{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T07:46:18Z","timestamp":1787730378069,"version":"build-2784847793"},"reference-count":23,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,12,7]],"date-time":"2020-12-07T00:00:00Z","timestamp":1607299200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>In this study we compared intraoperative bleeding and regional cerebral oxygenation in patients with different degrees of the reverse Trendelenburg position (RTP) during endoscopic sinus surgery (ESS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In total, 120 patients with chronic rhinosinusitis treated by ESS were randomly assigned to the following 4 groups: a horizontal position (HP) group, and 5\u00b0, 10\u00b0, and 15\u00b0 RTP (5\u2010RTP, 10\u2010RTP, and 15\u2010RTP, respectively) groups. The primary outcome was the Boezaart grading scale (BS). The cerebral oxygen saturation (ScO<jats:sub>2<\/jats:sub>), total blood loss, numerical rating scale (NRS) scores, and complications were also recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median BS values in the HP, 5\u2010RTP, 10\u2010RTP, and 15\u2010RTP groups were 2.0, 2.0, 2.1, and 1.7, respectively. Multiple pairwise comparisons of the BS showed significant differences between the 15\u2010RTP group and the other 3 groups (HP, 5\u2010RTP, and 10\u2010RTP). Regarding the NRS and bleeding rate, significant differences were found between the HP and 15\u2010RTP groups. No difference was found in ScO<jats:sub>2<\/jats:sub> among the 4 groups, and no cerebral desaturation events occurred in any group. No complications, including vital organ (heart, brain, and kidney) dysfunction problems, were reported in this study during hospitalization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Compared with HP, 5\u2010RTP, and 10\u2010RTP, 15\u2010RTP can improve visual clarity during ESS, and ScO<jats:sub>2<\/jats:sub> is not affected by the degree of RTP. No cerebral deoxygenation or vital organ dysfunction was observed in this study. Therefore, we recommend 15\u2010RTP with moderate deliberate hypotension for ESS.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.22734","type":"journal-article","created":{"date-parts":[[2020,12,7]],"date-time":"2020-12-07T08:23:02Z","timestamp":1607329382000},"page":"993-1000","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["The 15\u00b0 reverse Trendelenburg position can improve visualization without impacting cerebral oxygenation in endoscopic sinus surgery\u2014A prospective, randomized study"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1101-8893","authenticated-orcid":false,"given":"Wenjing","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Beijing TongRen Hospital Capital Medical University  Beijing 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