Optimization of the Surgical Field in Endoscopic Sinus Surgery: an Evidence-Based Approach

  • Saad AlsalehEmail author
  • Jamil Manji
  • Amin Javer
Rhinosinusitis (J. Mullol, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Rhinosinusitis


Purpose of Review

The advent of endoscopic sinus surgery (ESS) has enabled the development of minimally invasive surgical procedures in Rhinology. However, proficiency with ESS techniques can still be hampered by poorly controlled bleeding limiting visibility of the surgical field (VSF). This can lead to increased operating time and, more importantly, increased risk of major and minor complications. To optimize the VSF and mitigate the risk of complications, many strategies have been explored.

Recent Findings

This is a narrative review of the relative risks and benefits of pre- and intra-operative interventions aimed at optimizing intraoperative conditions during ESS. The value of these interventions is determined based on their impact on intraoperative blood loss, time of surgery, and the VSF, and weighed against their adverse event profile.


This review provides a comprehensive overview of the evidence relating to the safety and efficacy of interventions used to improve intraoperative conditions during ESS.


Hemostasis Blood loss Endoscopic sinus surgery Surgical field Rhinosinusitis Evidence-based 


Compliance with Ethical Standards

Conflict of Interest

The authors declare no conflicts of interest relevant to this manuscript.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Otolaryngology – Head and Neck Surgery Department, College of MedicineKing Saud University Medical CityRiyadhSaudi Arabia
  2. 2.St. Paul’s Sinus CentreVancouverCanada

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