xRead - Nasal Obstruction (September 2024) Full Articles

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Orlandi et al.

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Nonsignificant trend toward MM spacers for prevention of synechiae Subgroup analysis: nonabsorbable spacers may be more effective than

absorbable spacers for reducing risk of synechiae compared to no spacers Rudmik 2289 2011 1 Systematic review Adult CRS patients Evidence based approach to early postoperative care following ESS

solution, drug-eluting spacers/stents Incidence of major complications was 0.85%, with CSF leak being the most common. The incidence of minor

complication was 6.9%, with the most common complications consisting of

middle turbinate adhesions and those related to orbital penetration.

TIVA resulted in significantly less blood loss and improved intraoperative visualization for patients with severe CRS

MM silastic stents significantly reduce MTL, adhesions, and crusting

Recommended: nasal saline irrigations, sinus cavity debridement, standard topical nasal steroid spray

Options: postop abx, systemic steroids, nonstandard topical nasal steroid

TABLE XII-27 Evidence for complications of sinus surgery Study Year LOE Study Design Study Groups Clinical Endpoint Conclusions Brunner 1838 2018 1 Double-blind randomized controlled trial 72 patients undergoing ESS (total intravenous anesthesia vs inhaled anesthesia cohorts) Evaluate effect of TIVA for ESS in patients with high-grade CRS Lee 2207 2012 1 Systematic review &

Effectiveness of middle meatal (MM)l spacers vs no spacers in pts undergoing ESS

Evaluate incidence and prevention of sinus

surgery complications

middle meatal silastic stent in reducing synechiae

Evaluate efficacy of

35CRS ± NP undergoing ESS

May 104 1994 1 Meta-analysis 2108 of the authors’ CRS patients undergoing ESS compared to 17 series of patients

undergoing sinus surgery

CRS patients undergoing ESS

randomized

controlled trial

meta-analysis of RCT

Chan 105 2015 2 Double blind,