Evaluating the role of topical tranexamic acid in cancers of the head-and-neck: A single-center randomized controlled trial

Anand, Sanjeev; Singh, Vikram; Sahu, Pankaj Kumar

doi:10.4103/crst.crst_216_20

Cited by 7 publications

(16 citation statements)

References 15 publications

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“…However, since the study procedures were similar between the intervention and control groups for the individual RCTs, any confounding effect on our analysis was likely to be small. 25 Second, the meta-analysis included only five prospective studies, resulting in a small overall sample size. In addition, the timing, amounts and dose measurements of the topical steroids differed among the studies.…”

Section: Discussionmentioning

confidence: 99%

“…First, it included studies using different methods and steroids for olfactory recovery. However, since the study procedures were similar between the intervention and control groups for the individual RCTs, any confounding effect on our analysis was likely to be small 25 . Second, the meta‐analysis included only five prospective studies, resulting in a small overall sample size.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of topical steroids for the treatment of olfactory disorders caused by COVID‐19: A systematic review and meta‐analysis

Kim

Kang

et al. 2022

Clinical Otolaryngology

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Objectives The aim of this study was to assess the effect of topical steroids on acute‐onset olfactory dysfunction in patients infected with COVID‐19. Design and Setting Systematic review and meta‐analysis of cohort studies. Participants Patients infected with COVID‐19. Main outcome measures PubMed, Embase, the Web of Science, SCOPUS, Cochrane database and Google Scholar were searched for articles up to September 2021. We analysed studies comparing the improvement of olfactory dysfunction between topical steroid treatment and control groups (placebo or no treatment). In addition, we performed a subgroup analysis by study type. Results The improvement of olfactory score at 2 (standardised mean difference [SMD] = 0.7272, 95% confidence interval = [0.3851, 1.0692], p < .0001, I 2 = 62.1%) and 4 weeks post‐treatment (SMD = 1.0440 [0.6777, 1.4102], p < .0001, I 2 = 61.2%) was statistically greater in the treatment than control group. However, there was no significant difference (odds ratio [OR] = 1.4345 [0.9525, 2.1604], p = .0842, I 2 = 45.4%) in the incidence of fully recovery from anosmia/hyposmia between the treatment and control groups. In subgroup analysis, there were no significant differences in the improvement of olfactory score at 4 weeks post‐treatment (OR = 0.6177 [0.1309, 1.1045] vs. 0.1720 [0.8002, 1.5438], p = .0761) or the incidence of full recovery from anosmia/hyposmia (OR = 1.8478 [0.6092, 5.6053] vs. 1.3784 [0.8872, 2.1414], p = .8038) between randomised and non‐randomised controlled trials. Conclusions Although this meta‐analysis found that topical steroids improved the acute‐onset olfactory dysfunction caused by COVID‐19, there was no difference in the rate of full olfactory recovery between treated and control patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Efficacy of topical steroids for the treatment of olfactory disorders caused by COVID‐19: A systematic review and meta‐analysis

Kim

Kang

et al. 2022

Clinical Otolaryngology

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“…In the individual controlled or comparative studies, these factors would be similar in the intervention and control groups and considered to have little effect on the results of the analysis. 30 However, when data is integrated, it could cause heterogeneity. Second, we found only 9 relevant studies; therefore, our sample size was relatively small.…”

Section: Discussionmentioning

confidence: 99%

The Efficacy of Olfactory Training as a Treatment for Olfactory Disorders Caused by Coronavirus Disease-2019: A Systematic Review and Meta-Analysis

