Surgical therapy vs continued medical therapy for medically refractory chronic rhinosinusitis: a systematic review and meta-analysis

2016 ◽  
Vol 7 (2) ◽  
pp. 119-127 ◽  
Author(s):  
Zara M. Patel ◽  
Andrew Thamboo ◽  
Luke Rudmik ◽  
Jayakar V. Nayak ◽  
Timothy L. Smith ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Rhinosinusitis ◽  
Medical Therapy ◽  
Surgical Therapy ◽  
Meta Analysis

Endoscopic Sinus Surgery Improves Sleep Quality in Chronic Rhinosinusitis: A Systematic Review and Meta-analysis

2017 ◽  
Vol 158 (2) ◽  
pp. 249-256 ◽  
Author(s):  
Daniel C. Sukato ◽  
Jason M. Abramowitz ◽  
Marina Boruk ◽  
Nira A. Goldstein ◽  
Richard M. Rosenfeld
Keyword(s):  
Systematic Review ◽  
Sleep Quality ◽  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Meta Analysis ◽  
Research Direction ◽  
Sinus Surgery ◽  
Future Research ◽  
Apnea Hypopnea Index ◽  
Poor Sleep

Objective Up to 75% of patients with chronic rhinosinusitis (CRS) suffer with poor sleep quality and reduced quality of life. Endoscopic sinus surgery has demonstrated encouraging results in improving sleep function. The aim of this systematic review is to assess the change in sleep quality after surgery for CRS. Data Sources PubMed, Web of Science, EMBASE. Review Methods An electronic search was conducted with the keywords “sinusitis” or “rhinosinusitis” and “sleep.” Studies were included only when adults underwent endoscopic sinus surgery and were evaluated pre- and postoperatively by the Epworth Sleepiness Scale (ESS), the Pittsburgh Sleep Quality Index (PSQI), the Apnea-Hypopnea Index (AHI), the sleep domain of Sino-Nasal Outcome Test–22, or the sleep domain of Rhinosinusitis Disability Index. Results The database search yielded 1939 studies, of which 7 remained after dual-investigator screening. The standardized mean differences (95% CI) for the ESS, PSQI, and AHI were −0.94 (−1.63 to −0.26), −0.80 (−1.46 to −0.14), and −0.20 (−0.32 to −0.07), indicating large, moderate to large, and small improvements, respectively. All analyses displayed high heterogeneity ( I2 = 95%-99%). Conclusion Sleep quality, as measured by the ESS and PSQI surveys, shows substantial improvement after surgery for CRS, with smaller improvement seen for AHI. Generalizability of our results is limited by high heterogeneity among studies and by broad confidence intervals that cannot exclude small to trivial changes. The findings of this meta-analysis provide insight into the effect of CRS-related endoscopic sinus surgery on sleep quality, which should guide future research direction and counseling of patients in the clinical setting.

scholarly journals Efficacy and safety of omalizumab in chronic rhinosinusitis with nasal polyps: a systematic review and meta-analysis of randomised controlled trials

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e047344
Author(s):  
Qingwu Wu ◽  
Lianxiong Yuan ◽  
Huijun Qiu ◽  
Xinyue Wang ◽  
Xuekun Huang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Chronic Rhinosinusitis ◽  
Randomised Controlled Trials ◽  
Nasal Polyps ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Randomised Controlled

