{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T22:45:23Z","timestamp":1785797123082,"version":"3.56.0"},"reference-count":10,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Otolaryngology - Head &amp; Neck Surgery"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p> Cocaine has traditionally been the topical decongestant most frequently used for visualization of the surgical field in Endoscopic Sinus Surgery (ESS). Alternatives include xylometazoline, oxymetazoline, and epinephrine. The understanding of the safety profile of each agent is changing, as are the practices of Otolaryngologists-Head &amp; Neck Surgeons. The objective of this study is to determine decongestant use practices in ESS across Canada, which has not previously been studied. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> A cross-sectional survey design using a 24-item electronic questionnaire was distributed to actively practicing members of the Canadian Society of Otolaryngology-Head and Neck Surgery via email. A French translated version of the survey was also available. Questions explored the respondents\u2019 demographics and decongestion practices for ESS. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Ninety-six surveys from otolaryngologists practicing in Canada were completed (19% response rate). The average time in practice was 16.5\u2009years (range 1\u201350\u2009years, SD 12.0\u2009years). Twenty-six (27%) of respondents use some form of cocaine solution for topical decongestion in ESS. Over a total of over 1500 combined practice-years, eight respondents (8%) personally experienced an adverse event that could be attributed to cocaine, including two mortalities. One cardiac even was directly attributable to the patients\u2019 use of recreational cocaine in the immediate pre-operative period. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> The popularity of cocaine for topical decongestion in ESS in present-day Canada is less than in surveys from other countries. However, there are few reported adverse events with long-term consequences that are attributable to intraoperative cocaine. Considering the beneficial effects of cocaine for visualization and pain control, this change in practice warrants further investigation. <\/jats:p><\/jats:sec>","DOI":"10.1186\/s40463-019-0337-8","type":"journal-article","created":{"date-parts":[[2019,3,18]],"date-time":"2019-03-18T12:03:16Z","timestamp":1552910596000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["Contemporary decongestant practices of Canadian otolaryngologists for endoscopic sinus surgery"],"prefix":"10.1177","volume":"48","author":[{"given":"Jonathan W.","family":"Reid","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Western University, London, Ontario, Canada"},{"name":"Schulich School of Medicine and Dentistry, 1151 Richmond St, N6A 5C1, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian W.","family":"Rotenberg","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Western University, London, Ontario, Canada"},{"name":"St. Joseph's Hospital, 268 Grosvenor Street, N6A 4V2, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5825-2759","authenticated-orcid":false,"given":"Leigh J","family":"Sowerby","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Western University, London, Ontario, Canada"},{"name":"St. Joseph's Hospital, 268 Grosvenor Street, N6A 4V2, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,1,1]]},"reference":[{"issue":"1","key":"bibr1-s40463-019-0337-8","first-page":"26","volume":"5","author":"Irani D","year":"2002","journal-title":"Aust J Oto - Laryngol St Leonards"},{"key":"bibr2-s40463-019-0337-8","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25836"},{"key":"bibr3-s40463-019-0337-8","doi-asserted-by":"publisher","DOI":"10.1111\/coa.12563"},{"key":"bibr4-s40463-019-0337-8","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21286"},{"key":"bibr5-s40463-019-0337-8","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.1988.tb09011.x"},{"issue":"6","key":"bibr6-s40463-019-0337-8","first-page":"969","volume":"84","author":"Johns ME","year":"1977","journal-title":"Trans Sect Otolaryngol Am Acad Ophthalmol Otolaryngol"},{"key":"bibr7-s40463-019-0337-8","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200409000-00022"},{"key":"bibr8-s40463-019-0337-8","doi-asserted-by":"publisher","DOI":"10.1258\/002221503762624530"},{"key":"bibr9-s40463-019-0337-8","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-4486.2011.02280.x"},{"key":"bibr10-s40463-019-0337-8","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.3283.1018"}],"container-title":["Journal of Otolaryngology - Head &amp; Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1186\/s40463-019-0337-8","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s40463-019-0337-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1186\/s40463-019-0337-8","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s40463-019-0337-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1186\/s40463-019-0337-8","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T15:07:37Z","timestamp":1741619257000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1186\/s40463-019-0337-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,1]]}},"alternative-id":["10.1186\/s40463-019-0337-8"],"URL":"https:\/\/doi.org\/10.1186\/s40463-019-0337-8","relation":{},"ISSN":["1916-0216","1916-0216"],"issn-type":[{"value":"1916-0216","type":"print"},{"value":"1916-0216","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,1]]},"article-number":"15"}}