***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Background Steroid-infused absorbable nasal dressings after endoscopic sinus surgery ( ESS ) have been used to improve wound healing and to reduce the recurrence of polyps . However , their systemic effects are not well known . The purpose of this study was to evaluate the systemic effects and safety of steroid-impregnated absorbable nasal packing after ESS . Methods Patients who underwent bilateral ESS for chronic rhinosinusitis were recruited and r and omized into two groups . Ten patients in the triamcinolone ( TA ) group received a TA ( 20 mg)-soaked bioabsorbable dressing in both nasal cavities while 10 patients in the control group took saline-impregnated dressing in both nasal cavities . Nasal dressings were not removed until postoperative day 10 . Serum cortisol , 12-hour urine cortisol , serum adrenal-corticotropic hormone ( ACTH ) , and serum osteocalcin were measured preoperatively and on postoperative days 2 and 10 . Serum cortisol levels were checked 1 day after surgery additionally , while urine cortisol levels were not checked at postoperative day 10 . Results All 20 patients completed this study . The serum cortisol levels were significantly suppressed at postoperative days 1 and 2 in the TA group . Serum ACTH and 12-hour urine cortisol levels were lower 2 days after surgery in the TA group , although these changes were not statistically significant . There were no differences in all other parameters between the TA and control groups on postoperative day 10 . Conclusions TA-impregnated nasal dressings suppress serum cortisol levels during the early postoperative period . This systemic effect was recovered gradually and normalized 10 days after the operation Objective . Endoscopic sinus surgery ( ESS ) for chronic rhinosinusitis ( CRS ) may be compromised by postoperative inflammation , polyposis , and adhesions , often requiring subsequent intervention . To address this issue , the authors investigated the safety and effectiveness of controlled delivery of mometasone furoate to the sinus mucosa via bioabsorbable implants deployed at the time of ESS . Study Design . Prospect i ve , multicenter , r and omized , controlled , double-blind trial using an intrapatient control design . Setting . Otolaryngology – head and neck surgery centers ; both academic and private practice s. Subjects and Methods . The study enrolled 105 patients with CRS undergoing bilateral ethmoidectomy  to compare the effect of drug-releasing to non-drug-releasing implants using an intrapatient control design . Postoperative interventions , polyposis , and adhesions were assessed postoperatively . Efficacy was determined through independent analysis of r and omized video-endoscopies by 3 blinded sinus surgeons . Safety assessment s included ocular examinations . Results . Implants were successfully deployed in all 210 ethmoid sinuses . Compared with control sinuses with non-drug-releasing implants , the drug-releasing implant provided a 29.0 % relative reduction in postoperative interventions ( P = .028 ) and a 52 % ( P = .005 ) decrease in lysis of adhesions . The relative reduction in frank polyposis was 44.9 % ( P = .002 ) . Similar reductions were observed in real-time grading performed by the clinical investigators . No clinical ly significant changes from baseline in intraocular pressure or cataracts were observed . Conclusion . This study provides a high level of evidence that use of steroid-releasing implants that apply a sustained release of corticosteroid improves surgical outcomes by reducing synechiae formation , polyposis , and the need for postoperative interventions , with no observable ocular safety risk Background Nasal packing is usually performed to control bleeding after endoscopic sinus surgery ( ESS ) . Although new packing material s have been developed , they still cause pain . This study was design ed to evaluate the effect of lidocaine-soaked packs on pain after ESS . Methods A prospect i ve , r and omized , double-blind controlled trial was conducted in 63 patients with CRS undergoing ESS . At the conclusion of the operation , 2 % lidocaine-soaked biodegradable synthetic polyurethane foam and saline-soaked polyurethane foam were inserted in both nasal cavities of 31 patients and 32 control patients , respectively . The same lidocaine or saline was reapplied into the nasal packs at postoperative 8 hours . Pain was evaluated using a visual analog scale at postoperative 1 , 4 , 8 , 16 , 20 , and 