National survey on the use of preoperative systemic steroids in endoscopic sinus surgery

González-Castro, Javier; Pascual, J Gasco; Busquets, José M.

doi:10.1002/alr.21122

Cited by 17 publications

(13 citation statements)

References 13 publications

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“…In a national survey on the use of preoperative systemic corticosteroids in ESS, 96.64% of respondents prescribed them in CRSwNP patients. 1154 In conclusion, preoperative treatment with topical or oral corticosteroids is recommended to ensure better intraoperative conditions in the absence of comorbidities that are aggravated with systemic corticosteroids. …”

Section: Xc3 Crswnp: Preoperative Corticosteroidsmentioning

confidence: 99%

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Orlandi

Kingdom

Hwang

et al. 2016

Int Forum Allergy Rhinol

554

888

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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

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Section: Xc3 Crswnp: Preoperative Corticosteroidsmentioning

confidence: 99%

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Orlandi

Kingdom

Hwang

et al. 2016

Int Forum Allergy Rhinol

554

888

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“…Die überwiegende Mehrheit amerikanischer HNO-Ärzte setzt bei CRSwNP präoperativ systemische Steroide ein, obwohl keine klare Evidenz besteht. Es werden üblicherweise 30-50 mg (bis zu 1mg/kg) Prednisolon für 5-7 Tage gegeben [137]. Den Argumenten der Entzündungsreduktion, besseren intraoperativen Übersicht und geringeren intraoperativen Blutung stehen gegenüber die mögliche Verschleierung des wahren Ausmaßes der Erkrankung durch künstliche Verbesserung mit der Folge einer zu kurz greifenden operativen Therapie und die potentiellen Nebenwirkungen von systemischen Steroiden, auch bei kurzfristiger Gabe, zudem in der Kumulation über die Lebenszeit [44].…”

Section: Vorbereitung Des Operationsgebietesunclassified

“…Die Antibiotikagabe sollte nach Maßgabe von Abstrichen geplant werden [1378]. Eine prä-und postoperative Kortisontherapie mit 30 mg Prednisolon bewirkte eine verbesserte Wundheilung und ein besseres endoskopisches Bild sowie weniger Symptome über mindestens 6 Monate ( [137]; 30 mg Prednisolon 5 Tage präoperativ bis 9 Tage postoperativ). Alternativ werden 20 mg für 14 Tage gegeben (aktuelles eigenes Therapieschema), 30, 20 und 10 mg für je 4 Tage [1332], 25, 12,5 und 5mg für je 1 Woche [21] oder 25, 12,5 und 12,5 mg (alle 2 Tage) für je 1 Woche [270,359].…”

Section: Systemische Therapieunclassified

Aktueller Stand der endonasalen Nasennebenhöhlenchirurgie

Weber

2015

Laryngo-Rhino-Otol

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Endonasal endoscopic sinus surgery is the standard procedure for surgery of most paranasal sinus diseases.Appropriate frame conditions provided, the respective procedures are safe and successful.These prerequisites encompass appropriate technical equipment, anatomical oriented surgical technique, proper patient selection, and individually adapted extent of surgery.The range of endonasal sinus operations has dramatically increased during the last 20 years and reaches from partial uncinectomy to pansinusoperation with extended surgery of the frontal (Draf type III), maxillary (grade 3-4, medial maxillectomy, prelacrimal approach) and sphenoid sinus.In addition there are operations outside and beyond the paranasal sinuses. The development of surgical technique is still constantly evolving.This article gives a comprehensive review on the most recent state of the art in endoscopic sinus surgery according to the literature with the following aspects: principles and fundamentals, surgical techniques, indications, outcome, postoperative care, nasal packing and stents, technical equipment.

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“… 23 , 25 In a national survey from the American Rhinologic Society, 88.82% of the study population of physicians used PSS in their practice. 26 There are few recent reports with randomized and blinded trials, and most of the evidence to support PSS use in ESS is anecdotal and based on expert opinion.…”

Section: Discussionmentioning

confidence: 99%

Availability of Preoperative Systemic Steroids on Endoscopic Sinus Surgery for Chronic Rhinosinusitis with Nasal Polyposis

Hong

Lee

et al. 2014

Yonsei Med J

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PurposeTo analyze the outcome of endoscopic sinus surgery (ESS) after preoperative systemic steroid (PSS) treatment for chronic rhinosinusitis (CRS) with nasal polyposis (NP) and to investigate and compare clinicopathological factors associated with the outcome.Materials and MethodsWe performed a retrospective chart review of 468 patients with CRS with NP who underwent primary ESS between January 2005 and October 2011. 124 patients who met the inclusion criteria were included. Beginning from 2008, our clinic administered steroid preoperatively in patients of CRS with NP, thus there were 84 patients with preoperative systemic steroid (PSS group) and another 40 patients without such regimen (no PSS group). To evaluate the outcome after ESS, poor outcome and complication were analyzed according to the following parameters: age, sex, follow-up duration, eosinophilic infiltration, atopy, asthma, Lund-Mackay score, and polyp grade.ResultsThere was no significant difference in poor outcome rates between the PSS and no PSS group (35.0% vs. 47.6%, p=0.185). There was no significant difference in complication rates between the PSS and no PSS group (10% vs. 6%, p=0.468). As with the multivariate analysis of the clincopathological factors to the poor outcome rate, presence of asthma and eosinophilic infiltration were significantly related (odds ratio as 6.555 and 4.505, respectively), whereas PSS was confirmed as less likely related (odds ratio 0.611).ConclusionLow dose PSS administration does not seem to have an effect on the outcome after ESS in patients who have CRS with NP. Eosinophilic infiltration and presence of asthma are important predictors of surgical outcome.

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National survey on the use of preoperative systemic steroids in endoscopic sinus surgery

Abstract: The current study shows that most of the respondents in our group do in fact see an advantage in the use of PSS before ESS. The data also highlights the opinion of most experts that more research with higher levels of evidence is still lacking.

Cited by 17 publications

References 13 publications

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Aktueller Stand der endonasalen Nasennebenhöhlenchirurgie

Availability of Preoperative Systemic Steroids on Endoscopic Sinus Surgery for Chronic Rhinosinusitis with Nasal Polyposis

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