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Early postoperative care following endoscopic sinus surgery: an evidence-based review with recommendations.

Abstract：

BACKGROUND:Early postoperative care following endoscopic sinus surgery (ESS) has been suggested to minimize avoidable complications and optimize long-term outcomes. Several postoperative care strategies have been proposed but a formal comprehensive evaluation of the evidence has never been performed. The purpose of this article is to provide an evidence-based approach to early postoperative care following ESS. METHODS:A systematic review of the literature was performed and the Clinical Practice Guideline Manual, Conference on Guideline Standardization (COGS), and the Appraisal of Guidelines and Research Evaluation (AGREE) instrument recommendations were followed. Study inclusion criteria were: adult population >18 years old; chronic rhinosinusitis (CRS) based on published diagnostic criteria; ESS following failed medical therapy; primary study objective was to evaluate an ESS early postoperative care strategy; and clearly defined primary clinical end-point. RESULTS:This review identified and evaluated the literature on 7 early postoperative care strategies following ESS: saline irrigations, sinus cavity debridements, systemic steroids, topical steroids, oral antibiotics, topical decongestants, and drug-eluting spacers/stents. CONCLUSION:Based on the available evidence, use of nasal saline irrigation, sinus cavity debridement, and standard topical nasal steroid spray are recommended early postoperative care interventions. Postoperative antibiotic, systemic steroid, nonstandard topical nasal steroid solution, and/or drug-eluting spacers/stents are options in postoperative management. These evidence-based recommendations should not necessarily be applied to all postoperative patients and clinical judgment, in addition to evidence, is critical to determining the most appropriate care.

journal_name

Int Forum Allergy Rhinol

journal_title

International forum of allergy & rhinology

authors

Rudmik L,Soler ZM,Orlandi RR,Stewart MG,Bhattacharyya N,Kennedy DW,Smith TL

doi

10.1002/alr.20072

subject

Has Abstract

pub_date

2011-11-01 00:00:00

pages

417-30

issue

6

eissn

2042-6976

issn

2042-6984

journal_volume

1

pub_type

杂志文章,评审

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