Treatment of Paranasal Sinus Fungus Ball: A Systematic Review and Meta-Analysis

Objectives: Paranasal sinus fungus ball is a common non-invasive mycosis with excellent long-term surgical treatment results. The present systematic review and meta-analysis were undertaken to define current treatment concepts and success rates in paranasal sinus fungus ball treatment. Methods: Systematic searches were performed in multiple databases with criteria designed to include all studies published until May 2020 focusing on paranasal sinuses fungus ball treatment in humans. We selected studies including at least 10 patients, specifying treatment modalities, providing a minimum 6-month follow-up, and objectivating treatment success. After duplicate removal, abstract and full-text selection, and quality assessment, we reviewed eligible articles for treatment modalities and success rates. Success rates were pooled in a random effect meta-analysis and compared according to the use of intraoperative sinus lavages and postoperative antibiotics. Results: Among 740 unique citations, 14 studies were deemed eligible. Most (n = 11) were retrospective case series. All studies relied on endoscopic sinus surgery. Intraoperative lavages were proposed in 10 studies and postoperative antibiotics in 7 (for all patients in 5 studies and for selected patients in 2). No significant heterogeneity was observed between results (Cochran’s Q P = .639, I2 test = 0). Treatment success rate was 98.4% (95% confidence interval 97.4%-99.3%). Intraoperative sinus toilette and postoperative antibiotics didn’t significantly improve the success rate. Conclusion: Endoscopic sinus surgery shows excellent results in fungus ball treatment. Further prospective studies might help further reducing antibiotics prescriptions in these patients and improve their management.

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447 What Age is Best to Perform Myringoplasty?

British Journal of Surgery ◽

10.1093/bjs/znab134.556 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

L Wilks ◽

R Mcleod ◽

V Unadkat

Keyword(s):

Systematic Review ◽

Success Rate ◽

Meta Analysis ◽

Paediatric Population ◽

Cochrane Library ◽

Clear Correlation ◽

Success Rates ◽

Prisma Statement ◽

Transitional Point ◽

The Cochrane Library

Abstract Aim This systematic review and meta-analysis aims to assess this relationship and determine the most appropriate age for recommendation of surgery. Method According to the “Preferred Reporting items for systematic review and meta-analysis” (PRISMA) statement, a literature search was performed across Medline, EMBASE and the Cochrane library from 1946-2018. Articles examining a relationship between age and myringoplasty or type 1 tympanoplasty success rates were screened. Results 20 articles encompassing data from 2244 procedures were included. The overall results conveyed a clear correlation between increasing age and rising success rate. A t-test was conducted which demonstrated a significant (P = 0.05) transition at aged 10, whereby success rate below age 10 was 70.6% and above 10 was 86%. Conclusions This systematic review and meta-analysis has uncovered a clear correlation between increasing age and increasing success rate for myringoplasty in the paediatric population. Furthermore, a significant transitional point has been demonstrated at the age of 10 and We hope that knowledge of increased success rates particularly after the age of 10 helps clinicians make more informed decisions about when to operate

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Endoscopic Sinus Surgery Improves Sleep Quality in Chronic Rhinosinusitis: A Systematic Review and Meta-analysis

Otolaryngology ◽

10.1177/0194599817737977 ◽

2017 ◽

Vol 158 (2) ◽

pp. 249-256 ◽

Cited By ~ 12

Author(s):

Daniel C. Sukato ◽

Jason M. Abramowitz ◽

Marina Boruk ◽

Nira A. Goldstein ◽

Richard M. Rosenfeld

Keyword(s):

Systematic Review ◽

Sleep Quality ◽

Chronic Rhinosinusitis ◽

Endoscopic Sinus Surgery ◽

Meta Analysis ◽

Research Direction ◽

Sinus Surgery ◽

Future Research ◽

Apnea Hypopnea Index ◽

Poor Sleep

Objective Up to 75% of patients with chronic rhinosinusitis (CRS) suffer with poor sleep quality and reduced quality of life. Endoscopic sinus surgery has demonstrated encouraging results in improving sleep function. The aim of this systematic review is to assess the change in sleep quality after surgery for CRS. Data Sources PubMed, Web of Science, EMBASE. Review Methods An electronic search was conducted with the keywords “sinusitis” or “rhinosinusitis” and “sleep.” Studies were included only when adults underwent endoscopic sinus surgery and were evaluated pre- and postoperatively by the Epworth Sleepiness Scale (ESS), the Pittsburgh Sleep Quality Index (PSQI), the Apnea-Hypopnea Index (AHI), the sleep domain of Sino-Nasal Outcome Test–22, or the sleep domain of Rhinosinusitis Disability Index. Results The database search yielded 1939 studies, of which 7 remained after dual-investigator screening. The standardized mean differences (95% CI) for the ESS, PSQI, and AHI were −0.94 (−1.63 to −0.26), −0.80 (−1.46 to −0.14), and −0.20 (−0.32 to −0.07), indicating large, moderate to large, and small improvements, respectively. All analyses displayed high heterogeneity ( I2 = 95%-99%). Conclusion Sleep quality, as measured by the ESS and PSQI surveys, shows substantial improvement after surgery for CRS, with smaller improvement seen for AHI. Generalizability of our results is limited by high heterogeneity among studies and by broad confidence intervals that cannot exclude small to trivial changes. The findings of this meta-analysis provide insight into the effect of CRS-related endoscopic sinus surgery on sleep quality, which should guide future research direction and counseling of patients in the clinical setting.

