xRead - Nasal Obstruction (September 2024) Full Articles

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ICAR SINONASAL TUMORS

TABLE XVII.A.5 Evidence surrounding techniques for hemostasis in JNA, including embolization.

Clinical endpoints

Study

Year LOE Study design Study groups

Conclusion

1. 217 min mean operative time, 784 mL mean blood loss, no complications 2. Preoperative arterial embolization is a safe procedure in the management of JNA Mean operative time 2.5 h, mean 225 mL blood loss, and no complications

1. Operative time 2. Blood loss 3. Complications

Giorgianni et al. 795

2021 4

Retrospective case series

Patients undergoing preoperative ECA superselective arterial embolization ( n = 79) Patients undergoing preoperative

Abouzeid et al. 800

2021 4

Retrospective case series

1. Operative time 2. Blood loss 3. Complications

embolization prior to surgical resection of JNA( n = 20)

Vakharia et al. 799

There was an average of 86% devascularization postembolization; no complications

2021 4

Retrospective case series

Patients embolized withOnyx ( n = 5)

1. Degree of

devasculariza tion 2. Complications 1. LOS 2. Perioperative blood transfusion 3. Cost

Choi et al. 801

2020 4

Retrospective cohort

Patients—comparison of patients who underwent preoperative embolization to patients who did not ( n = 473) Prospectively recruited patients underwent endoscopic resection

Preoperative embolization reduced LOS (decrease by 1 day),

decreased odds of requiring perioperative transfusion, increased cost of $36,500

Jaiswal et al. 803

Significantly lower intraoperative blood loss (648 mL) and duration of surgery (84 min) in patients with plasma-assisted surgery after embolization and with low-stage tumors Patients with preoperative embolization had significantly less bleeding (385 vs. 1215 mL) and shorter surgical time (205 vs. 264 min) than patients without preoperative embolization Preoperative embolization significantly decreased bleeding in Radkowski Stage II and III tumors with no difference in surgical time or duration of stay

1. Intraoperative blood loss 2. Duration of surgery

2020 4

Case–control

assisted by plasma ablation compared to 18 historical controls ( n = 18)

Pei et al. 796

2018 4

Case–control

Patients with JNA—10 with no preoperative

1. Intraoperative blood loss 2. surgical time

embolization; 17 with preoperative gelatin sponge embolization ( n = 27)

Tanet al. 797

1. Intraoperative bleeding 2. surgery time 3. hospital stay duration 1. Intraoperative blood loss 2. Perioperative transfusion

2017 4

Retrospective case series

Patients with JNA; 32 with surgery + pre operative embolization versus 42 with surgery alone ( n = 74) Patients embolized with particulate

Gaoet al. 798 Patients embolized with Onyx had significantly lower intraoperative blood loss (569 vs. 1348 mL) and required significantly lower number of transfusions (0.45 vs. 1.56 U PRBCs) Abbreviations: JNA, nasopharyngeal angiofibroma (formerly juvenile nasopharyngeal angiofibroma); LOS, length of stay; PRBC, packed red blood cells. 2013 4 Retrospective case series agents; 11 patients with liquid agent (Onyx) ( n = 39)