Hwang

Kim

Basurrah

et al. 2023

Am J Rhinol�Allergy

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Background There have been reports investigating the use of olfactory training in olfactory dysfunction after COVID-19. Objective We evaluated the effect of olfactory training on the olfactory dysfunction of patients infected with COVID-19. Methods We searched PubMed, EMBASE, the Web of Science, the Cochrane database, SCOPUS, and Google Scholar up to May 2022. We retrieved studies that compared the extents of olfactory dysfunction before and after olfactory training. We performed a subgroup analysis by the duration of olfactory dysfunction. Results The olfactory score after olfactory training (standard mean difference [SMD] = 1.0830, 95% confidence interval [CI] [0.6416; 1.5245], P < .0001, I2 = 90.4%) was higher than that before training. The olfactory dysfunction rate differed significantly (OR = 0.0232, 95% CI [0.0052; 0.1044], P < .0001, I2 = 63.1%) before and after olfactory training. On subgroup analysis, although patients with both acute (onset < 30 days prior) and chronic (onset > 30 days prior) olfactory dysfunction evidenced clinically significant improvements, training during acute dysfunction (compared to acute dysfunction) increased the olfactory score to a greater extent (SMD = 1.7779, 95% CI [1.0077; 2.5481] vs 0.6928 [0.2143; 1.1712], P = 0.0190). Moreover, as a result of subgroup analysis by dividing the included studies into2 using 2-month training period as standard, there was no statistically significant difference in the effect of the training period in the included study. Conclusion Olfactory training improved olfactory disorders caused by COVID-19. Such training was effective in both the acute and chronic phases.

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“…do not differ significantly with the use of TXA and continue to present as a major challenge. into two main categories-8 out of the 16 studies were identified to be major H&N surgical studies [6][7][8][18][19][20][21][22] while the other 8 were tonsillectomy studies. [23][24][25][26][27][28][29][30] The characteristics of the studies for the tonsillectomy studies are defined in Table 4 and for the H&N studies in Table 5, including a breakdown of the type of H&N operations undertaken.…”

Section: The Rates Of Secondary Posttonsillectomy Haemorrhagementioning

confidence: 99%

“…Six H&N studies measured this in their outcomes, and five reported a significant reduction in the mean postoperative drain volume. [6][7][8]18,21,22 Again, heterogeneity within included studies was high ( p < 0.00001; I 2 = 85%) (Figure S3 in Appendix S2).…”

Section: Postoperative Drain Volumementioning

confidence: 99%

A systematic review on the efficacy of tranexamic acid in head and neck surgery

Jamshaid

Coulson

et al. 2023

Clinical Otolaryngology

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Background Intraoperative and postoperative blood loss is a major risk in head and neck (H&N) surgery. Recently the use of tranexamic acid (TXA) has been investigated by multiple studies for reducing intraoperative and postoperative bleeding, however reported results are variable. Objectives To determine the safety and efficacy of TXA use in H&N surgery. Methods Systematic review of MEDLINE, EMBASE, CINAHL, Cochrane Library, PubMed, ClinicalKey, and Clinicaltrials.gov according to the PRISMA guidelines. Studies were included if they reported on intraoperative bleeding, volume or duration of postoperative drain or return to theatre rate for postoperative haemorrhage in adult populations following use of TXA. Risk of bias assessment with Cochrane Risk of Bias (RoB2) tool for randomised controlled trials and Newcastle–Ottawa Scale tool for non‐randomised studies. Results Sixteen studies were identified (114 407 patients). Eight studies evaluated TXA in major H&N surgery and eight studies in tonsillectomy. Primary outcomes were reduction in intraoperative or postoperative bleeding. Secondary outcomes included the duration of postoperative drain placement and return to theatre rate. No adverse events were reported in any patients. TXA is effective in reducing intraoperative blood loss in tonsillectomy. However, the effect on posttonsillectomy haemorrhage was unclear. Insufficient evidence exists of benefit of TXA on intraoperative bleeding in major H&N procedures. Postoperative drainage volumes were significantly reduced in most major H&N studies. The duration of drain placement and risk of blood transfusion was unchanged in most cases. Conclusion TXA use is safe in H&N patients. Whilst sufficient evidence exists to support the use of TXA in tonsillectomy, insufficient evidence exists to recommend use in major H&N surgery.

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Evaluating the role of topical tranexamic acid in cancers of the head-and-neck: A single-center randomized controlled trial

Cited by 7 publications

References 15 publications

Efficacy of topical steroids for the treatment of olfactory disorders caused by COVID‐19: A systematic review and meta‐analysis

Efficacy of topical steroids for the treatment of olfactory disorders caused by COVID‐19: A systematic review and meta‐analysis

The Efficacy of Olfactory Training as a Treatment for Olfactory Disorders Caused by Coronavirus Disease-2019: A Systematic Review and Meta-Analysis

A systematic review on the efficacy of tranexamic acid in head and neck surgery

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