***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 Chronic rhinosinusitis ( CRS ) is a common disease that has a significant impact on quality of life ( QOL ) . The aim of this study was to evaluate the longer-term effects of combined medical and surgical therapy for CRS on overall health status and QOL . Methods We used a prospect i ve study that utilized the Short-Form 36 Survey at baseline presentation and at a mean time of 3 years  post-functional endoscopic sinus surgery  to assess the general health status of patients who presented for their initial visit from 1996 to 1998 . Of the 200 r and omly selected patients , 150 respondents completed follow-up surveys ( a 75 % response rate ) . Results Eighty-nine ( 59.3 % ) women and 61 ( 40.7 % ) men were included in the study . Baseline QOL scores indicated significant differences between patients with CRS and published norms in 6/8 subscale parameters ( role physical , bodily pain , general health , social function , vitality , and mental health ) . Significant improvement in all six categories was maintained at the end of the study period ( p < 0.05 ) with QOL scores within limits of published norms for the general population . Conclusion Our data indicate that functional endoscopic sinus surgery , combined with appropriate postoperative care , is effective at maintaining a significant improvement in the overall general health status of patients for at least 3 years after surgical intervention and that the overall scores return to a range of normative values for the general population The safety and efficacy of a new hemostatic sealant , based on a gel with collagen derived particles and topical thrombin ( FloSeal , Fusion Medical Technologies , Inc. Fremont , CA ) were assessed as an alternative to nasal packing for hemostasis in functional endoscopic sinus surgery . In a prospect i ve clinical study of 50 patients undergoing bilateral endoscopic anterior ethmoidectomy  , 2 ml FloSeal was used after surgery to stop bleeding . The results were compared to a control group of 50 patients with Merocel packing  and showed that intraoperative hemostasis was rapid and equal in both groups . The main advantages of the new hemostatic sealant included a higher degree of comfort during postoperative nasal breathing and absence of complaints due to pressure or pain . There was only one case of postoperative bleeding on the 6th day , which required nasal packing . There were no more cases of stenoses or synechia in the ostiomeatal complex than were found in the Merocel group . No systemic side effects due to FloSeal were observed . This specific hemostatic sealant was shown to be a safe and efficacious alternative method for hemostasis in endoscopic sinus surgery with high patient satisfaction and an easy and fast mode of application After functional endoscopic sinus surgery ( FESS ) , nasal packing may be necessary and a packing material which has benefits in both cost and efficacy would be required . This study aim ed to determine the efficacy of Gelfoam packing on hemostasis and wound healing after FESS .  Patients who underwent bilateral FESS due to chronic bilateral rhinosinusitis were enrolled . R and omly , one side was selected for Gelfoam packing and the other side for no packing . Subjective symptoms and objective findings such as synechia , granulation , pus discharge , edema , stenosis , and crust were evaluated . A total of 21 patients ( 17 men and 4 women ; mean age 39.7 years ranging from 12 to 75 years ) were included . There were no statistical significant differences between two groups regarding both subjective symptoms and objective findings during 4 months after surgery . Three patients had postoperative bleeding in the no packing side . Gelfoam packing may be recommendable in terms of efficacy and cost-benefit after FESS OBJECTIVES /HYPOTHESIS Absorbable packing material s are commonly used after  endoscopic sinus surgery ( ESS ) . Cutanplast is a novel gelatin sponge with a powerful hemostatic effect that is rapidly absorbed . The purpose of this study was to investigate the efficacy of Cutanplast in patients following ESS . STUDY DESIGN A multicenter , prospect i ve , r and omized , double-blind , paired , controlled trial . METHODS One hundred adult patients with chronic sinusitis requiring the same extent of ESS were included . Patients were excluded if they were undergoing septoplasty , turbinate surgery , revision surgery , and taking anticoagulants .  Following surgery , one nasal cavity was packed with Cutanplast and the other one with Merocel .  