Use of Microporous Polysaccharide Hemispheres (MPH) for Endoscopic Sinus Surgery

Endoscopic sinus surgery (ESS) now widely conducted in nasal and paranasal sinus surgery uses one of the excellent bioabsorbable and comfortable hemostatic agent available obviating the need for packing following ESS. We report the use of microporous polysaccharide hemispheres (MPH), an absorbable hemostatic powder produced from purified potato starch, following ESS in 12 subjects with sinonasal disorders treated in 2009. ESS under general anesthesia on 17 sides was conducted by the same surgeon. The series consisted of 5 inflammation, 2 mucoceles, and 5 benign tumors. Treatment was successful in all cases, with MPHs used hemostatically at the end of surgery. No postoperative hemorrhage was seen and the postoperative course was uneventful in all cases. Acting as a molecular sieve by osmotically extracting fluid from blood, MPH particles concentrate platelets and other formed elements, promoting fibrin clot formation. MPH is rapidly cleared within 24 to 48 hours. Our initial experience suggests that MPH is a useful hemostatic agent following ESS.