{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:08:31Z","timestamp":1772168911393,"version":"3.50.1"},"update-to":[{"DOI":"10.12688\/f1000research.143321.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T00:00:00Z","timestamp":1717545600000}}],"reference-count":34,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T00:00:00Z","timestamp":1717545600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>Background Chronic rhinosinusitis (CRS) is a condition that affects 5\u201312% of the general population. Endoscopic sinus surgery (ESS) is the preferred treatment because of its few adverse effects and highest success rates. The most common post-operative consequences include synechia, nasal blockage, and disease recurrence. Spray cryotherapy is a novel therapeutic approach with promising outcomes for the treatment of upper airway disorders. This review aimed to investigate the effects of spray cryotherapy (SCT) following ESS in patients with chronic rhinosinusitis. Methods Six electronic databases were searched for randomized clinical trials (RCTs). The selected trials were evaluated for methodological quality, and data were extracted by two independent reviewers. The Cochrane risk-of-bias tool was used to assess the quality of evidence. Results Three RCTs with 85 patients were included in the final analysis. SCT was related to -16 and -77 reductions in Lund-McKay and SNOT-22 scores after 36 weeks of follow-up, in contrast to a placebo, which showed -10.4, -65. Regarding the side effects of SCT, no adverse effects were reported, and visual assessments showed no pain, visual field loss, or any other ocular complications. Conclusions SCT is a new treatment modality after endoscopic sinus surgery that shows an effective post-operative management strategy with better post-operative scales (Lund-McKay, SNOT-22, POSE, and Lund-Kennedy) and less edema, obstruction, crusting, and inflammation with minimal or no side effects. However, further research with longer follow-ups, a larger sample size, and subjective assessment is needed to assess any possible long-term side effects.<\/ns3:p>","DOI":"10.12688\/f1000research.143321.2","type":"journal-article","created":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T13:00:35Z","timestamp":1717592435000},"page":"4","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The safety and efficacy of spray cryotherapy after endoscopic sinus surgery in chronic rhinosinusitis: A systematic review of randomized controlled trials"],"prefix":"10.12688","volume":"13","author":[{"given":"Mohammad J. 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It may be worth adding information about the difficulties and challenges of postoperative care of the nasal mucosa after ESS, postoperative access to prevent scarring and synechiae formation. Response: We appreciate the suggestion to provide more details on postoperative care. We will add information focusing on these challenges and how they can be managed effectively, as highlighted in references 5 and 6.  Comment (Resolved Line 239): The paragraph beginning &quot;Greenwald et al.&quot; is most likely a misspell: replace endoscopic sinus surgery with spray cryotherapy. Given the researchers' stated goal, it seems rational to replace chronic rhinitis with chronic rhinosinusitis in the conclusion section. Response: The corrections have been made to accurately reflect the treatment discussed and the condition being addressed in the conclusion.  Comment: The authors applied an extremely rigorous selection criterion for articles, including only those containing randomized and blinded clinical trials. This design is not well-suited for surgical procedures and introduces significant uncertainties about the reliability of the data included in the clinical trials. The inclusion of other well-designed prospective studies would have been acceptable. Response: We use randomized control trials as our inclusion criterion to ensure the highest quality data. Despite an extensive search for additional relevant studies, none met our rigorous standards, not even non-randomized clinical studies.  Comment (Lines 99-101): Given the novelty of spray cryotherapy in the field of ESS, the authors could have provided more information about this therapy in the Introduction, as adverse events and complications are well-known. Response: We acknowledge this oversight and will revise the Introduction to include more comprehensive details about spray cryotherapy, especially regarding its adverse events and complications.  Comment (Line 36): In the Abstract, a consideration needs improvement: The phrase &quot;Endoscopic sinus surgery (ESS) is the preferred treatment because of its few adverse effects&quot; significantly limits the objective of the surgery if it is not stated that the reason for choosing this technique is due to achieving the best results, not only due to adverse effects. Response: We will adjust the wording to clarify that the choice of ESS is based on its effectiveness in achieving the best outcomes, not merely its few adverse effects.  Comment (Line 121): The third inclusion criterion in the Methodology section has &quot;Only in English&quot; capitalized, whereas the first criterion is in lowercase. The decision on capitalization should be consistent. Response: The capitalization will be corrected to maintain consistency throughout the document.  Comment (Line 223): In the first paragraph of the Discussion, the phrase is incomplete or has punctuation errors: &quot;Following the Albu study, Rezaeian22 and Trombitas et al.20 Three studies...&quot; Response: This error will be rectified to ensure the sentence is complete and clear.  Comment (Line 261): In the phrase &quot;Other advantages of using SCT in the management of airway diseases have been reported in many other studies,&quot; the word &quot;many&quot; is excessively emphatic and should be omitted. Response: The word &quot;many&quot; will be removed to avoid undue emphasis and maintain a neutral tone.  Comment (Lines 270-271): The first sentence of the Conclusions, &quot;The present systematic review...&quot; could be better expressed as &quot;The present systematic review was designed to determine the impact of SCT on ESS in patients with chronic rhinosinusitis&quot; or \u201c...following endoscopic surgery for chronic rhinosinusitis\u201d Response: We will revise the conclusion to reflect these suggestions for greater clarity and precision in presenting the study\u2019s objectives and outcomes.","URL":"https:\/\/f1000research.com\/articles\/13-4\/v2#referee-comment-11695","order":2,"name":"referee-comment-11695","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.167402.r330039, Antonino Maniaci, Department of Medicine and Surgery, University of Enna Kore, Research Committee of Young Otolaryngologists of the International Federation of Otorhinolaryngological Societies, Enna, 21 Oct 2024, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/13-4\/v2#referee-response-330039","order":3,"name":"referee-response-330039","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":4,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}