Efficacy of hyaluronic acid in postoperative care following functional endoscopic sinus surgery

BACKGROUND: Endoscopic sinus surgery (ESS) is a widely used intervention for chronic rhinosinusitis (CRS), but postoperative care significantly influences recovery outcomes. This study examines the role of hyaluronic acid (HA) in improving mucosal healing, symptom relief, and overall patient outcomes following ESS. METHODS: A retrospective study was conducted on 28 patients who underwent ESS. Patients were divided into two groups: those receiving saline nasal washes and HA-based topical therapy (Group A), and those treated only with saline nasal washes (Group B). Key outcome measures included symptom severity (assessed by a Visual Analog Scale [VAS]), mucosal status, synechiae occurrence, and cytological changes, evaluated at both preoperative (T0) and six-month postoperative (T1) intervals. RESULTS: Group A demonstrated significant reductions in symptom severity, with nasal obstruction scores decreasing from 7.11±2.42 at T0 to 3.21±2.91 at T1 (P<0.001). HA-treated patients showed superior mucosal recovery, with eutrophic turbinates increasing from 21.4% (T0) to 78.6% (T1) (P<0.05). VAS scores for pruritus dropped significantly in Group A (3.21±3.37 at T0 to 1.39±1.85 at T1; P=0.033), compared to negligible changes in Group B. Synechiae occurrence was markedly lower in Group A (20% vs. 62.5%; P<0.05). Cytological analysis revealed significant reductions in neutrophil counts, supporting HA’s anti-inflammatory properties. CONCLUSIONS: HA demonstrates a clear advantage in accelerating mucosal healing, reducing inflammation, and improving postoperative quality of life. These findings suggest its broader implementation in clinical protocols for ESS recovery.