Document Detail

Preoperative treatment with topical corticoids and bleeding during primary endoscopic sinus surgery.
MedLine Citation:
PMID:  20869570     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To find out whether the constant preoperative use of a topical corticoid (mometasone furoate [MF]) could really improve the operative field quality and decrease bleeding during endoscopic sinus surgery (ESS). STUDY DESIGN: Double-blind, randomized controlled trial. SETTING: Tertiary referral center. SUBJECTS AND METHODS: Seventy patients with chronic rhinosinusitis (CRS) with and without polyps underwent ESS under standardized general anesthesia with equal randomization into two groups. During four weeks within the preoperative period, 35 cases were treated with MF, while the other half received placebo matching sprays. Total blood loss, operation time, and surgical field quality were recorded. RESULTS: Intraoperative blood loss in the MF-treated group was 142.8 mL, less than in the control group (170.6 mL). The difference between the groups is 27.7 mL (95% confidence interval [CI] 3.5-51.92), statistically significant: P = 0.025. Time of surgery was 59 minutes in the MF group and 70 minutes in the control group. The difference was 11.2 minutes (95% CI 2.82-19.51), which is statistically significant: P = 0.009. The quality of the endoscopic surgical field was significantly better for patients treated with MF. Treatment with topical corticoid enables significantly reduced bleeding, decreased operation time, and improved endoscopic vision during ESS for CRS. CONCLUSION: The use of topical corticoid (MF) in the preoperative period can improve endoscopic vision, reduce bleeding, and decrease operation time in CRS patients with and without polyps undergoing ESS, but our sample size cannot exclude small, and possibly trivial, group differences.
Silviu Albu; Anamaria Gocea; Ileana Mitre
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery     Volume:  143     ISSN:  1097-6817     ISO Abbreviation:  Otolaryngol Head Neck Surg     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-27     Completed Date:  2010-11-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8508176     Medline TA:  Otolaryngol Head Neck Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  573-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 American Academy of Otolaryngology–Head and Neck Surgery Foundation. Published by Mosby, Inc. All rights reserved.
Second Department of Otolaryngology, University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania.
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MeSH Terms
Administration, Intranasal
Administration, Rectal
Anti-Inflammatory Agents / administration & dosage*,  adverse effects
Blood Loss, Surgical / prevention & control*
Chronic Disease
Double-Blind Method
Glucocorticoids / administration & dosage*
Nasal Polyps / surgery
Paranasal Sinuses / surgery*
Pregnadienediols / administration & dosage*,  adverse effects
Preoperative Care*
Rhinitis / complications,  surgery
Sinusitis / complications,  surgery
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Glucocorticoids; 0/Pregnadienediols; 83919-23-7/mometasone furoate

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