Increasing RTP Levels Reduces Bleeding, Improves Surgical Field-of-View in ESS

What is the optimum amount of reverse Trendelenburg position to reduce bleeding without compromising surgical technique in endoscopic sinus surgery (ESS)?

Background: Bleeding can significantly reduce visualization of the surgical field in ESS. Various measures can be used to reduce or control bleeding in ESS, including the reverse Trendelenburg position (RTP). The optimum angle of RTP that gives the maximum benefit for reduction of bleeding and does not interfere with surgical access has not been determined.

Study design: Prospective, double-blind, randomized, controlled study.

Setting: Rhinology Clinic, St. Paul’s Sinus Centre, Vancouver, British Columbia, Canada.