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Invited Commentary
December 2013

The Role of Middle Meatal Dressings in Endoscopic Sinus Surgery

Author Affiliations
  • 1Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland

Copyright 2013 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Otolaryngol Head Neck Surg. 2013;139(12):1354-1355. doi:10.1001/jamaoto.2013.5475

Outcomes in endoscopic sinus surgery are determined by an interplay of numerous factors, some intrinsic to the patient and others related to management decisions and actions taken by the surgeon before, during, and after surgery. There is great variety in the specific perioperative medical regimens and surgical techniques that sinus surgeons employ. This is in part necessitated by the heterogeneity of sinus disease but mainly reflects individual practice preferences derived from training, experience, and interpretation of expert recommendations. A relatively small number of these interventions have a strong evidence basis in randomized clinical trials. In formulating treatment plans, we all strive to use our informed clinical judgment to achieve the best results for our patients. One of the numerous decisions faced along the way in the surgical management of sinusitis is the placement of a postsurgical middle meatal dressing. The article by Soler and Schlosser1 in this issue cogently reviews the current evidence regarding the pros and cons of this practice. Interestingly, despite the widespread use of middle meatal dressings and the number of products on the market, Soler and Schlosser1 conclude, as others have in the past,24 that insufficient evidence exists to demonstrate a necessity for dressings in most endoscopic sinus surgery procedures.

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