title: French Otorhinolaryngology Society guidelines for day-case nasal surgery.
abstract: OBJECTIVE
  The French Otorhinolaryngology Society (SFORL) set up a work group to draw up a consensus document on day-case surgery in four rhinologic procedures: endoscopic middle meatal antrostomy (French National Health Insurance (CCAM) code GBPE001), septoplasty (GAMA007), and reduction of nasal bone fracture using a direct approach (LAEA007) and using a closed technique (LAEP002).
  
  
  METHODS
  Methodology followed the French Health Authority (HAS) "Methodological Bases for Drawing Up Professional Guidelines by Formalized Consensus" published in January 2006; the method chosen was the short version of the RAND/UCLA Appropriateness Method (without editorial group), as the work group topic was highly specialized, with few experts available.
  
  
  RESULTS
  Ahead of any day-case sinonasal surgery, it is recommended that patient eligibility criteria be respected and hemorrhagic risk assessed; preference should be given to short procedures involving little variation in surgery time and minimizing blood-loss, and associated procedures (e.g., septoplasty+turbinectomy) should be avoided. The patient and family should be informed of specific hemorrhagic, orbital and/or neuromeningeal risks, onset of which may preclude discharge home. Uni- or bilateral postoperative nasal packing is not a contraindication to day-case management.
  
  
  CONCLUSIONS
  All four procedures may be performed on a day-case basis. Eligibility criteria should be systematically respected, but hemorrhagic risk, which is very specific to the sinonasal organ, is to be assessed on a case-by-case basis, as it is a major issue in this kind of management for a non-negligible number of patients.
authors.affiliation: Service d'ORL et chirurgie cervico-faciale, hôpital Pellegrin, centre Michelet, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France. Electronic address: ludovic.de-gabory@chu-bordeaux.fr.
authors.forename: L
authors.initials: L
authors.lastname: de Gabory
authors.affiliation: Service d'ORL et de chirurgie cervico-faciale, CHU de Toulouse, 31059 Toulouse cedex 9, France.
authors.forename: E
authors.initials: E
authors.lastname: Serrano
authors.affiliation: Institut Arthur-Vernes, Paris, France.
authors.forename: J-B
authors.initials: JB
authors.lastname: Lecanu
authors.affiliation: Service d' O.R.L. et de chirurgie cervico-faciale, hôpital Saint-Joseph, Paris, France.
authors.forename: D
authors.initials: D
authors.lastname: Ebbo
authors.affiliation: Cabinet médical, Rueil-Malmaison, France.
authors.forename: F
authors.initials: F
authors.lastname: Coudert
authors.affiliation: Centre médical Alexandre-Dumas, Amiens, France.
authors.forename: M
authors.initials: M
authors.lastname: Hanau
authors.affiliation: Service d'ORL et de chirurgie cervico-faciale, centre hospitalier intercommunal de Créteil et CHU Henri Mondor, 94010 Créteil cedex, France.
authors.forename: V
authors.initials: V
authors.lastname: Escabasse
mesh_terms: D000556:Ambulatory Surgical Procedures / Q000592:standards*; D006801:Humans; D059747:Nasal Surgical Procedures / Q000592:standards*
keywords: Day-case surgery; Guidelines; Rhinology; Sinus surgery