24 hour(s ) . The number of gauze that cleaned the blood around the nose was counted . Heart rate , rhythm , and blood pressures were checked preoperatively and postoperatively to evaluate the influence of lidocaine on vital signs . Results Postoperative pain decreased in lidocaine group at all of the postoperative time periods ( p < 0.05 ) . Lidocaine reduced postoperative bleeding at postoperative 8 and 24 hours . Changes of blood pressure from preoperative values in the lidocaine group were not different from those in the control group ( p > 0.05 ) . Heart rate in the lidocaine group was more stable than that in the control group ( p < 0.05 ) . Conclusion Lidocaine-soaked packs significantly reduced postoperative pain without serious changes on vital sign . These findings suggest that topical lidocaine application to nasal packs could be a useful method to reduce pain during the early postoperative period after ESS OBJECTIVES We sought to determine the efficacy of MeroGel , an absorbable hyaluronic acid nasal dressing ( HA ) in reducing synechia after functional endoscopic sinus surgery ( FESS ) compared with Merocel , a nonabsorbable packing ( NAP ) requiring removal . METHODS We conducted a blinded , r and omized , controlled trial of 37 patients requiring bilateral FESS for chronic sinusitis . Patients were r and omized to placement of HA within the right or left middle meatus and NAP on the other side . Patients were evaluated at 2 , 4 , 6 , and 8 weeks postoperatively . RESULTS Blinded evaluation revealed 5 patients ( 14 % ) with synechia at last follow-up : 3 sides ( 8 % ) with HA and 3 ( 8 % ) with NAP . Thirteen patients ( 35 % ) had synechia at any visit , 10 sides ( 27 % ) with HA and 9 ( 24 % ) with NAP . Seven patients ( 19 % ) required lysis of synechia , 5 sides ( 14 % ) with HA and 3 ( 8 % ) with NAP . CONCLUSION We found no statistically significant difference between HA and NAP dressings Background The aim of this study was to determine whether there was any benefit or detrimental consequences of placing a hyaluronic acid pack ( Merogel ) into the middle meatus after  endoscopic sinus surgery ( ESS ) . Methods A r and omized controlled blinded study was performed in 42 patients with chronic sinusitis undergoing ESS . The patients were r and omized to receive Merogel on one side and no packing on the other side . Patients were assessed at 2 , 4 , and 6–8 weeks after surgery and the presence of synechia , edema , and infection was noted with the observer blinded to the side that had received the Merogel . Results At 2 weeks the side packed with Merogel had 35 % synechiae , 83 % edema , and 30 % mucopurulent discharge and on the control side the figures were similar with 22.5 % synechiae , 83 % edema , and 28 % mucopurulent discharge . In both groups these figures improved over the observation period but percentages in the groups remained similar . At no time point was the difference between the packed and unpacked sides statistically significant for any of the measures when assessed with Fisher 's exact test . Conclusion Merogel nasal packing has no significant beneficial or detrimental effect in terms of synechia , edema , or infection when placed in the middle meatus after ESS OBJECTIVES /HYPOTHESIS Disease recurrence and adverse wound healing in the form of inflammation , polyposis , adhesions , and middle turbinate lateralization may induce suboptimal outcomes following sinus surgery . The study objective was to assess the safety and effectiveness of a bioabsorbable , steroid-eluting implant used following functional endoscopic sinus surgery in patients with chronic rhinosinusitis ( CRS ) . STUDY DESIGN Prospect i ve , multicenter , single-cohort trial enrolling 50 patients . METHODS The study allowed bilateral or unilateral steroid-eluting implant placement . Oral and topical steroids were withheld for 60 days postoperatively . Endoscopic follow-up was performed to 60 days . Patient-reported outcomes ( Sino-Nasal Outcome Test-22 Question naire , Rhinosinusitis Disability Index ) were collected to 6 months . Efficacy was assessed by grading inflammation , polyp formation , adhesions , and middle turbinate position . Safety assessment included ocular exams at baseline and 30 days . RESULTS Implants were successfully placed in all 90 sinuses . Mean inflammation scores were minimal at all time points . At 1 month , the prevalence of polypoid edema was 10.0 % , significant adhesions 1.1 % , and middle turbinate lateralization 4.4 % . Changes