Effect of Ankaferd bloodstopper tampon on postoperative synechia and nasaal symptoms in patients undergoing functional endoscopic sinus surgery

Aim: Ankaferd Blood Stopper is a very effective tampon in bleeding control that can be used safely in healthy individuals and those with bleeding diathesis. Due to this feature, its use is increasing especially in upper gastrointestinal system bleeding, periodontal surgeries, and ear, nose, and throat surgeries, especially in epistaxis control. Bleeding control and rapid re-epithelialization of the wound site after functional endoscopic sinus surgery are important for both patient-physician comfort and reduction of adhesions. Reduction in adhesions is important for reducing postoperative recurrences. For this purpose, we aimed to evaluate the nasal synechia parameters of patients who used and did not use Ankaferd blood stopper in endoscopic sinus surgery retrospectively. Materials and Methods: In this study, we retrospectively analyzed whether the use of Ankaferd blood stopper in endoscopic sinus surgery performed in our clinic between 1.1.2022 and 30.12.2024 made a difference compared to the cases where it was not used. For this purpose, parameters such as synechia score, endoscopic Meltzer score, bleeding score, Lund-Mackay Computed Tomography score, and NOSE (Nasal Obstruction Symptom Evaluation) score, which evaluates subjective symptoms, were evaluated in the preoperative period and 1,3,6 months postoperatively. Findings: A total of 48 patients were included in the evaluation. 8 of the patients were excluded from the study because their data were missing in the 6-month follow-up. 20 (50%) of the patients were evaluated in the study (Ankaferd Blood Stopper) group and 20 (50%) as the control group. In the control group, 7 (35%) of the patients were female, 13 (65%) were male, and 5 (25%) of the experimental group were female and 15 (75%) were male. No patients with the Samter triad were observed in either group. Septoplasty was performed in 4 (20%) patients in the study group and 10 (50%) patients in the control group. The mean age of the control group was 41.6±14.04, and the mean age of the study group was 50.05±12.27. There was no statistically significant difference between the groups regarding patient ages (p:0.387). In the study group, the NOSE score was found to be 16.05±3.77 preoperatively, 3.20±2.46 postoperatively in the first month, 2.20±2.33 in the third month, and 2.05±2.98 postoperatively in the sixth month. In the control group, the NOSE score was found as 16.40±3.63 preoperatively, 3.00±3.06 postoperatively in the first month, 2.25±2.55 in the third month, and 3.60±3.85 in the sixth month. There was no statistically significant difference between the two groups (p>0.05). The preoperative endoscopic Meltzer score of the study group was 6.10±1.44, and the score of the control group was 4.95±2.01 (p:0.76); The postoperative first-month score of the study group was 0.30±0.73, and the postoperative first-month score of the control group was 1.05±1.19 (p:0.06). The postoperative third-month score of the study group was 0.65±0.81, and the postoperative third-month score of the control group was 1.10±1.29 (p:0.34); The postoperative sixth-month score of the study group was found to be 1.20±1.05, and the postoperative sixth-month score of the control group was found to be 1.10±1.16 (p:0.25). There was no statistically significant difference between the two groups (p>0.05). The preoperative Lund-Mackay CT score in the study group was 16.50±5.50, and the preoperative 12.20±5.69 in the control group (p<0.01); the postoperative sixth-month score in the study group was 8.40±4.87, and the postoperative sixth-month score in the control group was 11.30±6.37 (p:0.428). There was no statistically significant difference between the two groups (p:0.428). The synechia score of the preoperative study and control groups was found to be 0, the postoperative sixth-month score of the study group was 0.50±1.05, and the postoperative first-month score of the control group was found to be 1.20±1.05. The study group had better synechiae scores and there was a statistically significant difference compared to the control group (p:0.028). When the postoperative bleeding data were compared, the bleeding score of the study group was 0.30±0.47 and the bleeding data of the control group was 0.85±074, and a statistically significant difference was found between the two groups (p:0.026). Conclusion: It was observed that the study group was superior to the control group regarding bleeding scores and postoperative 6th-month synechiae scores, and a statistically significant difference was found. As a result, we saw that the use of an ankaferd blood stopper in endoscopic sinus surgery significantly reduced synechiae, which causes serious problems in terms of recurrence and patient comfort. Although our study is the first study on this subject in the literature, we believe that large-scale studies including more patients will yield more results. Keywords: Funtional Endoscopic Surgery, Ankaferd Blood Stopper, Nasopore, Nasal Pack, synechia, Bleeding