European Archives of Oto-Rhino-Laryngology最新文献

{"title":"Pre- and post-operative outcomes of endoscopic posterior cricoid split with graft placement.","authors":"Zahra Almoumen, Luluh Alsughayer, Hanna Alrshaid, Abdullah Sindi, Ahmed Alammar","doi":"10.1007/s00405-025-09259-2","DOIUrl":"10.1007/s00405-025-09259-2","url":null,"abstract":"<p><strong>Purpose: </strong>The primary objective of this study was to assess the impact of EPCS/RG on swallowing function using Dysphagia Outcome and Severity Scale (DOSS) scores. Secondary objectives included decannulation rates, voice changes, and breathing improvements assessed by Empey index.</p><p><strong>Methods: </strong>This retrospective study included patients who underwent EPCS/RG between 2017 and 2024. Patient demographics, pre- and post-procedure swallowing capacity (DOSS), tracheostomy status, and pulmonary function were extracted from medical records. Statistical analysis included Fisher exact test, Mann-Whitney-U test and Spearman's correlation.</p><p><strong>Results: </strong>A total of 23 patients were included. The mean age was 9 years, with 68% being male. The median DOSS score changed insignificantly from 7 pre-op to 6 post-op (p = 0.8087), while Empey index significantly improved (p = 0.022).</p><p><strong>Conclusion: </strong>EPCS/RG did not significantly affect swallowing capacity but improved pulmonary function and increased decannulation rates.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"2015-2019"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smartphone-based thermal imaging for pedicled skin flaps: a pilot study toward objective perfusion assessment in facial, head, and neck reconstruction.","authors":"Lukas Sebastian Fiedler, Meyer Tobias, Lippert M Burkard, Adrian Lukas","doi":"10.1007/s00405-024-09048-3","DOIUrl":"10.1007/s00405-024-09048-3","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to develop a practical algorithm for utilizing smartphone-based thermal imaging (SBTI) in the perioperative setting and to establish a standardized evaluation method for objectively assessing SBTI images for cutaneous perfusion of pedicled flaps in the face, head, and neck.</p><p><strong>Methods: </strong>This prospective conducted study, integrated SBTI into the assessment of 16 patients undergoing reconstructive surgery for face and neck defects. Thermal images were captured at four timepoints: after marking (T1), after flap elevation (T2), upon completion of surgery (T3), and 24 h postoperatively (T4). The flap areas were divided into three flap zones and graded based on temperature differences (ΔT), with a grading system where grade 1 indicated perfect perfusion and grades 2 to 5 indicated increasing perfusion impairment.</p><p><strong>Results: </strong>6 male and 10 female patients aged 64-93 years (mean 78.5 years) undergoing reconstructive pedicled skin flap surgery for facial and neck defects (1 × 1 cm to 11 × 8 cm) due to diagnoses of malignant cutaneous lesions were investigated. Intraoperative assessments indicated good perfusion across flaps. One postoperative dehiscence occurred in an 83-year-old male with a cervical advancement flap, correlated with a significant temperature difference (ΔT > 4 °C) intraoperatively. Statistical analysis revealed a strong positive correlation (p = 0.0003) between clinical assessment grades and ΔT values between specific flap zones at T3.</p><p><strong>Conclusion: </strong>SBTI is an easy-to-apply, low-cost, real-time and reproducible technique for indirect perfusion assessment in pedicled skin flaps of the head and neck region. Further studies are needed implementing this methodology in large and free flaps.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"2077-2085"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of intracranial and orbital complications of acute rhinosinusitis and acute otitis media in the post covid-19 era in pediatric patients.","authors":"Francesco Salonna, Valentina Foscolo, Vito Pontillo, Vito De Giglio, Luca Speranzon, Nicola Quaranta, Francesco Signorelli, Desiree Caselli, Raffaella Messina","doi":"10.1007/s00405-024-09183-x","DOIUrl":"10.1007/s00405-024-09183-x","url":null,"abstract":"<p><strong>Purpose: </strong>Acute bacterial rhinosinusitis (ABRS) and acute otitis media (AOM) are common diseases in pediatric populations that rarely lead to intracranial infection and/or orbital complications. The incidence of these complications has increased in recent years and the main aim of this study is to analyze the tendency of this increase during the pandemic years, compared with the pre-pandemic era and to propose our management of ABRS and AOM.</p><p><strong>Method: </strong>Clinical data from children, admitted to our hospital during the period from January 2018 to March 2024 with a diagnosis of complicated ABRS and AOM was collected. The sample was divided into two groups: Group A (January 2018- December 2020) and Group B (January 2021- March 2024).</p><p><strong>Results: </strong>The retrospective cohort consisted of 35 patients, seven patients (20%) belong to Group A, twenty-eight patients (80%) belong to Group B. 67.9% of subjects during the COVID-19 era tested positive for SARS CoV-2 infection on average 5.5 months prior to hospital admission. Statistical analysis showed that there was a sharp increase in surgical cases of complicated AOM and complicated ABRS, after the lock-down period, compared to the previous years.