from baseline in patient-reported outcomes were statistically significant ( P < .0001 ) . No clinical ly significant changes from baseline in intraocular pressure occurred . CONCLUSIONS This consecutive case series provides clinical evidence of the safety , effectiveness , and clinical utility of a bioabsorbable steroid-eluting implant for use in CRS patients . The implant was associated with favorable rates of sinus patency . At 1 month , minimal degrees of inflammation and adhesions were observed , suggesting a positive clinical impact of local steroid delivery without evidence of ocular risk Nasal packings can aid in control of postoperative bleeding and healing following functional endoscopic sinus surgery ( FESS ) , but traditional non-resorbable stents have several inherent drawbacks . We performed a r and omized , controlled , multicenter clinical trial to assess efficacy of resorbable nasal packing in patients undergoing FESS for chronic rhinosinusitis . A total of 66 patients for 88 nasal cavities were r and omized to receive either hyaluronan resorbable packing ( MeroGel ® ) or st and ard non-resorbable nasal dressing after FESS . All underwent preoperative rhinoscopy , CT of sinuses , and , after surgery , were reassessed by rhinoscopy at 2 , 4 , and 12 weeks in blinded fashion . A total of 44 nasal cavities ( MeroGel ® -group ) received resorbable packing , whereas the remaining 44 were packed with non-resorbable nasal dressing . At follow-up endoscopic visit , the presence of nasal synechia was evaluated as primary outcome . Moreover , the tolerability and surgical h and ling properties of MeroGel ® and its comfort were assessed by surgeons and patients . Preoperative severity of rhinosinusitis was similar in both groups . No significant adverse events were observed in all patients . Follow-up endoscopy showed a lower proportion of nasal adhesions in MeroGel ® -group at both 4 ( P = 0.041 ) and 12 weeks ( P < 0.001 ) . Moreover , an improvement of other endoscopic nasal findings such as re-epithelialization , presence of granulation tissue , and appearance of nasal mucosa of nasal cavities after FESS was observed in the MeroGel ® -group . Tolerability and surgical h and ling properties of MeroGel ® were positively rated by clinicians and the overall patient judged comfort of MeroGel ® was favorable . In conclusion , MeroGel ® can be considered a valid alternative to st and ard non-resorbable nasal dressings . It is safe , well-accepted , well-tolerated , and has significant advantage of being resorbable . Moreover , it may favor improved healing in patients undergoing FESS and reduce formation of adhesions Background This study investigated the efficacy of glove finger – coated polyvinyl acetate ( PA ) pack on hemostasis , pain levels , and wound healing after endoscopic sinus surgery ( ESS ) . Methods A prospect i ve , r and omized , double-blinded controlled study was performed in 30 patients who underwent bilateral ESS for chronic rhinosinusitis . Fifteen patients ( control group ) had both nasal cavities packed with PA pack ( Merocel ; Medtronic Xomed , Jacksonville , FL ) and another 15 subjects ( experimental group ) had their nasal cavities packed with PA in a glove finger .  Pain levels were assessed by patients on a visual analog scale 12 hours after surgery and at the time of packing removal . The amount of bleeding on removal were quantified by weighing it after removal . Lund-Kennedy score and synechiae formation were assessed at 4 , 8 , and 12 weeks after surgery . The use of analgesics and oral steroid was compared between the two groups . Results The experimental group showed lower levels of pain and lessened bleeding during packing removal than the control group . There were no differences in pain levels at 12 hours after surgery , use of analgesics and oral steroid between the two groups . One ( 6 % ) of each group had postoperative bleeding and required additional packing for hemostasis . Lower Lund-Kennedy score at postoperative 4 weeks was documented in the experimental group . In addition , two ( 13 % ) control subjects developed a synechiae between 
    Output:
    
We are unable to provide evidence to establish whether steroid-eluting sinus stents have potential advantages and disadvantages for patients with CRS undergoing FESS .
Future , high- quality RCTs are needed to assess whether or not steroid-eluting sinus stents confer any beneficial effects , over those of surgery alone , when compared to non-steroid sinus stents