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Protocol for systematic review and meta-analysis of treatment success rate among adult patients with tuberculosis in sub-Saharan Africa

BMJ Open ◽

10.1136/bmjopen-2018-024559 ◽

2018 ◽

Vol 8 (12) ◽

pp. e024559 ◽

Cited By ~ 2

Author(s):

Jonathan Izudi ◽

Daniel Semakula ◽

Richard Sennono ◽

Imelda K Tamwesigire ◽

Francis Bajunirwe

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Treatment Success ◽

Adult Patients ◽

Sub Saharan Africa ◽

Forest Plot ◽

Kappa Statistics ◽

Success Rates ◽

Ethical Approval ◽

Sub Saharan

IntroductionTuberculosis (TB) is a leading cause of mortality globally. Despite being curable, treatment success rates (TSRs) among adult patients with bacteriologically confirmed pulmonary TB (BC-PTB) in sub-Saharan Africa (SSA) differ considerably. This protocol documents and presents an explicit plan of a systematic review and meta-analysis to summarise TSR among adult patients with BC-PTB in SSA.Methods and analysisTwo reviewers will search and extract data from MEDLINE, EMBASE, Ovid, Cumulative Index to Nursing and Allied Health Literature and Web of Science electronic databases. Observational and interventional studies published between 1 July 2008 and 30 June 2018, involving adult patients with BC-PTB will be eligible. Data abstraction disagreements will be resolved by consensus with a third reviewer, while percentage agreement computed with kappa statistics. TSR will be computed with Metaprop, a Stata command for pooling proportions using DerSimonian and Laird random effects model and presented in a forest plot with corresponding 95% CIs. Heterogeneity between included studies will be assessed with Cochran’s Q test and quantified with I-squared values. Publication bias will be evaluated with funnel plots and tested with Egger’s weighted regression. Time trends in TSR will be calculated with cumulative meta-analysis.Ethics and disseminationNo ethical approval will be needed because data from previous published studies in which informed consent was obtained by primary investigators will be retrieved and analysed. We will prepare a manuscript for publication in a peer-reviewed journal and present the results at conferences.PROSPERO registration numberCRD42018099151.

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Hyaluronic acid for post sinus surgery care: systematic review and meta-analysis

The Journal of Laryngology & Otology ◽

10.1017/s0022215116009269 ◽

2017 ◽

Vol 131 (S1) ◽

pp. S2-S11 ◽

Cited By ~ 8

Author(s):

E Fong ◽

M Garcia ◽

C M Woods ◽

E Ooi

Keyword(s):

Systematic Review ◽

Hyaluronic Acid ◽

Endoscopic Sinus Surgery ◽

Meta Analysis ◽

Adhesion Formation ◽

Sinus Surgery ◽

Current Evidence ◽

Secondary Outcome ◽

Control Group ◽

Patient Reported

AbstractBackground:Wound healing after endoscopic sinus surgery may result in adhesion formation. Hyaluronic acid may prevent synechiae development. A systematic review was performed to evaluate the current evidence on the clinical efficacy of hyaluronic acid applied to the nasal cavity after sinus surgery.Methods:Studies using hyaluronic acid as an adjunct treatment following endoscopic sinus surgery for chronic rhinosinusitis were identified. The primary outcome was adhesion formation rates. A meta-analysis was performed on adhesion event frequency. Secondary outcome measures included other endoscopic findings and patient-reported outcomes.Results:Thirteen studies (501 patients) met the selection criteria. A meta-analysis of adhesion formation frequency on endoscopy demonstrated a lower risk ratio in the hyaluronic acid intervention group (42 out of 283 cases) compared to the control group (81 out of 282) of 0.52 (95 per cent confidence interval = 0.37–0.72). Hyaluronic acid use was not associated with any significant adverse events.Conclusion:Hyaluronic acid appears to be clinically safe and well tolerated, and may be useful in the early stages after sinus surgery to limit adhesion rate. Further research, including larger randomised controlled trials, is required to evaluate patient- and clinician-reported outcomes of hyaluronic acid post sinus surgery.