Hemostatic properties , patient discomfort while the packing was in situ , patient pain on removal , degree of bleeding on removal , time required to control bleeding after removal , the cost of the pack , and postoperative wound healing were evaluated . RESULTS Both packs were effective at preventing postoperative hemorrhage . However , Cutanplast was significantly more comfortable while in situ ( mean difference , 0.90 ; 95 % confidence interval [ CI ] , 0.75 - 1.25 ) and less painful on removal of the pack ( mean difference , 1.36 ; 95 % CI , 0.85 - 1.71 ) . The Merocel pack was associated with significantly more bleeding on removal ( mean difference , 1.23 ; 95 % CI , 0.61 - 2.29 ) , therefore much time was needed to control hemorrhage ( mean difference , 1.05 ; 95 % CI , 0.31 - 1.45 ) . There was no significant difference in the cost of the pack used and outcome measure of wound healing . CONCLUSIONS Cutanplast nasal pack results in significantly less pain and less bleeding compared to Merocel pack Aim is to determine the efficacy and pain level associated with the use of dissolvable carboxymethyl cellulose ( CMC ) foam dressing in functional endoscopic sinus surgery ( FESS ) in adult patients . In the present prospect i ve study , 60 patients with bilateral chronic rhinosinusitis were included . All patients underwent bilateral FESS . Thirty patients had both nasal cavities packed with dissolvable CMC foam ( CMCF ) and another 30 patients had their nasal cavities packed with routine nasal packing ( RNP ) in latex glove fingers . The haemostatic effect of the CMCF was assessed during the recovery period , and pain levels were recorded by the patients on a visual analogue scale 24 h after surgery . The prevalence of postoperative middle meatal synechia formation was assessed 1 , 2 , 4 and 8 weeks after the operation . Four ( 13.3 % ) of the patients packed with CMCF had primary postoperative bleeding during the recovery period and required additional dressing . Bleeding appeared in two ( 6.7 % ) patients packed with RNP . The mean level of pain was 0.962 ( range 0–4 ) for patients packed with CMCF but was 5.5 ( range 3–9 ) for patients packed with RNP . Four ( 6.7 % ) of 26 CMCF patients and 10 ( 35.7 % ) of 28 RNP patients developed a synechia in the middle meatus . We found that dissolvable CMC foam dressing is associated with very low levels of localised pain and with low levels of postoperative bleeding and synechia formation OBJECTIVES The aim of the study was to evaluate the effects and morbidities of Meropack , an absorbable hyaluronic acid packing material , placed in the middle meatus after endoscopic sinus surgery in children with chronic sinusitis . METHODS Sixty consecutive children with similar degrees of bilateral chronic sinusitis were enrolled in the study . Meropack was r and omly inserted into one side of the middle meatus , while the opposite sinus was not packed after functional endoscopic sinus surgery . Patients were investigated 3 , 8 , and 12 weeks after surgery . The effects and morbidities of nasal dressings in the middle meatus were evaluated with respect to six distinct parameters : blood loss during surgery , postoperative hemorrhage , synechiae , granulation tissue , infection , and patency of the maxillary sinus ostia . RESULTS Mean blood loss of packed and unpacked sinuses did not significantly differ ( p > 0.05 ) . Twenty-nine ( 15 packed , 14 unpacked ) of the 120 sinuses underwent resection of the lateral wall of concha bullosa . Four of 14 unpacked sinuses had postoperative hemorrhaging , while the 15 packed sinuses did not ( p < 0.05 ) . The mean synechiae scores at the first follow-up visit for the Meropack filled and unpacked sinuses differed significantly ( p < 0.05 ) . For the 8- and 12-week follow-up visits , severity of adhesions , granulation tissue formation , infection rate , and patency of the maxillary sinus ostia did not differ significantly between the Meropack filled sinuses and the unpacked sinuses ( p > 0.05 for all ) . CONCLUSION Meropack dressings effectively prevented postoperative hemorrhage , but did not significantly reduced synechiae after endoscopic sinus surgery . Therefore , we recommend that Meropack packing is not necessary for routine use following pediatric functional endoscopic sinus surgery ( FESS ) . However , it should be reserved for children who are predisposed to develop postoperative hemorrhages or adhesions , such as resection of the concha bullosa , traumatic surgery with the creation of large raw surfaces on the middle turbinate , and revision surgery with preexisting adhesions 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 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 
    Output:
    
Postoperative bleeding was lower in the absorbable groups , whereas there was no clear finding regarding postoperative pain .
Postoperative edema was generally similar between groups .
There were no consistent findings regarding bleeding and pain on packing removal .