title: Benefit of Preoperative Oral Steroids during Sinus Surgery when Utilizing Concentrated Topical Epinephrine.
abstract: OBJECTIVE
  Oral steroids have been advocated in the preoperative setting as a means of reducing intraoperative blood loss and surgical time during sinus surgery. The purpose of this study was to analyze the impact of preoperative oral steroid administration on intraoperative bleeding and surgical duration when coupled with concentrated topical epinephrine.
  
  
  METHODS
  The medical records of 302 patients who underwent bilateral 'full house' sinus surgery were reviewed. Concentrated topical epinephrine and inhalational anesthesia was used in all patients. Surgical duration and estimated blood loss were compared between the preoperative steroid-exposed and steroid-naive groups. χ2 and Student's t tests were used for statistical analysis.
  
  
  RESULTS
  One hundred and forty-two patients were exposed to steroid, while the remaining 160 were steroid naive. No significant differences were found with respect to surgical time between the steroid-exposed (96.91 ± 25.97 min) and steroid-naive patients (91.24 ± 32.29 min, p = 0.100). The steroid-exposed group demonstrated a marginally increased blood loss (66.03 ± 55.81 ml) as compared to steroid-naive patients (55.00 ± 38.71 ml, p = 0.048).
  
  
  CONCLUSIONS
  When coupled with intraoperative concentrated topical epinephrine use, preoperative oral steroid administration provides no clinically significant benefit with respect to reduced intraoperative bleeding or surgical duration.
authors.affiliation: Otorhinolaryngology Department, Ordu University Faculty of Medicine, Ordu, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Korkmaz
authors.forename: William
authors.initials: W
authors.lastname: Yao
authors.forename: Mukadder
authors.initials: M
authors.lastname: Korkmaz
authors.forename: Benjamin S
authors.initials: BS
authors.lastname: Bleier
mesh_terms: D000284:Administration, Oral; D000287:Administration, Topical; D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D016208:Databases, Factual; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D013517:Otorhinolaryngologic Surgical Procedures / Q000009:adverse effects / Q000379:methods; D010256:Paranasal Sinuses / Q000503:physiopathology / Q000601:surgery*; D011300:Preoperative Care / Q000379:methods; D012016:Reference Values; D012189:Retrospective Studies; D012220:Rhinitis / Q000175:diagnosis / Q000601:surgery; D018570:Risk Assessment; D012852:Sinusitis / Q000175:diagnosis / Q000601:surgery; D013256:Steroids / Q000008:administration & dosage*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D013256:Steroids; D004837:Epinephrine