</p><p><strong>Conclusion: </strong>The main findings of the present study are the significant increase of complicated ABRS and AOM as well as severe complications requiring surgical treatment, after the COVID-19 pandemic.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"2125-2133"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of FESS on symptomatology and quality of life of patients with CRSsNP.","authors":"A Romano, Simona Barone, G Borriello, G R De Fazio, S Paesano, G Grassia, P Bonavolontà, G Dell'Aversana Orabona, S Sivero","doi":"10.1007/s00405-024-09139-1","DOIUrl":"10.1007/s00405-024-09139-1","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic rhinosinusitis (CRS) has an impact on health related quality of life (HRQOL). The objective of this study was to examine generic and disease specific HRQOL and symptoms in CRS patients before and 6 months after sinus surgery.</p><p><strong>Methods: </strong>This prospective, observational study consisted of 30 patients with chronic sinusitis. Generic and disease specific HRQOL were measured using the Short Form Health Survey (SF 36) and Sino Nasal Outcome Test (SNOT 22).</p><p><strong>Results: </strong>The results revealed that chronic sinusitis has a significant impact on a person's quality of life reflected in the vitality, mental health, social activities, physical pain and perceived health status of patients also a positive correlation emerged between functional endoscopic sinus surgery (FESS) and improvement not only in symptomatology but also overall quality of life.</p><p><strong>Conclusions: </strong>FESS turns out to be a useful and necessary intervention for the improvement of symptomatology related to chronic sinusitis but also for the improvement of the quality of life of individuals who appear to be severely affected by the condition.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"1891-1900"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic revision surgery for ossicular chain reconstruction: intraoperative findings and functional outcomes.","authors":"Juan Wang, Yueying Wang, Shubin Fang, Lusha Huang, Xiaoqing Cen, Yue Liang, Anhai Chen, Wenbin Lei, Guanxia Xiong, Xuan Wu, Kaitian Chen","doi":"10.1007/s00405-024-09068-z","DOIUrl":"10.1007/s00405-024-09068-z","url":null,"abstract":"<p><strong>Purpose: </strong>To report the intraoperative observations and hearing outcomes in patients undergoing endoscopic revision ossiculoplasty.</p><p><strong>Methods: </strong>A retrospective cohort of patients who had undergone revision ossiculoplasty were enrolled in this study. Intraoperative findings were documented. Follow-up visits were scheduled from 3 to 12 months post-surgery to assess hearing levels and record any potential complications.</p><p><strong>Results: </strong>Between April 2020 and May 2023, a total of 26 cases were enrolled, with 11 male patients represented. The mean age of the patients was 40.5 ± 9.4 years, ranging from 18 to 66 years. During the revision surgeries, various intraoperative findings were noted, including adhesive tissues affecting the activity of ossicular chain (observed in 37.0% of cases), tympanosclerosis of the ossicular chain (also in 37.0% of cases), dislocation of ossicular prosthesis (33.3%), erosion of the ossicular chain (33.3%), and identified cholesteatoma (11.1%). In terms of hearing outcomes, a significant improvement was observed. Overall, only 37.0% of patients achieved an air-bone gap of 20 dB or less, indicating the inferior outcome in revision ossiculoplasty.</p><p><strong>Conclusions: </strong>This study highlight the role of inflammatory responses (adhesion, tympanosclerosis), stapes erosion, and prosthesis dislocation, as contributing factors to the failure of primary tympanoplasty. Endoscopic revision ossiculoplasty emerges as a reliable and effective approach.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"1809-1814"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sequential or simultaneous bilateral cochlear implantation: attention, memory, and language skills in children.","authors":"Nuriye Yıldırım Gökay, Drilon Pula, Recep Karamert, Bülent Gündüz, Emre Orhan, Burak Kabiş, Hakan Gölaç, Volkan Tutar, Hakan Tutar, Mehmet Birol Uğur","doi":"10.1007/s00405-024-09061-6","DOIUrl":"10.1007/s00405-024-09061-6","url":null,"abstract":"<p><strong>Purpose: </strong>The effect of the inter-implant interval time on language and communication skills has been a subject of research for years in children with bilateral cochlear implants. This study aimed to investigate language and some attention and memory skills in children with bilateral sequential and simultaneous cochlear implants.</p><p><strong>Method: </strong>The study included a total of 40 children aged between 6 and 8 years old, grouping bilateral simultaneous cochlear implanted children, sequential implanted children with 0-2 years interval, sequential implanted children with 2-4 years interval, and normal hearing peers. The language skills of the children were assessed using the Test of Language Development: Primary 4th edition, their selective attention and coping skills with disruptive effect were evaluated using the Stroop test, sustained attention and visual-motor synchronization skills were assessed using the Cancellation Test, and short-term memory skills were evaluated using the Visual Auditory Digit Span Test. The findings were analyzed using nonparametric statistical methods, with a significance level set at 0.05.