Optimization of the Surgical Field in Endoscopic Sinus Surgery: an Evidence-Based Approach

Alsaleh, Saad; Manji, Jamil; Javer, Amin R.

doi:10.1007/s11882-019-0847-5

Cited by 32 publications

(42 citation statements)

References 72 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…From the early years of ESS, there has been recognition that anesthetic type impacts the amount of blood lost during the procedure 1826 . As bleeding during ESS limits visualization, increases operative time, and risk of complications, appropriate anesthetic selection is imperative 1827 . Today there are 2 anesthetic paradigms in ESS: total intravenous anesthesia (TIVA) and inhalation anesthesia (IA).…”

Section: Surgery For Chronic Rhinosinusitismentioning

confidence: 99%

See 1 more Smart Citation

International consensus statement on allergy and rhinology: rhinosinusitis 2021

Orlandi

Kingdom

Smith

et al. 2021

Int Forum Allergy Rhinol

423

479

View full text Add to dashboard Cite

I. Executive Summary Background The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS.

show abstract

Section: Surgery For Chronic Rhinosinusitismentioning

confidence: 99%

“…Today there are 2 anesthetic paradigms in ESS: total intravenous anesthesia (TIVA) and inhalation anesthesia (IA). Both can be used to lower patients’ blood pressure, a technique called controlled or deliberate hypotension, to reduce bleeding 1827 …”

Section: Surgery For Chronic Rhinosinusitismentioning

confidence: 99%

International consensus statement on allergy and rhinology: rhinosinusitis 2021

Orlandi

Kingdom

Smith

et al. 2021

Int Forum Allergy Rhinol

423

479

View full text Add to dashboard Cite

show abstract

“…Both intranasal and oral corticosteroids suppress inflammation and reduce bleeding during surgery 12 . Intraoperatively, reverse Trendelenburg position, local injection of vasoconstrictor, topical vasoconstrictor, hot saline irrigation, lowering mean arterial blood pressure, and use of tranexamic acid have been reported to contribute to the reduction of bleeding 13‐15 . These methods are generally used in combination; thus, a synergetic effect can be expected.…”

Section: Introductionmentioning

confidence: 99%

“…Topical infiltration and local injection of vasoconstrictors including adrenaline, oxymetazoline, and in some institutions, cocaine, are necessary for ESS 2,4‐6,8,11,13,14 . These reagents reduce mucosal thickness in the nasal cavity and create a widespread surgical corridor.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of gauze placement soaked with adrenaline at suprabullar recess on hemostasis during endoscopic sinus surgery: A randomized controlled trial

et al. 2020

View full text Add to dashboard Cite

Background Topical application of vasoconstrictors is necessary for endoscopic sinus surgery (ESS) for a bloodless surgical view and reduced intraoperative bleeding. We aimed to verify the effectiveness of gauze placement soaked with adrenaline at suprabullar recess, where the anterior ethmoidal artery exists, on hemostasis during ESS. Methods A randomized, double‐blinded trial was carried out for 26 patients receiving ESS. At the beginning of the surgery, gauze soaked with 2% lidocaine with or without 1:10 000 adrenaline was placed at the suprabullar recess for 8 minutes. Estimated blood loss, surgical field score, and operation time were compared between the two groups. Results Estimated blood loss and surgical field score were significantly smaller in the adrenaline group than in the no adrenaline group. Operation time was not significantly different between the two groups. Conclusion Gauze placement soaked with adrenaline at suprabullar recess reduces estimated blood loss and clears the surgical field during ESS.

show abstract

The 15° reverse Trendelenburg position can improve visualization without impacting cerebral oxygenation in endoscopic sinus surgery—A prospective, randomized study

Yang

Wang

et al. 2020

Int Forum Allergy Rhinol

View full text Add to dashboard Cite

Background In this study we compared intraoperative bleeding and regional cerebral oxygenation in patients with different degrees of the reverse Trendelenburg position RTP during endoscopic sinus surgery ESS Methods In total patients with chronic rhinosinusitis treated by ESS were randomly assigned to the following groups a horizontal position HP group and and RTP -RTP -RTP and -RTP respectively groups The primary outcome was the Boezaart grading scale BS The cerebral oxygen saturation ScO total blood loss numerical rating scale NRS scores and complications were also recorded ResultsThe median BS values in the HP -RTP -RTP and -RTP groups were and respectively Multiple pairwise comparisons of the BS showed significant differences between the -RTP group and the other groups HP -RTP and -RTP Regarding the NRS and bleeding rate significant differences were found between the HP and -RTP groups No difference was found in ScO among the groups and no cerebral de-saturation events occurred in any group No complications including vital organ heart brain and kidney dysfunction problems were reported in this study during hospitalization Conclusion Compared with HP -RTP and -RTP -RTP can improve visual clarity during ESS and ScO is not affected by the degree of RTP No cerebral deoxygenation or vital organ dysfunction was observed in this study Therefore we recommend -RTP with moderate deliberate hypotension for ESS © 2020 ARS-AAOA, LLC.

show abstract

Optimization of the Surgical Field in Endoscopic Sinus Surgery: an Evidence-Based Approach

Cited by 32 publications

References 72 publications

International consensus statement on allergy and rhinology: rhinosinusitis 2021

International consensus statement on allergy and rhinology: rhinosinusitis 2021

Effect of gauze placement soaked with adrenaline at suprabullar recess on hemostasis during endoscopic sinus surgery: A randomized controlled trial

The 15° reverse Trendelenburg position can improve visualization without impacting cerebral oxygenation in endoscopic sinus surgery—A prospective, randomized study

Contact Info

Product

Resources

About