Early postoperative care following endoscopic sinus surgery: an evidence‐based review with recommendations

Rudmik, Luke; Soler, Zachary M.; Orlandi, Richard R.; Stewart, Michael G.; Bhattacharyya, Neil; Kennedy, David W.; Smith, Timothy L.

doi:10.1002/alr.20072

Cited by 152 publications

(153 citation statements)

References 40 publications

Supporting

Mentioning

141

Contrasting

Unclassified

Order By: Relevance

“…Although current practices in peri-and post-operative FESS care can vary widely among otolaryngologists and are not uniformly driven by evidence-based outcome research (7), use of nasal saline irrigation, sinus cavity debridement, topical nasal steroids, antibiotics and mucolytic agents are recommended as early postoperative care interventions (10,11).…”

Section: Discussionmentioning

confidence: 99%

Hyaluronan Plus Saline Nasal Washes in the Treatment of Rhino-Sinusal Symptoms in Patients Undergoing Functional Endoscopic Sinus Surgery for Rhino-Sinusal Remodeling

Macchi

Terranova

Digilio

et al. 2013

Int J Immunopathol Pharmacol

View full text Add to dashboard Cite

Hyaluronic acid is a major component of many extracellular matrices and plays a central role in the homeostasis of physiology in upper and lower airways. When topically administered following endoscopic sinus surgery, hyaluronic acid may be effective in functional recovery and in the prevention of recurrence of chronic rhinosinusistis. This pilot study was aimed at evaluating the effects of nebulised 9 mg of sodium hyaluronate given for 15 days per months over 3 months in 46 patients aged> 4 years who underwent functional endoscopic sinus surgery (FESS) for rhino-sinusal remodelling. Eligible patients were randomized to receive nebulised 9 mg sodium hyaluronate nasal washes plus saline solution or 5 ml saline alone (23 patients in each group), according to an open-label, parallel group design, with blind observer assessment. Treatment was administered by means of a nasal ampoule that allows nebulisation of particles with a median aerodynamic diameter> 10 micron, i.e, suitable for upper respiratory airways deposition. The efficacy variables included clinical (presence of nasal dyspnoea), endoscopical (ostium of paranasal sinuses, oedema, respiratory patency, synechiae, and appearance of nasal mucosa) and cytological (ciliary motility and presence of neutrophils, eosinophils, mast cells, bacteria, mycetes and bio film) measures. At the end of the study, patients expressed an opinion on the overall tolerability of treatment. The two treatment groups were comparable at baseline. Treatment with 9 mg of sodium hyaluronate was associated with significantly greater improvements compared to controls in nasal dyspnoea (p

show abstract

Section: Discussionmentioning

confidence: 99%

Hyaluronan Plus Saline Nasal Washes in the Treatment of Rhino-Sinusal Symptoms in Patients Undergoing Functional Endoscopic Sinus Surgery for Rhino-Sinusal Remodeling

Macchi

Terranova

Digilio

et al. 2013

Int J Immunopathol Pharmacol

View full text Add to dashboard Cite

show abstract

“…702,1020 No RCTs have been done to adequately address this issue but those studies that have considered this aspect have not shown any overt problem. Bhalla et al 722 retrospectively considered 18 patients receiving budesonide irrigation and showed no reduction in morning cortisol, and in selected patients an adrenocorticotropic hormone (ACTH) stimulation test did not show hypothalamic-pituitary-adrenal (HPA) axis suppression.…”

Section: Viiie1 Crswnp Management:-saline (Spray and Irrigation)mentioning

confidence: 99%

“…In 2011, Rudmik et al 1020 published an EBRR on postoperative care after ESS and divided the types of postoperative care into several distinct categories, which are followed in this update. Additional evidence was identified for many of these categories and also on the use of Mitomycin C, so that category was added.…”

