A comparison of mometasone versus triamcinolone-soaked gelfoam in reducing postoperative inflammation and adhesions after functional endoscopic sinus surgery: a randomized controlled trial

Abstract Background Intranasal corticosteroids are widely used following functional endoscopic sinus surgery (FESS) to reduce inflammation and prevent postoperative complications. However, there is limited data directly comparing the efficacy of different corticosteroid preparations delivered via Gelfoam packing. Objectives To compare the postoperative outcomes of mometasone-soaked Gelfoam versus triamcinolone-soaked Gelfoam following FESS. Methods This prospective comparative study included 34 patients undergoing FESS, randomized into two equal groups: the Mometasone group ( n = 17) and the Triamcinolone group ( n = 17). Baseline demographics, clinical history, and operative details were recorded. Postoperative outcomes were assessed on days 6, 12, and 18, with a focus on inflammation scores, adhesion formation, and crusting. Independent t -tests and chi-square tests were used for statistical analysis. Results Baseline characteristics and operative details were comparable between groups ( p > 0.05). At 18 days, both groups showed significantly lower inflammation and adhesion scores on the study side compared with their respective control sides. In the mometasone group, the mean score was 0.76 ± 0.97 on the study side versus 2.24 ± 0.66 on the control side ( p = 0.001). Similarly, in the triamcinolone group, the mean score was 1.29 ± 1.05 on the study side compared with 2.53 ± 0.51 on the control side ( p = 0.001). Comparing both groups, the study side showed that at day 18, the inflammation and adhesion score was lower in the mometasone group but without statistical significance (Day 18: 0.76 ± 0.97 vs. 1.29 ± 1.05, p = 0.119). Conclusion Both mometasone- and triamcinolone-soaked Gelfoam were effective in minimizing postoperative complications after FESS. The within-group comparison showed a significant difference between the study side and the control side in both mometasone and triamcinolone groups. Although the differences were not statistically significant, the mometasone study side showed a trend toward higher effectiveness in lowering inflammation and avoiding adhesion than the triamcinolone study side. Larger, multicenter trials with longer follow-up periods are needed to corroborate these findings.