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Endoscopic sinus surgery in patients with cystic fibrosis: a systematic review and meta-analysis of pulmonary function

Rhinology Journal ◽

10.4193/rhino11.271 ◽

2012 ◽

Vol 50 (4) ◽

pp. 360-369

Author(s):

K.I. Macdonald ◽

A. Gipsman ◽

A. Magit ◽

M. Fandino ◽

E. Massoud ◽

...

Keyword(s):

Systematic Review ◽

Cystic Fibrosis ◽

Pulmonary Function ◽

Endoscopic Sinus Surgery ◽

Meta Analysis ◽

Pulmonary Function Tests ◽

Sinus Surgery ◽

Intravenous Antibiotics

Introduction: The role of endoscopic sinus surgery (ESS) in patients with cystic fibrosis (CF) is not clearly defined. Objective: TO perform a systematic review of subjective and objective outcomes of ESS in CF. Methods: A systematic review was performed using the keywords 'sinusitis,' 'sinus surgery,' 'nasal polyps' and 'cystic fibrosis.' The quality of papers was assessed using the NICE scoring scale. Outcomes included safety, subjective symptoms, objective endoscopy scores, days spent in hospital, courses of antibiotics, and pulmonary function tests (PFTs). Results: Nineteen studies involving 586 patients were included in the review. There were four prospective cohort trials, and three were rated as good quality. There were no major complications attributable to ESS. There was consistent evidence in four cohort studies of improved sinonasal symptoms, including nasal obstruction, facial pain, headaches, rhinorrhea and olfaction. Three studies reported conflicting results in post-operative endoscopy scores. Three studies showed a decrease in days spent in hospital, and two showed a significant decrease in courses of intravenous antibiotics. A recent study, however, did not show a difference in either days spent in hospital or courses of antibiotics. Pulmonary function tests were not improved by ESS in six cohort trials, and one small study found significant improvement. A meta-analysis of FEV1 scores confirmed no significant difference. Conclusion: THE most consistent findings of this review were that ESS in patients with CF is safe, produces symptomatic benefit, and does not consistently improve PFTs. There were more conflicting results with regards to endoscopy scores, days spent in hospital, and courses of intravenous antibiotics. Future prospective studies, utilizing validated quality of life, symptom and endoscopy scales, are needed to further elucidate the role of ESS in the management of chronic rhinosinusitis in CF patients.

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Materials for pulpotomy in immature permanent teeth: a systematic review and meta-analysis

BMC Oral Health ◽

10.1186/s12903-019-0917-z ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 4

Author(s):

Yuan Chen ◽

Xinlei Chen ◽

Yali Zhang ◽

Fangjie Zhou ◽

Jiaxin Deng ◽

...

Keyword(s):

Systematic Review ◽

Success Rate ◽

Meta Analysis ◽

Mineral Trioxide Aggregate ◽

Systemic Review ◽

Permanent Teeth ◽

Cochrane Library ◽

Success Rates ◽

The Cochrane Library

Abstract Background Pulpotomy is one of the most widely used methods in preserving vital pulp in teeth, which is of great significance in achieving continue root formation in immature permanent teeth suffering from dental caries or trauma. The aim of this meta-analysis and systemic review is to synthesize the available evidences to compare different pulpotomy dressing agents for pulpotomy treatment in immature permanent teeth. Methods Electronic databases including MEDLINE (via Pubmed), EMBASE, the Cochrane library (CENTRAL) and the clinicaltrials.gov database were searched. The references of all included articles or relevant reviews were cross-checked. Only randomized controlled trials (RCTs) comparing two or more pulp dressing agent in permanent teeth with open apex would be included. Also, the studies should have at least 6 months of follow-up, report clinical and radiographic success in detail and publish in English. Results Five RCTs were included for a systematic review, and all of them had a high risk of bias. There is little difference in success rate between mineral trioxide aggregate (MTA) and calcium hydroxide (CH) at 6-month follow-up (risk ratio (RR) 1; 95% confidence interval (CI) 0.94 to 1.06) and 12-month follow-up (RR 1.04; 95% CI 0.96 to 1.13). There is no difference between MTA versus platelet-rich fibrin and MTA versus calcium-enriched mixture (CEM). There is only weak evidence of increased success rate in using MTA and triple antibiotic paste (TAP) rather than abscess remedy. Conclusions Based on the present evidence, similar success rates with MTA were found between the dressing agents CH, CEM, RPF and TAP as pulpotomy-dressing agents in the treatment of immature permanent teeth. More high-quality RCTs are needed in this field in future studies.

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