Postoperative protocols following endoscopic skull base surgery: An evidence-based review with recommendations.
endoscopic repair
endoscopic skull base surgery
postoperative management
postoperative precautions
reconstruction
skull base
Journal
International forum of allergy & rhinology
ISSN: 2042-6984
Titre abrégé: Int Forum Allergy Rhinol
Pays: United States
ID NLM: 101550261
Informations de publication
Date de publication:
01 2023
01 2023
Historique:
revised:
30
05
2022
received:
01
05
2022
accepted:
31
05
2022
pubmed:
10
6
2022
medline:
6
1
2023
entrez:
9
6
2022
Statut:
ppublish
Résumé
Postoperative management strategies for endoscopic skull base surgery (ESBS) vary widely because of limited evidence-based guidance. The PubMed, EMBASE, and Cochrane databases were systematically reviewed from January 1990 through February 2022 to examine 18 postoperative considerations for ESBS. Nonhuman studies, articles written in a language other than English, and case reports were excluded. Studies were assessed for levels of evidence, and each topic's aggregate grade of evidence was evaluated. A total of 74 studies reporting on 18 postoperative practices were reviewed. Postoperative pain management, prophylactic antibiotics, and lumbar drain use had the highest grades of evidence (B). The literature currently lacks high quality evidence for a majority of the reviewed ESBS precautions. There were no relevant studies to address postoperative urinary catheter use and medical intracranial pressure reduction. The evidence for postoperative ESBS precautions is heterogeneous, scarce, and generally of low quality. Although this review identified the best evidence available in the literature, it suggests the urgent need for more robust evidence. Therefore, additional high-quality studies are needed in order to devise optimal postoperative ESBS protocols.
Sections du résumé
BACKGROUND
Postoperative management strategies for endoscopic skull base surgery (ESBS) vary widely because of limited evidence-based guidance.
METHODS
The PubMed, EMBASE, and Cochrane databases were systematically reviewed from January 1990 through February 2022 to examine 18 postoperative considerations for ESBS. Nonhuman studies, articles written in a language other than English, and case reports were excluded. Studies were assessed for levels of evidence, and each topic's aggregate grade of evidence was evaluated.
RESULTS
A total of 74 studies reporting on 18 postoperative practices were reviewed. Postoperative pain management, prophylactic antibiotics, and lumbar drain use had the highest grades of evidence (B). The literature currently lacks high quality evidence for a majority of the reviewed ESBS precautions. There were no relevant studies to address postoperative urinary catheter use and medical intracranial pressure reduction.
CONCLUSION
The evidence for postoperative ESBS precautions is heterogeneous, scarce, and generally of low quality. Although this review identified the best evidence available in the literature, it suggests the urgent need for more robust evidence. Therefore, additional high-quality studies are needed in order to devise optimal postoperative ESBS protocols.
Types de publication
Journal Article
Review
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
42-71Subventions
Organisme : NIGMS NIH HHS
ID : T32 GM008620
Pays : United States
Informations de copyright
© 2022 ARS-AAOA, LLC.
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