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Indications for image-guided sinus surgery: the current evidence.

Timothy L Smith1, Michael G Stewart, Richard R Orlandi

  • 1Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon, USA. smithtim@ohsu.edu

American Journal of Rhinology
|February 8, 2007
PubMed
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Image-guided sinus surgery (IGSS) has expert and case series support for its indications, though definitive randomized trials are not feasible. Clinical experience supports its use in sinus surgery.

Area of Science:

  • Otolaryngology
  • Medical technology
  • Evidence-based medicine

Background:

  • Evaluating scientific evidence for medical treatments is crucial.
  • This report synthesizes evidence for image guidance in sinus surgery.
  • Key questions address complication rates and clinical outcomes with IGSS.

Purpose of the Study:

  • To evaluate the evidence supporting the use of image-guided sinus surgery (IGSS).
  • To determine if IGSS reduces complication rates.
  • To assess if IGSS improves clinical outcomes in sinus surgery.

Main Methods:

  • A PubMed search identified primary research articles.
  • Two authors independently reviewed 105 articles, highlighting 5.
  • Articles were graded by evidence level (1-5), with Level 1 being randomized trials and Level 5 expert opinion.

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Main Results:

  • Evidence primarily consists of expert opinion (Level 5) and case series (Level 4).
  • Sample size and design limitations preclude definitive randomized trials of IGSS.
  • Current evidence supports the indications for IGSS.

Conclusions:

  • Randomized trials for IGSS are impractical, unethical, and not feasible.
  • Clinical experience, expert opinion, and case series support current IGSS indications.
  • Studies to definitively assess IGSS's role in reducing major complications are not possible.