The Clinical Outcome of Image‐Guided System in Endoscopic Sinus Surgery for Chronic Rhinosinusitis: A Systematic Review and Meta‐Analysis

ABSTRACT Objective Although image‐guided system (IGS) is considered useful in endoscopic sinus surgery (ESS), its impact on clinical outcomes needs further evaluation. This study aimed to compare clinical outcomes in patients with chronic rhinosinusitis (CRS) undergoing ESS with or without IGS. Data...

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Main Authors: Kangchen Lyu, Baoying Tan, Ziling Su, Jianwei Xuan
Format: Article
Language:English
Published: Wiley 2025-04-01
Series:Laryngoscope Investigative Otolaryngology
Subjects:
Online Access:https://doi.org/10.1002/lio2.70106
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author Kangchen Lyu
Baoying Tan
Ziling Su
Jianwei Xuan
author_facet Kangchen Lyu
Baoying Tan
Ziling Su
Jianwei Xuan
author_sort Kangchen Lyu
collection DOAJ
description ABSTRACT Objective Although image‐guided system (IGS) is considered useful in endoscopic sinus surgery (ESS), its impact on clinical outcomes needs further evaluation. This study aimed to compare clinical outcomes in patients with chronic rhinosinusitis (CRS) undergoing ESS with or without IGS. Data Sources Two independent reviewers searched PubMed, EMBASE, Cochrane, CNKI, WanFang, and VIP to identify comparative clinical studies on clinical outcomes of ESS with or without IGS. Methods The primary outcome were total complications. Secondary outcomes were recurrence, revision surgery, blood loss, surgical time, and patient‐reported outcomes. A meta‐analysis was performed to calculate odds ratios (OR) and weighted mean difference (WMD). Results A total of 16 studies were included with a total sample size of 3014 patients. Compared with non‐IGS, total complications were less common in IGS group (OR = 0.52, 95% CI, 0.37 to 0.74, p < 0.01), and recurrence rate and revision surgery rate in IGS group was also lower (recurrence rate: OR = 0.31, 95% CI, 0.18 to 0.52, p < 0.001; revision surgery rate: OR = 0.59, 95% CI, 0.36 to 0.98, p = 0.04). What is more, IGS could reduce intraoperative blood loss (WMD = −10.74 mL; 95% CI, −20.92 to −0.57; p = 0.04) and surgical time (WMD = −6.25 min; 95% CI, −9.59 to −2.90, p < 0.001). Conclusion Compared with non‐IGS, IGS‐assisted ESS was associated with a lower risk of total complications, recurrence, and revision surgery, and with a reduction of intraoperative blood loss and surgical time. These findings support the clinical use of IGS as an adjunct in ESS for CRS patients. Level of Evidence 3
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spelling doaj-art-cf8df62f27094399b5e75d9b5c9c9a912025-08-20T02:20:22ZengWileyLaryngoscope Investigative Otolaryngology2378-80382025-04-01102n/an/a10.1002/lio2.70106The Clinical Outcome of Image‐Guided System in Endoscopic Sinus Surgery for Chronic Rhinosinusitis: A Systematic Review and Meta‐AnalysisKangchen Lyu0Baoying Tan1Ziling Su2Jianwei Xuan3Health Economic Research Institute, School of Pharmacy, Sun Yat‐Sen University Guangzhou ChinaHealth Economic Research Institute, School of Pharmacy, Sun Yat‐Sen University Guangzhou ChinaHealth Economic Research Institute, School of Pharmacy, Sun Yat‐Sen University Guangzhou ChinaHealth Economic Research Institute, School of Pharmacy, Sun Yat‐Sen University Guangzhou ChinaABSTRACT Objective Although image‐guided system (IGS) is considered useful in endoscopic sinus surgery (ESS), its impact on clinical outcomes needs further evaluation. This study aimed to compare clinical outcomes in patients with chronic rhinosinusitis (CRS) undergoing ESS with or without IGS. Data Sources Two independent reviewers searched PubMed, EMBASE, Cochrane, CNKI, WanFang, and VIP to identify comparative clinical studies on clinical outcomes of ESS with or without IGS. Methods The primary outcome were total complications. Secondary outcomes were recurrence, revision surgery, blood loss, surgical time, and patient‐reported outcomes. A meta‐analysis was performed to calculate odds ratios (OR) and weighted mean difference (WMD). Results A total of 16 studies were included with a total sample size of 3014 patients. Compared with non‐IGS, total complications were less common in IGS group (OR = 0.52, 95% CI, 0.37 to 0.74, p < 0.01), and recurrence rate and revision surgery rate in IGS group was also lower (recurrence rate: OR = 0.31, 95% CI, 0.18 to 0.52, p < 0.001; revision surgery rate: OR = 0.59, 95% CI, 0.36 to 0.98, p = 0.04). What is more, IGS could reduce intraoperative blood loss (WMD = −10.74 mL; 95% CI, −20.92 to −0.57; p = 0.04) and surgical time (WMD = −6.25 min; 95% CI, −9.59 to −2.90, p < 0.001). Conclusion Compared with non‐IGS, IGS‐assisted ESS was associated with a lower risk of total complications, recurrence, and revision surgery, and with a reduction of intraoperative blood loss and surgical time. These findings support the clinical use of IGS as an adjunct in ESS for CRS patients. Level of Evidence 3https://doi.org/10.1002/lio2.70106blood losschronic rhinosinusitiscomplicationsendoscopic sinus surgeryimage‐guided systemmeta‐analysis
spellingShingle Kangchen Lyu
Baoying Tan
Ziling Su
Jianwei Xuan
The Clinical Outcome of Image‐Guided System in Endoscopic Sinus Surgery for Chronic Rhinosinusitis: A Systematic Review and Meta‐Analysis
Laryngoscope Investigative Otolaryngology
blood loss
chronic rhinosinusitis
complications
endoscopic sinus surgery
image‐guided system
meta‐analysis
title The Clinical Outcome of Image‐Guided System in Endoscopic Sinus Surgery for Chronic Rhinosinusitis: A Systematic Review and Meta‐Analysis
title_full The Clinical Outcome of Image‐Guided System in Endoscopic Sinus Surgery for Chronic Rhinosinusitis: A Systematic Review and Meta‐Analysis
title_fullStr The Clinical Outcome of Image‐Guided System in Endoscopic Sinus Surgery for Chronic Rhinosinusitis: A Systematic Review and Meta‐Analysis
title_full_unstemmed The Clinical Outcome of Image‐Guided System in Endoscopic Sinus Surgery for Chronic Rhinosinusitis: A Systematic Review and Meta‐Analysis
title_short The Clinical Outcome of Image‐Guided System in Endoscopic Sinus Surgery for Chronic Rhinosinusitis: A Systematic Review and Meta‐Analysis
title_sort clinical outcome of image guided system in endoscopic sinus surgery for chronic rhinosinusitis a systematic review and meta analysis
topic blood loss
chronic rhinosinusitis
complications
endoscopic sinus surgery
image‐guided system
meta‐analysis
url https://doi.org/10.1002/lio2.70106
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