Temporal Effects of Tranexamic Acid Administration on Functional Endoscopic Sinus Surgery

TL;DR

This study examines how tranexamic acid affects outcomes in sinus surgery when administered before the procedure.

Contribution

The study is the first to investigate the time-dependent effects of tranexamic acid within the same patient during surgery.

Findings

Tranexamic acid allowed comparable surgical quality on both sides during bilateral sinus surgery.

No significant differences in operative time or endoscopic scores were found between first and second sides.

Eosinophilic and non-eosinophilic chronic rhinosinusitis groups showed similar outcomes with tranexamic acid.

Abstract

Introduction

Functional endoscopic sinus surgery (FESS) is a commonly performed procedure, and tranexamic acid (TXA) has been shown to improve surgical outcomes. However, no previous studies have examined the time-dependent effects of TXA within the same patient during surgery. This study was conducted to address this gap.

Methods

This study included patients who underwent bilateral full-house FESS performed by a single surgeon at each institution. Patient demographics, operative times, and endoscopic scores for each side were retrospectively collected and analyzed. A within-patient design was used by comparing the first-operated side with the second-operated side during bilateral FESS.

Results

A total of 51 patients were included. The mean operative times for the first and second sides were 28 min 25 s and 28 min 49 s, respectively. The mean endoscopic scores were 1.4 and 1.5, respectively; these differences were not statistically significant. Patients were further stratified into eosinophilic chronic rhinosinusitis (ECRS) and non-ECRS groups to evaluate differences in operative time and endoscopic scores. No significant differences were found between the two groups.

Conclusion

Intravenous administration of 1000 mg TXA before surgery allowed bilateral full-house FESS to be performed with comparable quality on both sides. If the procedure is completed within the approximate 2-hour elimination half-life of TXA, additional or continuous administration may not be necessary.