Indications for image-guided sinus surgery: The current evidence

Timothy L. Smith, Michael G. Stewart, Richard R. Orlandi, Michael Setzen, Donald C. Lanza

Research output: Contribution to journalArticle

60 Scopus citations

Abstract

Background: Evidence-based medicine calls for a critical evaluation of the scientific evidence for treatments of disease. This report synthesizes the available evidence supporting the indications for image guidance in sinus surgery, examining two important questions: (1) Does image-guided sinus surgery (IGSS) reduce complication rates? (2) Does IGSS improve clinical outcomes? Methods: Primary research articles evaluated for this report were identified using appropriate search terms and a PubMed search. Two authors independently reviewed each article. Articles were assigned an evidence level based on accepted guidelines: level 1 = randomized trials, level 2 = prospective cohort studies with comparison group, level 3 = case-control studies, level 4 = retrospective case series, and level 5 = expert opinion. Results: We identified 105 articles for full review and highlight 5 articles in our report. Primarily, there is expert opinion (level 5) and case series (level 4) with and without comparison groups supporting the indications for IGSS. In addition, authors point out that sample size and design issues preclude definitive randomized trials using IGSS. Conclusion: Although randomized trials of IGSS are not practical, ethical, or feasible, clinical experience, expert opinion, and case series support the current indications for IGSS. Studies designed to draw conclusions about the role of IGSS in decreasing major complications of sinus surgery are not possible.

Original languageEnglish (US)
Pages (from-to)80-83
Number of pages4
JournalAmerican Journal of Rhinology
Volume21
Issue number1
DOIs
StatePublished - Jan 1 2007

Keywords

  • Computer assisted
  • Endoscopic sinus surgery
  • Evidence-based medicine
  • Image guidance
  • Surgical complications

ASJC Scopus subject areas

  • Otorhinolaryngology

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