</p><p><strong>Results: </strong>Children with bilateral simultaneous cochlear implants demonstrated better performance in language skills and the attention-related subtests of the Stroop test (p < 0.05). On the other hand, children with simultaneous and sequential cochlear implants achieved similar scores in the Cancellation and the Visual Auditory Digit Span Test (p > 0.05).</p><p><strong>Conclusions: </strong>Bilateral simultaneous cochlear implantation in children is beneficial for language, selective attention, and coping with the Stroop effect. However, these children may still lag behind their normal-hearing peers in terms of language, attention, and memory skills.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"1783-1790"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term facial nerve outcome in surgically treated petrous bone cholesteatoma patients.","authors":"Melcol Hailu Yilala, Giuseppe Fancello, Lucia Belen Musumano, Lorenzo Lauda, Mario Sanna","doi":"10.1007/s00405-024-09052-7","DOIUrl":"10.1007/s00405-024-09052-7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;The term petrous bone cholesteatoma (PBC) represents a slow-growing epidermal lesion arising from the petrous part of the temporal bone. It is a rare incidence accounting for only 4-9% of all petrous bone lesions. PBC represents a real surgical challenge due to its complex relationship with critical neurovascular structures.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To demonstrate our experience in using various options of facial nerve (FN) management during surgical treatment of PBC and analyze the long-term facial function outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Retrospective medical record review in a quaternary skull-base center.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;Medical records of 298 PBC cases operated between the years 1983 and 2024 were thoroughly evaluated. Sanna's classification scheme was used to classify cases into the appropriate class and the House-Brackmann (HB) grading system of the FN was used to assess the facial function pre- and postoperatively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 298 PBC cases were surgically treated at our center. Males constitute 68% (n = 203) of total operated PBC patients while the rest 32% (95) were females, making the male-to-female ratio 2.2:1. The age in this series ranged from 9 to 85. According to updated Sanna's PBC classification, 44% were supralabyrinthine, 33% were massive, 9% were infralabyrinthine-apical, 8% were infralabyrinthine, and 5% were apical. On preoperative FN function examination, 45% (n = 133) of patients had various degrees of paresis and complete paralysis whereas 55% (n = 165) had normal FN function. The commonest degree of paresis observed was HB-III (18.5%) followed by HB-IV (5.7%). A total of 40(13.4%) patients, however, had complete facial paralysis at the initial presentation. The facial function was compromised more frequently in supralabyrinthine and massive PBCs. Among the total patients who had an abnormal facial function at presentation, 52% had paresis/paralysis for less than a year whereas 48% had FN paresis/paralysis for greater than one year. The most commonly used surgical approaches at our center were transotic (TO), modified transcochlear type A (MTCA) with rerouting of the FN, and translabyrinthine (TLAB) with external auditory canal (EAC) closure. Intraoperatively an intact fallopian canal was found only in 33% (n = 99) cases whereas the rest 67% (n = 199) had erosion of the fallopian canal either with intact (n = 24) or infiltrated FN (n = 175). The FN was maintained in the bony fallopian canal in 35% (n = 104) cases. An active form of FN management, however, was required in 65% (n = 194) of cases either intraoperatively or as a second-stage procedure. Factors affecting postoperative FN function include age, preoperative FN function (HB), duration of paralysis, class of PBC, surgical approach, and method of active FN management.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;PBCs represent diagnostically and surgically ","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"1731-1742"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bibliometric analysis of global research trends in vestibular neuritis (1980-2024).","authors":"Mehmet Akif Dündar, Ahmet Avcı, Müşerref Arık, Ahmet Tayfur Akcan, Hasan Kazak","doi":"10.1007/s00405-024-09159-x","DOIUrl":"10.1007/s00405-024-09159-x","url":null,"abstract":"<p><strong>Purpose: </strong>Vestibular neuritis (VN) is a common cause of vertigo with significant impact on patients' quality of life. This study aimed to analyze global research trends in VN using bibliometric methods to identify key themes, influential authors, institutions, and countries contributing to the field.</p><p><strong>Methods: </strong>We conducted a comprehensive search of the Web of Science Core Collection database for publications related to VN from 1980 to 2024. Bibliometric data including publication year, keywords, citations, authors, journals, institutions, and countries were extracted and analyzed using VOSviewer software.