Polyhydrated ionogen enhances postoperative sinonasal ciliated remucosalization

Background: Mucosalization of the sinonasal cavity following surgery is critical for successful outcomes. Recently a novel anti-protease compound, polyhydrated-ionogen (PHI) with Mg ²⁺/Br ^-, demonstrated improved dermal wound healing. We set out to investigate the effect of PHI Mg ²⁺/Br ^- on sinus remucosalization following surgery. Methods: A total of 24 rabbits underwent bilateral medial-wall maxillary mucosal stripping followed by placement of an indwelling irrigation catheter. In a randomized fashion 1 side received 3 cc normal saline (NS) daily, while the contralateral side received PHI Mg ²⁺/Br ^-. Following a 14-day therapeutic trial, remucosalization was assessed by hematoxylin and eosin (H&E) staining and immunohistochemistry for β-tubulin, a marker of cilia. A semiquantitative grading of ciliated remucosalization was applied with a chi-square test used to compare distributions for each treatment. Results: H&E staining comparison demonstrated NS treated sinuses (n = 24) had substantial bare areas with predominant ciliation scores under 30%. The PHI Mg ²⁺/Br ^--treated group (n = 24) achieved a statistically significant improvement in reciliation (>60%) when compared with NS (p < 0.01). These results were confirmed with Type IV β-tubulin staining (p < 0.01). Conclusion: Poor postsurgical sinonasal mucosa healing results in adverse clinical outcomes. In a rabbit model of sinonasal mucosal healing, daily irrigation for 14 days with PHI Mg ²⁺/Br ^--enhanced ciliated remucosalization compared to saline.