Clinical advisory phenylephrine advisory panel report

Systematic review of topical vasoconstrictors in endoscopic sinus surgery

“…The review identified four pediatric and five adult patients who had hypertensive crisis or pulmonary edema. Two of the pediatric cases and one of the adult cases died after going into cardiac arrest 1, 2…”

Safety and efficacy of concentrated topical epinephrine use in endoscopic endonasal surgery

“…7 Phenylephrine, an α selective agonist, has also been largely abandoned in light of its unacceptable side effects including hypertensive crisis, cardiopulmonary compromise, pulmonary edema, and death. [9][10][11] As EES procedures have taken on greater complexity, the need for more powerful vasoconstriction has led to the emergence of topical concentrated (1:1000) epinephrine (CE) as a viable alternative to oxymetazoline. 10 As with cocaine and phenylephrine, complications arising from the administration of epinephrine have been reported including temporary hypotension, hypertensive crisis, tachycardia, cardiomyopathy, and cardiac arrhythmia.…”

Diagnosis of Allergic Fungal Sinusitis vs a Mucocele

“…In allergic fungal sinusitis, each ethmoid compartment is opacified and often expanded. However, the architecture, while distorted, is preserved to some extent with each air cell filled with hyperdense mucin and a peripheral rim of mucosal thickening 1. In this case, there is complete loss of all ethmoidal architecture, which is not consistent with allergic fungal sinusitis.Finally, pathological review of the specimen in this case confirmed the diagnosis of a mucocele.…”