Back to Search
Start Over
Middle meatal packing in endoscopic sinus surgery-to pack or not to pack?-a decision-analysis model.
- Source :
-
The Laryngoscope [Laryngoscope] 2017 Jul; Vol. 127 (7), pp. 1506-1512. Date of Electronic Publication: 2017 Apr 27. - Publication Year :
- 2017
-
Abstract
- Background: Packing of the middle meatus and ethmoid cavities is a common practice in endoscopic sinus surgery (ESS), but its necessity recently has been challenged. The aim of this study was to formulate a decision-analysis model to determine the need for packing in ESS and identify variables affecting the decision.<br />Methods: A systematic review of the literature was conducted for all randomized control trials comparing packing to no packing in ESS, and a decision-analysis model was generated. Probabilities and utilities were derived from the literature. Sensitivity analysis was used to determine which variables most affected the model.<br />Results: No packing was associated with better expected utilities than packing. On sensitivity analysis, packing was preferred when the disutility of no packing outweighed the disutility of packing, and when the probability for synechiae was greater than 35% without packing or lower than 2% with packing. When the component of packing removal was subtracted from the overall disutility simulating absorbable packing, the results favored packing.<br />Conclusion: Our decision-analysis model indicates that middle meatal packing is not advantageous for patients undergoing ESS. Absorbable packing materials have a less adverse effect on quality of life than nonabsorbable materials.<br />Level of Evidence: 1a. Laryngoscope, 127:1506-1512, 2017.<br /> (© 2017 The American Laryngological, Rhinological and Otological Society, Inc.)
- Subjects :
- Adult
Decision Trees
Evidence-Based Medicine
Humans
Nasal Obstruction etiology
Nasal Obstruction prevention & control
Postoperative Complications etiology
Postoperative Complications prevention & control
Postoperative Hemorrhage etiology
Postoperative Hemorrhage prevention & control
Randomized Controlled Trials as Topic
Software
Tampons, Surgical
Decision Support Techniques
Endoscopy methods
Paranasal Sinuses surgery
Rhinitis surgery
Sinusitis surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1531-4995
- Volume :
- 127
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- The Laryngoscope
- Publication Type :
- Academic Journal
- Accession number :
- 28449210
- Full Text :
- https://doi.org/10.1002/lary.26506