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Hot saline irrigation for haemostasis in functional endoscopic sinus surgery: a systematic review and meta-analysis

Published online by Cambridge University Press:  25 November 2021

D Ranford ,
B Fu ,
P Surda  and
J Rudd
D Ranford*
Affiliation:
Department of Otolaryngology, Guy's and St Thomas’ NHS Foundation Trust, London
B Fu
Affiliation:
Department of Otolaryngology, East Kent Hospitals University NHS Foundation Trust, Canterbury, UK
P Surda
Affiliation:
Department of Otolaryngology, Guy's and St Thomas’ NHS Foundation Trust, London
J Rudd
Affiliation:
Department of Otolaryngology, Guy's and St Thomas’ NHS Foundation Trust, London
*
Author for correspondence: Dr D Ranford, Department of Otolaryngology, Guy's Hospital, Great Maze Pond, LondonSE1 9RT, UK E-mail: david.ranford@nhs.net
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Abstract

Objective

The aim of this study was to perform a systematic review and meta-analysis of existing evidence on the role of hot saline irrigation in patients undergoing functional endoscopic sinus surgery and its impact on the visibility of the surgical field.

Method

A search of PubMed, Cochrane, Ovid databases and Google Scholar was performed.

Results

Three randomised controlled trials were included. Pooled meta-analysis demonstrated a statistically significant better visibility of the surgical field, and a reduction in total blood loss and operating time during functional endoscopic sinus surgery in the hot saline irrigation group compared with the room temperature irrigation group. Subgroup analysis of studies that did not use vasoconstrictors showed a significant reduction in total blood loss and operating time.

Conclusion

This is the first systematic review that addresses hot saline irrigation for haemostasis in functional endoscopic sinus surgery. The results suggest that hot saline irrigation in functional endoscopic sinus surgery for chronic rhinosinusitis may significantly improve visibility of the surgical field, reduce total blood loss by 20 per cent and decrease operating time by 9 minutes. However, there are limitations of the study because of the significant heterogeneity of the methods, quality and size of the studies.

Keywords

Endoscopic Sinus SurgeryChronic RhinosinusitisIrrigationsHot Saline
Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 8 , August 2022 , pp. 676 - 682
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr D Ranford takes responsibility for the integrity of the content of the paper

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