</p><p><strong>Results: </strong>A total of 624 publications were identified, showing a steady increase in VN research output, particularly after 2003. South Korea and the USA were the most prolific countries, while Acta Oto-Laryngologica and Otology & Neurotology were the leading journals in terms of publication count. Michael Strupp emerged as the most productive author. Keyword analysis revealed prominent research themes including diagnosis, treatment (vestibular rehabilitation, pharmacological interventions), pathophysiology, and the impact of VN on vestibular function.</p><p><strong>Conclusions: </strong>This bibliometric analysis provides a comprehensive overview of global VN research. The findings highlight the growing research interest in VN, with a focus on improving diagnostic accuracy, optimizing treatment strategies, and understanding the underlying mechanisms. This study can serve as a valuable resource for researchers, clinicians, and policymakers interested in the field of VN.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"1879-1890"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arcuate eminence distance to temporal bone outer table in the middle fossa repair of superior canal dehiscence.","authors":"Hong-Ho Yang, Isaac Yang, Quinton S Gopen","doi":"10.1007/s00405-024-09067-0","DOIUrl":"10.1007/s00405-024-09067-0","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the influence of arcuate eminence's distance to temporal bone outer table (AE-OT) on surgical outcomes following the middle fossa repair of superior canal dehiscence (SCD).</p><p><strong>Methods: </strong>We conducted a cohort study of consecutive repairs at a center between 2011 and 2022. AE-OT was measured on temporal bone CT imaging. Surgical outcomes were assessed with established metrics including Symptom Resolution Score (SRS), rate of Overall Symptom Improvement (OSI), and change in low-frequency air-bone gap (ΔLF-ABG) from pre- to post-surgery. Multivariable regression models assessing surgical outcomes were constructed with AE-OT as the primary predictor. Models adjusted for patient demographics, medical and surgical history, and follow-up duration.</p><p><strong>Results: </strong>A total of 402 repairs were included. Mean AE-OT was 27.1 mm (SD 2.1, range 20.8-33.9). Every mm increase in AE-OT was independently associated with a 14% reduction in odds of OSI (aOR 0.86, 95% C.I. [0.75, 0.98]) and a 4-point decrease in SRS (adj. β - 4.0 [- 6.9, - 1.1]) among frank dehiscences. AE-OT was also not associated with operative duration and ΔLF-ABG among both frank dehiscences and near dehiscences.</p><p><strong>Conclusions: </strong>Longer AE-OT predicted poorer symptomatic response but similar operative duration and audiometric improvement among frank SCD cases.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"1801-1808"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11950138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tranexamic acid in endoscopic sinus surgery: an updated systematic review and meta-analysis of randomized controlled trials.","authors":"Ebraheem Albazee, Ammar H Alabsi, Salman Hussain, Abdullah S Alghamdi, Ahmed Abu-Zaid","doi":"10.1007/s00405-024-09051-8","DOIUrl":"10.1007/s00405-024-09051-8","url":null,"abstract":"<p><strong>Purpose: </strong>To conduct an updated meta-analysis evaluating the efficacy and safety of tranexamic acid (TXA) versus control during endoscopic sinus surgery.</p><p><strong>Methods: </strong>Six databases were screened until July 7, 2024, and the quality of included randomized controlled trials (RCTs) was assessed. Endpoints were summarized as mean difference (MD) with 95% confidence intervals (CIs) using a random-effects model.</p><p><strong>Results: </strong>A total of 23 RCTs, including 29 arms and 1597 patients, were analyzed. The overall quality was rated as low-risk in 15 RCTs, high-risk in five RCTs, and of some concern in three RCTs. TXA significantly reduced intraoperative blood loss (n = 22 arms, MD = - 68.87 ml, 95% CI - 79.66, - 58.07) and operative time (n = 21 arms, MD = - 13.93 min, 95% CI - 17.49, - 10.37) compared to control. TXA also improved surgical field quality (measured on a 5-point Boezaart scale, n = 22 arms, MD = - 0.61, 95% CI - 0.88, - 0.34) and surgeon satisfaction scores (n = 9 arms, MD = 0.85, 95% CI 0.53, 1.17). No thromboembolic events were reported in either group. Leave-one-out sensitivity analyses confirmed the robustness of all endpoints, and no publication bias was detected. Subgroup analyses by route of administration (intravenous, topical, and oral) showed equal effectiveness. Additionally, analyses by sinus pathology demonstrated effectiveness in patients with severe chronic rhinosinusitis with nasal polyposis (CRSwNP). Trial sequential analysis showed conclusiveness for all outcomes.</p><p><strong>Conclusion: </strong>Perioperative TXA, whether administered systemically or topically, correlates with decreased intraoperative blood loss, shortened operating times, and enhanced surgical visualization compared to control interventions. However, these findings are constrained by significant heterogeneity and varying reporting quality among studies.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"1693-1707"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}