International forum of allergy & rhinology
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Int Forum Allergy Rhinol · Jan 2014
Randomized Controlled TrialFive-degree, 10-degree, and 20-degree reverse Trendelenburg position during functional endoscopic sinus surgery: a double-blind randomized controlled trial.
Using the reverse Trendelenburg position (RTP) during functional endoscopic sinus surgery (FESS) is a safe, simple, and cost-free method that has been found to reduce intraoperative blood loss. However, the critical angle of RTP that produces the least amount of bleeding without compromising surgical technique and safety remains unanswered. The objective of this study was to assess the effects of 5-degree, 10-degree, and 20-degree RTP (5-RTP, 10-RTP, and 20-RTP, respectively) on intraoperative bleeding during FESS. ⋯ FESS in 20-RTP produced the best BS and lowest blood loss without compromising surgical technique.
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Int Forum Allergy Rhinol · Apr 2013
Randomized Controlled TrialIntravenous tranexamic acid and intraoperative visualization during functional endoscopic sinus surgery: a double-blind randomized controlled trial.
Bleeding during endoscopic sinus surgery (ESS) can hinder surgical progress and may be associated with increased complications. Tranexamic acid is an antifibrinolytic that is known to reduce operative bleeding. The current study was designed to assess the effect of adjunctive intravenous tranexamic acid on intraoperative bleeding and the quality of the surgical field during ESS. ⋯ Adjunctive intravenous tranexamic acid does not appear to result in a clinically meaningful reduction in blood loss or improve visualization of the surgical field during ESS.
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Int Forum Allergy Rhinol · Apr 2013
Randomized Controlled Trial Comparative StudySingle-blind randomized controlled trial of surfactant vs hypertonic saline irrigation following endoscopic endonasal surgery.
Recent discussion has revolved around formulations of irrigation in the postoperative functional endoscopic sinus surgery patient, specifically the efficacy of emulsion based nasal irrigations. ⋯ There were no significant differences in overall subjective symptoms related to sinonasal disease between S and HS irrigation, but tolerability appeared to be an issue. More patients reported side effects with S irrigation, and 20% receiving S irrigation stopped the solution, compared to none receiving HS irrigation.
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Int Forum Allergy Rhinol · Jul 2012
Randomized Controlled Trial Comparative StudyThe safety and efficacy of intravenous ketorolac in patients undergoing primary endoscopic sinus surgery: a randomized, double-blinded clinical trial.
Ketorolac (KT) is an intravenous (IV) nonsteroidal anti-inflammatory drug (NSAID) for acute, moderate pain. KT is safe, but may be linked to increased risk of post-tonsillectomy hemorrhage. The safety and efficacy of KT following primary endoscopic sinus surgery (ESS) is unknown. ⋯ In this study, IVKT was a safe analgesic in the setting of primary ESS. There was no increased risk of hemorrhage or acute blood-loss anemia. IVKT did not appear to offer statistically significant pain control over IVF.
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Int Forum Allergy Rhinol · May 2012
Randomized Controlled Trial Comparative StudyDead Sea salt irrigations vs saline irrigations with nasal steroids for symptomatic treatment of chronic rhinosinusitis: a randomized, prospective double-blind study.
Intranasal steroids are 1 of the most frequently prescribed medications for the treatment of chronic rhinosinusitis (CRS), and saline irrigations are commonly used as an adjunct to medical therapy. We aimed to compare the efficacy of Dead Sea salt (DSS) irrigations and DSS nasal spray vs saline irrigations and topical nasal steroid spray in the treatment of symptoms of CRS. ⋯ For patients with CRS, treatment with DSS irrigations and sprays appears as effective for symptom reduction as a combination of hypertonic saline irrigations and sprays and a topical steroid spray.