xRead - Nasal Obstruction (September 2024) Full Articles

20426984, 2021, 3, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/alr.22741 by Stanford University, Wiley Online Library on [01/07/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License

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Orlandi et al.

(Continues)

Recommendation for postoperative debridement

Strong Recommendation for topical corticosteroids

Recommendation against topical decongestants

Recommendation for use of nasal saline irrigation

Option for oral antibiotics

Benefit-Harm Assessment Policy Level

Epistaxis, headache Moderate Preponderance of benefit over harm

harm over benefit

benefit over harm

Moderate to high Balance of benefit and harm

benefit over harm

Minimal Preponderance of

Minimal Preponderance of

Preponderance of

procedure with cost

TABLE I-8 Evidence for postoperative care following ESS for CRS Intervention Grade Benefit Harm Cost Saline Irrigations B Well-tolerated. Improved symptoms and endoscopic appearance Local irritation, ear symptoms Sinus Cavity Debridements B Improved symptoms and endoscopic appearance. Reduced risk of synechia and turbinate Inconvenience, pain, epistaxis, syncope, and mucosal injury. In-office

possible rhinitis

medicamentosa

GI upset, colitis, anaphylaxis,

bacterial resistance.

Increased pain,

A Improved symptoms and endoscopic appearance.

Reduced recurrence rate of polyps

mucosal swelling and bleeding.

Oral Antibiotics B Improved symptoms and endoscopic appearance. Topical

Reduced crusting.

lateralization

N/A Potential reduced

Corticosteroids

Decongestants

Topical