ObjectivesTo assess the efficacy and safety of omalizumab for chronic rhinosinusitis with nasal polyps (CRSwNP) and to identify evidence gaps that will guide future research on omalizumab for CRSwNP.DesignSystematic review and meta-analysis.Data sourcesA comprehensive search was performed in PubMed, Embase, Web of Science and the Cochrane Library on 13 October 2020.Eligibility criteriaRandomised controlled trials (RCTs) comparing omalizumab with placebo, given for at least 16 weeks in adult patients with CRSwNP.Data extraction and synthesisTwo independent authors screened search results, extracted data and assessed studies using the Cochrane risk of bias tool. Data were pooled using the inverse-variance method and expressed as mean differences (MDs) with 95% CIs. Heterogeneity was assessed by the χ2 test and the I2 statistic.ResultsA total of four RCTs involving 303 participants were identified. When comparing omalizumab to placebo, there was a significant difference in Nasal Polyps Score (MD=−1.20; 95% CI −1.48 to −0.92), Nasal Congestion Score (MD=−0.67; 95% CI −0.86 to −0.48), Sino-Nasal Outcome Test-22 (MD=−15.62; 95% CI −19.79 to −11.45), Total Nasal Symptom Score (MD=−1.84; 95% CI −2.43 to −1.25) and reduced need for surgery (risk ratio (RR)=5.61; 95% CI 1.99 to 15.81). Furthermore, there was no difference in the risk of serious adverse events ((RR=1.40; 95% CI 0.29 to 6.80), adverse events (RR=0.83; 95% CI 0.60 to 1.15) and rescue systemic corticosteroid (RR=0.52; 95% CI 0.17 to 1.61).ConclusionsThis was the first meta-analysis that identified omalizumab significantly improved endoscopic, clinical and patient-reported outcomes in adults with moderate to severe CRSwNP and it was safe and well tolerated.PROSPERO registration numberCRD42020207639.

Abstract 1122‐000227: Stenting Versus Medical Treatment for Chronic Internal Carotid Artery Occlusions: A Systematic Review and Meta‐analysis

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Cynthia Zevallos Mau ◽  
Cynthia B Zevallos ◽  
Milagros Galecio‐Castillo ◽  
Sameer Ansari ◽  
Julie Weng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Carotid Artery ◽  
Medical Therapy ◽  
Complex Disease ◽  
Internal Carotid ◽  
Meta Analysis ◽  
Carotid Occlusion ◽  
Stroke Recurrence ◽  
Safe Procedure ◽  
Long Term Outcome

Introduction : Chronic internal carotid occlusion is responsible for 10–15% ischemic strokes or transit ischemic attacks (TIA). Subsequent ipsilateral ischemic stroke rate is 5.9% per year. However, this risk can increase up to 23% in two years in a subgroup of patients with poor collaterals regardless of medical therapy with antiplatelet or anticoagulant agents. Prevention of subsequent stroke in patients with carotid artery occlusion remains a difficult challenge. Carotid artery stenting (CAS) has recently been considered in its management. However, there is ambiguity on its safety. We aim to evaluate the safety and feasibility of CAS and compared it with medical management. Methods : We performed a systematic review and meta‐analysis to compare long‐term outcome (stroke recurrence) of current carotid occlusion treatments (CAS vs medical therapy). Two independent reviewers performed the screening, data extraction, and quality assessment. A random effects model was used for analysis. Results : A total of 5720 studies were screened. Of these, 11 studies were included in our systematic review and meta‐analysis of proportions. The CAS group has lower proportions of recurrent strokes (5% vs 30%,) after 30 days than medical therapy alone. Additionally, the proportion of periprocedural intracranial hemorrhage was 4.4% (95% CI 2.5 to 6.8) in the CAS group. Conclusions : CAS of the chronically occluded cervical ICA seems to be a safe procedure with lower rates of recurrent stroke in clinical follow up. Future randomized studies are warranted to guide the optimal management of this complex disease.

Comorbidities associated with eosinophilic chronic rhinosinusitis: A systematic review and meta‐analysis

2020 ◽  
Vol 45 (4) ◽  
pp. 574-583
Author(s):  
Tobial McHugh ◽  
Marc Levin ◽  
Kornkiat Snidvongs ◽  
Sarfaraz M. Banglawala ◽  
Doron D. Sommer
Keyword(s):  
Systematic Review ◽  
Chronic Rhinosinusitis ◽  
Meta Analysis ◽  
Eosinophilic Chronic Rhinosinusitis

scholarly journals Efficacy of reconstructive surgical therapy at peri-implantitis-related bone defects. A systematic review and meta-analysis

2019 ◽  
Vol 46 ◽  
pp. 340-356 ◽  
Author(s):  
Cristiano Tomasi ◽  
Erik Regidor ◽  
Alberto Ortiz-Vigón ◽  
Jan Derks
Keyword(s):  
Systematic Review ◽  
Surgical Therapy ◽  
Meta Analysis ◽  
Bone Defects
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