavities. We introduced iatrogenic adhesions into the bilateral nasal cavities of 20 male Sprague-Dawley rats. S-HA/CMC was applied to the left nasal cavity, while no packing was placed in the right nasal cavity as a control. At 1, 2, and 4 weeks post-procedure, we examined the number of adhesions, the ratio of the longest cross-sectional length of adhesion to septal cartilage length (RAC), and the degree of fibrosis. S-HA/CMC significantly reduced the number of adhesions when compared to the control group in total (p = 0.031), but not at each individual time point. The S-HA/CMC group showed significantly shorter RAC than the control group in total (p = 0.044), but not at each individual time point. The total fibrosis score was less severe in the S-HA/CMC group than in the control group (p < 0.001), with a significant difference between the two groups at the second week (p = 0.001). Therefore, in an animal model, S-HA/CMC can prevent post-injury mucosal adhesions suggesting a potential for clinical applications in endoscopic sinus surgery. Further clinical trials are needed to determine the safety and efficacy of S-HA/CMC as nasal packing after endoscopic sinus surgery.