Section: Xe Surgery For Crswnp and Crssnp: Postoperative Managementmentioning

confidence: 99%

See 1 more Smart Citation

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Orlandi

Kingdom

Hwang

et al. 2016

Int Forum Allergy Rhinol

Self Cite

554

888

View full text Add to dashboard Cite

Background:The body of knowledge regarding rhinosinusitis (RS) continues to expand, with rapid growth in number of publications, yet substantial variability in the quality of those presentations. In an effort to both consolidate and critically appraise this information, rhinologic experts from around the world have produced the International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR:RS). Methods:Evidence-based reviews with recommendations (EBRRs) were developed for scores of topics, using previously reported methodology. Where existing evidence was insufficient for an EBRR, an evidence-based review (EBR) was produced. The sections were then synthesized and the entire manuscript was then reviewed by all authors for consensus. Results:The resulting ICAR:RS document addresses multiple topics in RS, including acute RS (ARS), chronic RS (CRS) with and without nasal polyps (CRSwNP and CRSsNP), recurrent acute RS (RARS), acute exacerbation of CRS (AE-CRS), and pediatric RS. Conclusion:As a critical review of the RS literature, ICAR:RS provides a thorough review of pathophysiology and evidence-based recommendations for medical and surgical treatment. It also demonstrates the significant gaps in our understanding of the pathophysiology and optimal management of RS. Too o en the foundation upon which these recommendations are based is comprised of lowerlevel evidence. It is our hope that this summary of the evidence in RS will point out where additional research efforts may be directed. C 2016 ARS-AAOA, LLC. Key Words:rhinosinusitis; chronic rhinosinusitis; acute rhinosinusitis; recurrent acute rhinosinusitis; evidence-based medicine; systematic review; endoscopic sinus surgery List of Abbreviations Used

show abstract

“…[47][48][49][50] Based on the available evidence, debridement has been recommended in the early postoperative care of adult ESS patients. 51 However, no corresponding studies have been published investigating the impact of postoperative debridement on PCRS patients. In fact, several studies have shown that postoperative debridement was not necessary in children.…”

Section: Endoscopic Sinus Surgery and Turbinoplastymentioning

confidence: 99%

Clinical Consensus Statement: Pediatric Chronic Rhinosinusitis

Brietzke

Shin

Choi

et al. 2014

Otolaryngol.--head neck surg.

181

View full text Add to dashboard Cite

Objective. To develop a clinical consensus statement on the optimal diagnosis and management of pediatric chronic rhinosinusitis (PCRS).Methods. A representative 9-member panel of otolaryngologists with no relevant conflicts of interest was assembled to consider opportunities to optimize the diagnosis and management of PCRS. A working definition of PCRS and the scope of pertinent otolaryngologic practice were first established. Patients of ages 6 months to 18 years without craniofacial syndromes or immunodeficiency were defined as the targeted population of interest. A modified Delphi method was then used to distill expert opinion into clinical statements that met a standardized definition of consensus.Results. After 2 iterative Delphi method surveys, 22 statements met the standardized definition of consensus while 12 statements did not. Four statements were omitted due to redundancy. The clinical statements were grouped into 4 categories for presentation and discussion: (1) definition and diagnosis of PCRS, (2) medical treatment of PCRS, (3) adenoiditis/adenoidectomy, and (4) endoscopic sinus surgery (ESS)/turbinoplasty.Conclusion. Expert panel consensus may provide helpful information for the otolaryngologist in the diagnosis and management of PCRS in uncomplicated pediatric patients.

show abstract

Early postoperative care following endoscopic sinus surgery: an evidence‐based review with recommendations

Cited by 152 publications

References 40 publications

Hyaluronan Plus Saline Nasal Washes in the Treatment of Rhino-Sinusal Symptoms in Patients Undergoing Functional Endoscopic Sinus Surgery for Rhino-Sinusal Remodeling

Hyaluronan Plus Saline Nasal Washes in the Treatment of Rhino-Sinusal Symptoms in Patients Undergoing Functional Endoscopic Sinus Surgery for Rhino-Sinusal Remodeling

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Clinical Consensus Statement: Pediatric Chronic Rhinosinusitis

Contact Info

Product

Resources

About