title: Systematic review of topical vasoconstrictors in endoscopic sinus surgery.
abstract: OBJECTIVE
  The objective of this study is to systematically review the literature and examine the safety for the use of topical vasoconstrictors in endoscopic sinus surgery.
  
  
  METHODS
  Systematic review clinical trials.
  
  
  METHODS
  A systematic literature search was performed in MEDLINE, EMBASE, The Cochrane Library, and National Guideline Clearinghouse, and references in the selected articles.
  
  
  RESULTS
  The search criteria captured 42 manuscripts with relevant titles. A systematic review on the topical use of phenylephrine was found; however, no other systematic review, meta-analyses, or clinical guidelines were identified. Six randomized clinical trials or comparative studies, as well as multiple case reports and review articles were also identified. The literature supports the safety of oxymetazoline and epinephrine when used judiciously in carefully selected patients undergoing endoscopic sinonasal surgery; however, topical phenylephrine is not recommended because of its risk profile.
  
  
  CONCLUSIONS
  In sinus or nasal surgery, topical vasoconstrictors should be used in a manner that minimizes the risk of cardiovascular morbidity.
authors.affiliation: Department of Otolaryngology and Head and Neck Surgery, Eastern Virginia Medical School, Norfok, Virginia 23507, USA.
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Higgins
authors.forename: Peter H
authors.initials: PH
authors.lastname: Hwang
authors.forename: Todd T
authors.initials: TT
authors.lastname: Kingdom
authors.forename: Richard R
authors.initials: RR
authors.lastname: Orlandi
authors.forename: Heinz
authors.initials: H
authors.lastname: Stammberger
authors.forename: Joseph K
authors.initials: JK
authors.lastname: Han
mesh_terms: D000287:Administration, Topical; D002986:Clinical Trials as Topic; D004724:Endoscopy; D006801:Humans; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D010256:Paranasal Sinuses / Q000601:surgery*; D010656:Phenylephrine / Q000008:administration & dosage / Q000009:adverse effects; D014662:Vasoconstrictor Agents / Q000008:administration & dosage*
chemical_list: D014662:Vasoconstrictor Agents; D010656:Phenylephrine