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Role of corticosteroids in Functional Endoscopic Sinus Surgery - a systematic review and meta-analysis

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Role of corticosteroids in Functional Endoscopic Sinus Surgery - a systematic review and meta-analysis. / Pundir, Vishal; Pundir, Jyotsna; Lancaster, Gillian Ann et al.
In: Rhinology, Vol. 54, No. 1, 2016, p. 3-19.

Research output: Contribution to Journal/MagazineJournal articlepeer-review

Harvard

Pundir, V, Pundir, J, Lancaster, GA, Baer, S, Kirkland, P, Cornet, M, Lourijsen, ES, Gerogalas, C & Fokkens, WJ 2016, 'Role of corticosteroids in Functional Endoscopic Sinus Surgery - a systematic review and meta-analysis', Rhinology, vol. 54, no. 1, pp. 3-19. https://doi.org/10.4193/Rhino15.079

APA

Pundir, V., Pundir, J., Lancaster, G. A., Baer, S., Kirkland, P., Cornet, M., Lourijsen, E. S., Gerogalas, C., & Fokkens, W. J. (2016). Role of corticosteroids in Functional Endoscopic Sinus Surgery - a systematic review and meta-analysis. Rhinology, 54(1), 3-19. https://doi.org/10.4193/Rhino15.079

Vancouver

Pundir V, Pundir J, Lancaster GA, Baer S, Kirkland P, Cornet M et al. Role of corticosteroids in Functional Endoscopic Sinus Surgery - a systematic review and meta-analysis. Rhinology. 2016;54(1):3-19. doi: 10.4193/Rhino15.079

Author

Pundir, Vishal ; Pundir, Jyotsna ; Lancaster, Gillian Ann et al. / Role of corticosteroids in Functional Endoscopic Sinus Surgery - a systematic review and meta-analysis. In: Rhinology. 2016 ; Vol. 54, No. 1. pp. 3-19.

Bibtex

@article{c0dba13a98274962b1fde5aa500092a4,
title = "Role of corticosteroids in Functional Endoscopic Sinus Surgery - a systematic review and meta-analysis",
abstract = "Background: The aim of our study is to systematically review the existing evidence on the role of corticosteroids in patients undergoing functional endoscopic sinus surgery (FESS). Methodology: Systematic search of MEDLINE (1950- 2014), EMBASE (1980-2014), metaRegister, Cochrane Library and ISI conference proceedings was carried out. Results: Eighteen randomised controlled trials with 1309 patients were included. Use of local and/or systemic corticosteroids with FESS was reported in four categories; operative, anaesthesia related, post-operative outcomes and risk of recurrence. Metaanalysis for operative outcomes demonstrated that, mean operative time (MD -10.70 minutes; 95% CI -15.86, -5.55; P <0.0001) and mean estimated blood loss (MD -28.32 mls; 95% CI -40.93, -15.72; P <0.0001) was significantly lower; and surgical field quality (MD -0.81; 95% CI -1.32, -0.30; P = 0.002) was significantly better in corticosteroid group. Meta-analysis showed that post-operative endoscopic scores (SMD -0.39; 95% CI -0.60, -0.17; P = 0.0004) were significantly better in corticosteroid group compared to no corticosteroid group. There was no increase in risk of sinusitis (RR 0.64; 95% CI 0.32, 1.30; P = 0.22) between use of corticosteroids and no corticosteroids; There was no significant difference in recurrence risk of chronic rhinosinusitis (CRS) in mixed population studies (RR 0.77; 95% CI 0.35, 1.70; P = 0.52) between the two groups but analysis of studies reporting on chronic rhinosinusitis with nasal polyps (CRSwNP) (RR 0.64;95% CI 0.45,0.91;P=0.01) showed significant difference in favour of the corticosteroid group. Conclusion: Pre-operative use of local and/or systemic corticosteroids in FESS, results in significantly reduced blood loss, shorter operative time and improved surgical field quality. Studies are limited on the intra-operative use of corticosteroids to reduce postoperative pain. Postoperative corticosteroids improve postoperative endoscopic scores in CRS and recurrence rates in cases of CRSwNP.",
author = "Vishal Pundir and Jyotsna Pundir and Lancaster, {Gillian Ann} and S. Baer and P. Kirkland and M. Cornet and Lourijsen, {E. S.} and C. Gerogalas and Fokkens, {W. J.}",
year = "2016",
doi = "10.4193/Rhino15.079",
language = "English",
volume = "54",
pages = "3--19",
journal = "Rhinology",
issn = "0300-0729",
publisher = "University Hospital Utrecht",
number = "1",

}

RIS

TY - JOUR

T1 - Role of corticosteroids in Functional Endoscopic Sinus Surgery - a systematic review and meta-analysis

AU - Pundir, Vishal

AU - Pundir, Jyotsna

AU - Lancaster, Gillian Ann

AU - Baer, S.

