PMID- 26980395
OWN - NLM
STAT- MEDLINE
DCOM- 20161223
LR  - 20161230
IS  - 1945-8932 (Electronic)
IS  - 1945-8932 (Linking)
VI  - 30
IP  - 2
DP  - 2016 Mar-Apr
TI  - Bleeding risk associated with resection of the middle turbinate during functional 
      endoscopic sinus surgery.
PG  - 140-2
LID - 10.2500/ajra.2016.30.4273 [doi]
AB  - BACKGROUND: The decision to resect the middle turbinate (MT) during functional 
      endoscopic sinus surgery is controversial. Although there have been a variety of 
      studies that examined the functional outcome related to this maneuver, very few 
      studies evaluated the potential for complications, in particular, epistaxis. 
      OBJECTIVE: We sought to determine if resection of the MT during functional 
      endoscopic sinus surgery leads to an increased risk for postoperative bleeding. 
      METHODS: Patients who underwent functional endoscopic sinus surgery for chronic 
      sinusitis or nasal polyposis between 2004 and 2014 at a single institution were 
      analyzed for bleeding and other complications after resection of the MT. RESULTS: 
      Between 2004 and 2014, 1185 sinus surgeries were performed by 18 surgeons. A 
      propensity matched set of 228 patients who underwent turbinate resection, and 228 
      controls were selected based on predicted probabilities from a logistic 
      regression that predicted turbinate resection and that was adjusted for age, sex, 
      and procedure. There were 89 patients with bilateral turbinates removed and 139 
      with unilateral turbinates removed. There was no significant difference in major 
      bleeding or other complication rates between the two groups. Patients who 
      underwent resection of at least one MT were 3.95 times more likely to have minor 
      bleeding compared with those who did not; this risk increased with the number of 
      turbinates resected (trend p = 0.008). Patients on anticoagulation medications 
      were at a significant risk of bleeding if their MT was removed (p = 0.007), 
      whereas patients on aspirin or antiplatelet therapy were not at a significant 
      risk. CONCLUSION: There was no increased risk of major bleeding or other 
      complication associated with resection of the MT. However, there was a 
      significantly increased minor bleeding rate associated with MT resection, 
      particularly if the patient was on anticoagulants.
FAU - Miller, Anya J
AU  - Miller AJ
AD  - Department of Otolaryngology, Henry Ford Health System, Detroit, Michigan, USA.
FAU - Bobian, Michael
AU  - Bobian M
FAU - Peterson, Ed
AU  - Peterson E
FAU - Deeb, Robert
AU  - Deeb R
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am J Rhinol Allergy
JT  - American journal of rhinology & allergy
JID - 101490775
RN  - 0 (Anticoagulants)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
MH  - Adult
MH  - Anticoagulants/therapeutic use
MH  - Aspirin/therapeutic use
MH  - Endoscopy
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Nasal Polyps/complications/drug therapy/*surgery
MH  - Platelet Aggregation Inhibitors/therapeutic use
MH  - Postoperative Hemorrhage/*epidemiology/prevention & control
MH  - *Rhinoplasty
MH  - Risk Factors
MH  - Sinusitis/complications/drug therapy/*surgery
MH  - Turbinates/drug effects/*surgery
EDAT- 2016/03/17 06:00
MHDA- 2016/12/24 06:00
CRDT- 2016/03/17 06:00
PHST- 2016/03/17 06:00 [entrez]
PHST- 2016/03/17 06:00 [pubmed]
PHST- 2016/12/24 06:00 [medline]
AID - 10.2500/ajra.2016.30.4273 [doi]
PST - ppublish
SO  - Am J Rhinol Allergy. 2016 Mar-Apr;30(2):140-2. doi: 10.2500/ajra.2016.30.4273.