Preoperative Corticosteroid Oral Therapy and Intraoperative Bleeding during Functional Endoscopic Sinus Surgery in Patients with Severe Nasal Polyposis: A Preliminary Investigation

Sieśkiewicz, Andrzej; Olszewska, Ewa; Rogowski, Marek; Grycz, Ewa

doi:10.1177/000348940611500702

Cited by 118 publications

(100 citation statements)

References 16 publications

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“…The outcome of ESS depends on several factors, and a clean surgical field, especially a bloodless one, is the most important factor. 1149 Impaired visibility due to a bloody field can impair surgical dissection, prolong the length of the procedure and increase the rate of complications. 1149,1150 Accordingly, it could be said that the substantive objective of preoperative management is to create a unobscured endoscopic view during ESS.…”

Section: XC Surgery For Crswnp and Crssnpmentioning

confidence: 99%

“…The results demonstrated a significantly higher percentage of severely inflamed mucosa in the placebo group, which was associated with a technically more difficult surgery. Sieskiewicz et al 1149 reported their open-label controlled trial in which 36 CRSwNP patients S145 were assigned to 30 mg of oral prednisone or no treatment.…”

Section: Xc3 Crswnp: Preoperative Corticosteroidsmentioning

confidence: 99%

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International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Orlandi

Kingdom

Hwang

et al. 2016

Int Forum Allergy Rhinol

557

888

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Background:The body of knowledge regarding rhinosinusitis (RS) continues to expand, with rapid growth in number of publications, yet substantial variability in the quality of those presentations. In an effort to both consolidate and critically appraise this information, rhinologic experts from around the world have produced the International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR:RS). Methods:Evidence-based reviews with recommendations (EBRRs) were developed for scores of topics, using previously reported methodology. Where existing evidence was insufficient for an EBRR, an evidence-based review (EBR) was produced. The sections were then synthesized and the entire manuscript was then reviewed by all authors for consensus. Results:The resulting ICAR:RS document addresses multiple topics in RS, including acute RS (ARS), chronic RS (CRS) with and without nasal polyps (CRSwNP and CRSsNP), recurrent acute RS (RARS), acute exacerbation of CRS (AE-CRS), and pediatric RS. Conclusion:As a critical review of the RS literature, ICAR:RS provides a thorough review of pathophysiology and evidence-based recommendations for medical and surgical treatment. It also demonstrates the significant gaps in our understanding of the pathophysiology and optimal management of RS. Too o en the foundation upon which these recommendations are based is comprised of lowerlevel evidence. It is our hope that this summary of the evidence in RS will point out where additional research efforts may be directed. C 2016 ARS-AAOA, LLC. Key Words:rhinosinusitis; chronic rhinosinusitis; acute rhinosinusitis; recurrent acute rhinosinusitis; evidence-based medicine; systematic review; endoscopic sinus surgery List of Abbreviations Used

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Section: XC Surgery For Crswnp and Crssnpmentioning

confidence: 99%

Section: Xc3 Crswnp: Preoperative Corticosteroidsmentioning

confidence: 99%

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Orlandi

Kingdom

Hwang

et al. 2016

Int Forum Allergy Rhinol

557

888

View full text Add to dashboard Cite

show abstract

“…Sieskiewicz et al (2) investigated the effects of oral steroid therapy on the improvement of surgical field conditions. The patients in group 1 received prednisone at a dose of 30 mg/d…”

Section: D1) Preoperative Steroidsmentioning

confidence: 99%

“…Bleeding hinders adequate visualisation of the surgical field (VSF) and thus increases the rate of complications (1)(2)(3)(4) , occasionally requires suspension of the intervention (3,4) , and can even put the patient's life at risk.…”

Section: Introductionmentioning

confidence: 99%

Bleeding control in endoscopic sinus surgery: a systematic review of the literature

Valiente¹,

Fidalgo²,

Ortega³

2013

Rhin

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SummaryIn the literature various methods are described to reduce bleeding in endoscopic sinus surgery. Scientific evidence and results were gathered and analysed to determine the effectiveness of the various methods used. A total of 20 articles fulfilled the inclusion criteria. Two retrospective articles studied the differences between local and general anaesthesia. Three articles analysed the use of local methods to control bleeding. The majority of the articles analysed the use of different systemic drugs to control intraoperative bleeding.Certain procedures, such as the reverse Trendelenburg position, the use of high doses of epinephrine, the infiltration of phenylephrine and lidocaine into the pterygopalatine fossa, the preoperative use of prednisone, and the control of the heart rate (with dexmedetomidine or remifentanil), appear to reduce the intraoperative blood loss and/or improve the visualisation of the surgical field. However, the evidence supporting these conclusions is poor. The benefits of other procedures, such as the preoperative use of β-blockers, antihypertensive agents, and surgical pledgets with oxymetazoline, phenylephrine, or cocaine, for bleeding control are not evidenced in the literature. In addition, the literature does not present any evidence on the benefits of local anaesthesia compared with general anaesthesia or the use of propofol compared to inhaled analgesics in terms of intraoperative bleeding or complication rates.

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“…6 GC may, however, not be effective in all cases; the success rate of this form of treatment is around 60.9 to 80%. 7,8 It is known that unsuccessful topical GC treatment is related to extensive NSP cases and lack of adhesion to therapy. The main factor that establishes the efficacy of GC therapy is the intrinsic, cell mechanismmediated, resistance to the drug.…”

Section: Introductionmentioning

confidence: 99%

Mecanismos de ação dos corticosteróides na polipose rinossinusal

Fernandes¹,

Valera²,

Anselmo‐Lima³

2008

Rev. Bras. Otorrinolaringol.

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Os glicocorticóides (GC) são drogas de escolha no tratamento clínico da polipose nasossinusal conforme recomendação da literatura. Entretanto, seus mecanismos de ação nas regressões dos sintomas clínicos e dos pólipos não são totalmente compreendidos. Sabe-se que a administração tópica e ou sistêmica dos glicocorticóides leva a variações na expressão de citocinas, quimiocinas e linfocinas, além das alterações celulares. Assim, os GC suprimem a expressão de citocinas pró-inflamatórias, de quimiocinas, de moléculas de adesão, além de estimular a transcrição de citocinas antiinflamatórias. Citocinas pró-fibróticas como a IL-11, fator básico de crescimento do fibroblasto (b-FGF) e fator de crescimento endotelial vascular (VEGF), relacionados com o crescimento do pólipo, também são suprimidos pela ação do GC. Tal ação depende fundamentalmente da interação com os seus receptores (GR), pois alguns indivíduos apresentam algum grau de resistência celular ao seu efeito, que parece estar relacionada com a presença da isoforma <FONT FACE=Symbol>b</font> do GR. Genes envolvidos nas fases de produção de imunoglobulinas, apresentação e processamento do antígeno também sofrem ação dos GC de forma variada. OBJETIVOS: Fazer uma revisão da literatura sobre os mecanismos de ação do GC na PNS. CONCLUSÃO: A compreensão desses mecanismos implicará no desenvolvimento de drogas mais eficazes na sua terapêutica.

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Preoperative Corticosteroid Oral Therapy and Intraoperative Bleeding during Functional Endoscopic Sinus Surgery in Patients with Severe Nasal Polyposis: A Preliminary Investigation

Abstract: Better surgical field conditions were the results of the powerful anti-inflammatory and antiedematous activity of the drug, which facilitated blood and secretion evacuation from the operated area and prevented the optic system from staining.

Cited by 118 publications

References 16 publications

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Bleeding control in endoscopic sinus surgery: a systematic review of the literature

Mecanismos de ação dos corticosteróides na polipose rinossinusal

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