title: Postoperative care in endoscopic sinus surgery: a critical review.
abstract: OBJECTIVE
  Chronic rhinosinusitis with and without nasal polyps is a common disease affecting people all over the world. Functional endoscopic sinus surgery (FESS) has become the gold standard treatment for medically refractive disease. Postoperative care is recommended by international leaders as an important part of the patient's management. This article is a critical review and discussion focusing on postoperative care, which is based on expert opinion, clinical studies, randomized controlled trials and meta-analysis studies.
  
  
  RESULTS
  Postoperative care including nasal rinsing, topical corticosteroids, antibiotics and avoidance of nasal packing are unanimously considered to be the cornerstone of best practice following FESS. However, the effectiveness of in-office nasal debridement is still under debate.
  
  
  CONCLUSIONS
  There is a lack of consensus regarding the necessity of performing in-office nasal debridement and the majority of clinicians carry out their postoperative care according to experience and their own preference. This is often determined by the extent of surgery performed, the severity of the postoperative inflammation, as well as being dependent on the patient's discomfort, the time constraints associated with postoperative care and the costs associated with additional appointments. Ideally, nasal debridement should be performed by the operating surgeon under endoscopic control both gently and atraumatically.
authors.affiliation: aENT Department, CHU UCL Namur, Yvoir, Belgium bThe Royal National Throat, Nose and Ear Hospital, London, UK cENT Department, CHU Sart Tilman, Liège, Belgium.
authors.forename: Philippe
authors.initials: P
authors.lastname: Eloy
authors.forename: Peter
authors.initials: P
authors.lastname: Andrews
authors.forename: Anne-Lise
authors.initials: AL
authors.lastname: Poirrier
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003646:Debridement / Q000379:methods; D019468:Disease Management; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D055556:Nasal Lavage / Q000379:methods*; D010254:Paranasal Sinus Diseases / Q000175:diagnosis / Q000601:surgery; D011182:Postoperative Care / Q000379:methods*; D012220:Rhinitis / Q000175:diagnosis / Q000601:surgery; D012852:Sinusitis / Q000175:diagnosis / Q000601:surgery; D015607:Stents; D000267:Tissue Adhesions / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents