Background: The safety and efficacy of endoscopic sinus surgery have improved with the development of new equipment and improved surgical techniques. However, it is accompanied by the risk of complications. Intraoperative blood loss is an important factor in the safe conduct of surgery. Therefore, we examined the factors associated with intraoperative blood loss.
Method: The amount of intraoperative bleeding experienced by 518 patients with sinonasal disease who underwent endoscopic sinus surgery under general anaesthesia at our hospital over nine years was tabulated. Thirty-four variables were extracted after analysis of patients' background, sinonasal pathology, and haematology results. Multivariate linear regression analysis was performed.
Results: Multivariate analysis revealed significant differences in the prothrombin time-international normalized ratio (PT-INR), Lund-Mackay score, operative time, and initial versus repeat surgery. The degree of change between the 25% and 75% points was significant for the following variables: an increase from 5 to 14 points for the Lund-Mackay score at 73 mL.
Conclusions: Preoperative precautionary measures should be implemented in the event of re-operation, expected prolonged operative time, high Lund-Mackay score, and prolonged PT-INR. Intraoperative blood loss in patients with a high Lund-Mackay score requires meticulous attention.
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http://dx.doi.org/10.7759/cureus.76286 | DOI Listing |
Cureus
December 2024
Otolaryngology, Yokohama City University Graduate School of Medicine, Yokohama, JPN.
Background: The safety and efficacy of endoscopic sinus surgery have improved with the development of new equipment and improved surgical techniques. However, it is accompanied by the risk of complications. Intraoperative blood loss is an important factor in the safe conduct of surgery.
View Article and Find Full Text PDFAllergol Int
January 2025
Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan.
Background: Although randomized controlled trials (RCT) have demonstrated the efficacy of mepolizumab for asthma, they have excluded certain patient subgroups. To bridge the gap between RCT and real-world practice, the effectiveness of mepolizumab in a diverse population, including those potentially excluded from RCT, was assessed. Its effects on imaging findings and symptoms of chronic rhinosinusitis (CRS) with asthma were also assessed.
View Article and Find Full Text PDFAJNR Am J Neuroradiol
January 2025
From the Department of Radiology (I.R., S.P., A.K., O.S.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
Background And Purpose: Granulomatosis with polyangiitis (GPA) and eosinophilic granulomatosis with polyangiitis (EGPA) are the most common causes of chronic sinusitis from systemic granulomatous diseases. While both are small- to medium-sized vasculitis with necrotizing granulomas, they have different clinical courses and prognoses. High-density sinus opacification has been reported in allergic fungal sinusitis with eosinophilic infiltrates.
View Article and Find Full Text PDFAm J Rhinol Allergy
January 2025
Department of Radiology, Hangzhou First People's Hospital, Hangzhou, P. R. China.
Background: Computed tomography (CT) plays a crucial role in assessing chronic rhinosinusitis, but lacks objective quantifiable indicators.
Objective: This study aimed to use deep learning for automated sinus segmentation to generate distinct quantitative scores and explore their correlations with disease-specific quality of life.
Methods: From July 2021 to August 2022, 445 CT data were collected from 2 medical centers.
Int Arch Otorhinolaryngol
January 2025
Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan.
There are no clear guidelines for deciding between endoscopic sinus surgery and tooth extraction for the treatment of odontogenic sinusitis. Furthermore, tooth extraction does not necessarily improve sinusitis and eventually results in additional endoscopic sinus surgery. The present study aimed to retrospectively investigate negative predictive factors of tooth extraction for odontogenic sinusitis.
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