Postoperative management of endoscopic sinus surgery

2002 ◽  
Vol 10 (1) ◽  
pp. 36-39 ◽  
Author(s):  
Rodney J. Schlosser ◽  
Stilianos Kountakis ◽  
Charles W. Gross
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Postoperative Management ◽  
Sinus Surgery

Effect of Microporous Polysaccharide Hemospheres (MPH) on Bleeding after Endoscopic Sinus Surgery

2009 ◽  
Vol 141 (3) ◽  
pp. 353-357 ◽  
Author(s):  
Jastin L. Antisdel ◽  
Jackie L. West-Denning ◽  
Raj Sindwani
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Postoperative Management ◽  
Postoperative Recovery ◽  
Early Postoperative Period ◽  
University Hospital ◽  
Sinus Surgery ◽  
Nasal Discharge ◽  
Visual Analog Scales ◽  
Microporous Polysaccharide Hemospheres ◽  
Bleeding Score

OBJECTIVES: Absorbable hemostatic agents are commonly used after endoscopic sinus surgery (ESS). MPH (microporous polysaccharide hemospheres) is a novel hemostatic powder that is rapidly absorbed. The goal of this study was to examine the effects of MPH on bleeding after ESS. STUDY DESIGN: Randomized, controlled, single-blinded. SETTING: Tertiary university hospital. SUBJECTS AND METHODS: Patients undergoing bilateral (symmetric) ESS for CRS by the same surgeon were randomized to unilateral treatment with MPH at surgical conclusion. The untreated opposite side served as a control. All patients received standard postoperative management. Patients completed symptom diaries using visual analog scales (VAS, scored out of 100) at baseline and through postoperative day (POD) 30. Outcomes including bleeding, pain, obstruction, and nasal discharge were recorded separately for left and right sides. RESULTS: Forty patients (19 men, 21 women) with an average age of 48.3 years were included. There were no complications, and all patients were discharged home the same day. The mean bleeding score on POD one for MPH-treated sides was 22.5 vs 39.0 for untreated controls (mean reduction 16.5, P < 0.0001, 95% CI −23.2 to −9.7). The scores for bleeding at baseline and at all other post-treatment days were not significantly different ( P > 0.05). There were no other significant differences between MPH-treated and control sides in any other variables measured. CONCLUSION: The use of MPH after ESS results in significantly less bleeding in the early postoperative period with no increase in pain, obstruction, or nasal discharge. Patients treated with MPH follow a normal postoperative recovery otherwise.

scholarly journals Diagnosis and Management of Orbital Fat Exposure During Endoscopic Sinus Surgery

2021 ◽  
pp. 014556132110154
Author(s):  
Edward Westfall ◽  
Zachary Fridirici ◽  
Nadeem El-Kouri ◽  
Ryan McSpadden ◽  
Mike Loochtan ◽  
...  
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Postoperative Management ◽  
Sinus Surgery ◽  
Postanesthesia Care Unit ◽  
Orbital Fat ◽  
Diagnosis And Management ◽  
Muscle Trauma ◽  
Intraoperative Management ◽  
Orbital Complications ◽  
Orbital Hematoma

Background: The orbital complication rate during endoscopic sinus surgery (ESS) is <1%. Orbital fat exposure during ESS can herald orbital complications including orbital hematoma, extraocular muscle trauma, optic nerve injury, or blindness. The objective of this study was to evaluate the current consensus regarding diagnosis and management of orbital fat exposure during ESS. Methods: A 24-point survey focused on orbital fat exposure during ESS was distributed to American Rhinologic Society members. Also, a retrospective review of 25 cases of orbital fat exposure drawn from the principal investigator’s 30-year experience was performed. Results: Over 10 000 surgical cases of the principal investigator were reviewed. Twenty-five patients had orbital fat exposure. Five developed minor complications while 2 were major (ie, temporary vision changes). Two hundred thirty-six surgeons responded to the survey; 93% had encountered orbital fat during ESS; 88% of surgeons identify orbital fat by either its appearance endoscopically or the “bulb press” test. Almost every responding surgeon will cautiously avoid further manipulation in the area of orbital fat exposure. Nearly half will immediately curtail the extent of surgery. Surgeons do not significantly change postoperative management. Considerations regarding observation in postanesthesia care unit, close follow-up, and strict nose blowing precautions are common. Conclusion: Orbital fat exposure during ESS is a rarely discussed, but clinically important. Orbital fat exposure can be a harbinger for major orbital complications that should be recognized by endoscopic appearance and confirmed with the bulb press test. Caution with “no further manipulation” of orbital fat is the guiding principle for intraoperative management, while postoperative management is generally expectant. Level 4 Evidence

Postoperative management of patients after transnasal endoscopic sinus surgery

Pharmateca ◽  
2021 ◽  
Vol 5_2021 ◽  
pp. 109-114
Author(s):  
M.A. Edzhe Edzhe ◽  
E.V. Marasanova Marasanova ◽  
A.Yu. Ovchinnikov Ovchinnikov ◽  
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Postoperative Management ◽  
Sinus Surgery

One-way Valve Bottle Contamination Rates in the Immediate Post–functional Endoscopic Sinus Surgery Period

2011 ◽  
Vol 25 (6) ◽  
pp. 393-396 ◽  
Author(s):  
Jennifer M. Kofonow ◽  
Aditi Bhuskute ◽  
Laurel Doghramji ◽  
James N. Palmer ◽  
Noam A. Cohen ◽  
...  
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Positive Culture ◽  
Postoperative Management ◽  
Delivery Systems ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Saline Irrigation ◽  
Time Of Surgery ◽  
Accepted Practice ◽  
Alternative Delivery

Background Sinonasal saline irrigation has become an accepted practice in the immediate postoperative management of functional endoscopic sinus surgery (FESS) patients. Recent studies have found that valveless delivery systems of sinonasal irrigation are colonized with bacteria. An alternative delivery system uses a one-way valve to reduce saline backflow and may limit bottle contamination. Our sole objective was to determine whether this system in post-FESS patients eliminates microbial bottle contamination. Methods Eight patients undergoing FESS were given one-way valve irrigation bottles to use immediately after surgery. Bottles were collected after 1 week of use and another set of bottles after an additional week. Endoscopic-directed cultures of the middle meatus were performed at the time of surgery. Returned used bottles were swabbed for bacteria and the valve system of the bottle was analyzed under scanning electron microscopy (SEM) for the presence of bacteria. Results All sinus swabs collected at the time of surgery grew bacteria with Staphylococcus sp. present in all samples. After the 1st week of use, 5/8 bottles grew bacterial cultures and showed bacterial presence on the valves by SEM. After the 2nd week, 4/5 bottles had positive culture results and also showed bacterial presence on the valves by SEM. Conclusion Despite commercial claims that the use of valves and limit of backflow into the bottle will eliminate contamination, our study showed that one-way valve delivery systems become contaminated with bacteria after 1 week of use. We also showed that the bottle valves themselves harbor bacteria after 1 week of use.

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