Hot Saline Irrigation for Improving Surgical Field Visibility in Endoscopic Sinus Surgery: A Systematic Review and Meta-Analysis
Year: 2026
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: Background: Intraoperative bleeding during endoscopic sinus surgery (ESS) impairs visualization and increases operative risks. Hot saline irrigation (HSI) has been proposed as a simple, safe hemostatic adjunct compared with room temperature saline. Objective: To evaluate the effects of HSI versus room temperature saline on surgical field visibility, blood loss, operative duration, and hemodynamic stability in ESS. Methods: Systematic review and meta-analysis of randomized and nonrandomized controlled trials identified through PubMed, Embase, Cochrane CENTRAL, and ClinicalTrials.gov up to 30 October 2025. Outcomes were pooled using random-effects inverse-variance models in RevMan 5.4.1 by Cochrane. Results: Seven studies (n = 453 patients) were included. HSI significantly improved Boezaart bleeding scores (mean difference [MD] −0.68, 95% confidence interval [CI] −1.01 to −0.34; P = .0002; I 2 = 79.7%), reduced intraoperative blood loss (MD −56.33 mL, 95% CI −57.22 to −55.44; I 2 = 37.1%), and shortened operative time (MD −9.78 minutes, 95% CI −14.62 to −4.94; P < .0001; I 2 = 85.0%). No significant difference was observed in mean arterial pressure (MD −0.68 mmHg, 95% CI −2.22 to 0.86; P = .39). Conclusion: HSI significantly enhances surgical field visibility, reduces blood loss, and shortens operative duration during ESS without affecting hemodynamic stability. It represents a safe, low-cost alternative or complement to pharmacological hemostatic agents.
Source: Ear Nose & Throat Journal
Language: English
Subfield: Otorhinolaryngology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,650
OpenAlex ID: W7130386587