AU - Kirkland, P.

AU - Cornet, M.

AU - Lourijsen, E. S.

AU - Gerogalas, C.

AU - Fokkens, W. J.

PY - 2016

Y1 - 2016

N2 - Background: The aim of our study is to systematically review the existing evidence on the role of corticosteroids in patients undergoing functional endoscopic sinus surgery (FESS). Methodology: Systematic search of MEDLINE (1950- 2014), EMBASE (1980-2014), metaRegister, Cochrane Library and ISI conference proceedings was carried out. Results: Eighteen randomised controlled trials with 1309 patients were included. Use of local and/or systemic corticosteroids with FESS was reported in four categories; operative, anaesthesia related, post-operative outcomes and risk of recurrence. Metaanalysis for operative outcomes demonstrated that, mean operative time (MD -10.70 minutes; 95% CI -15.86, -5.55; P <0.0001) and mean estimated blood loss (MD -28.32 mls; 95% CI -40.93, -15.72; P <0.0001) was significantly lower; and surgical field quality (MD -0.81; 95% CI -1.32, -0.30; P = 0.002) was significantly better in corticosteroid group. Meta-analysis showed that post-operative endoscopic scores (SMD -0.39; 95% CI -0.60, -0.17; P = 0.0004) were significantly better in corticosteroid group compared to no corticosteroid group. There was no increase in risk of sinusitis (RR 0.64; 95% CI 0.32, 1.30; P = 0.22) between use of corticosteroids and no corticosteroids; There was no significant difference in recurrence risk of chronic rhinosinusitis (CRS) in mixed population studies (RR 0.77; 95% CI 0.35, 1.70; P = 0.52) between the two groups but analysis of studies reporting on chronic rhinosinusitis with nasal polyps (CRSwNP) (RR 0.64;95% CI 0.45,0.91;P=0.01) showed significant difference in favour of the corticosteroid group. Conclusion: Pre-operative use of local and/or systemic corticosteroids in FESS, results in significantly reduced blood loss, shorter operative time and improved surgical field quality. Studies are limited on the intra-operative use of corticosteroids to reduce postoperative pain. Postoperative corticosteroids improve postoperative endoscopic scores in CRS and recurrence rates in cases of CRSwNP.

AB - Background: The aim of our study is to systematically review the existing evidence on the role of corticosteroids in patients undergoing functional endoscopic sinus surgery (FESS). Methodology: Systematic search of MEDLINE (1950- 2014), EMBASE (1980-2014), metaRegister, Cochrane Library and ISI conference proceedings was carried out. Results: Eighteen randomised controlled trials with 1309 patients were included. Use of local and/or systemic corticosteroids with FESS was reported in four categories; operative, anaesthesia related, post-operative outcomes and risk of recurrence. Metaanalysis for operative outcomes demonstrated that, mean operative time (MD -10.70 minutes; 95% CI -15.86, -5.55; P <0.0001) and mean estimated blood loss (MD -28.32 mls; 95% CI -40.93, -15.72; P <0.0001) was significantly lower; and surgical field quality (MD -0.81; 95% CI -1.32, -0.30; P = 0.002) was significantly better in corticosteroid group. Meta-analysis showed that post-operative endoscopic scores (SMD -0.39; 95% CI -0.60, -0.17; P = 0.0004) were significantly better in corticosteroid group compared to no corticosteroid group. There was no increase in risk of sinusitis (RR 0.64; 95% CI 0.32, 1.30; P = 0.22) between use of corticosteroids and no corticosteroids; There was no significant difference in recurrence risk of chronic rhinosinusitis (CRS) in mixed population studies (RR 0.77; 95% CI 0.35, 1.70; P = 0.52) between the two groups but analysis of studies reporting on chronic rhinosinusitis with nasal polyps (CRSwNP) (RR 0.64;95% CI 0.45,0.91;P=0.01) showed significant difference in favour of the corticosteroid group. Conclusion: Pre-operative use of local and/or systemic corticosteroids in FESS, results in significantly reduced blood loss, shorter operative time and improved surgical field quality. Studies are limited on the intra-operative use of corticosteroids to reduce postoperative pain. Postoperative corticosteroids improve postoperative endoscopic scores in CRS and recurrence rates in cases of CRSwNP.

U2 - 10.4193/Rhino15.079

DO - 10.4193/Rhino15.079

M3 - Journal article

VL - 54

SP - 3

EP - 19

JO - Rhinology

JF - Rhinology

SN - 0300-0729

IS - 1

ER -