الفهرس 
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Abstract
Endoscopic Sinus Surgery is a highly sophisticated type of surgery. It is one of the most common procedures performed by Otolaryngologists, because of its high success rate, low incidence of complications, advances in instrumentation and imaging and the introduction of computer-aided surgery (Musy et al., 2004).
One of the main concerns in sinus surgery is blood loss due to the high vasculature of the mucosa. Bleeding during and following endoscopic sinus surgery is still a challenge for surgeons and anesthesiologists. Although extensive blood loss is rare (Wormald et al., 2005).
Many techniques have been proposed to improve the field of endoscopic sinus surgery but there is no method of choice for this purpose. Head elevation, Bipolar diathermy, packing, local vasoconstrictors, administration of antifibrinolytic agents and induced hypotension are the most commonly used techniques (Shaw et al., 2000).
There has been an explosion of interest in the ability of tranexamic acid to reduce morbidity and mortality in ESS, without apparent safety issues.
The study group comprised of 60 patients suffered from sinonasal polyposis in the age group 20 to 50 years.
There was statistical difference between both study groups regarding net blood loss. The mean amount of collected blood during surgery was 155.50 +/- 64.93 ml for group A and 276.50 +/- 63.44 ml for group B, with a P-value <0.001.
With regard to the quality of the surgery site, based on the Boezaart grading scale, there were significant differences between groups A and B with a P-value <0.05.
The time of surgery was ranging between 30 - 60 min. with mean = 42.70 min. in the group A, whereas in group B it was ranging between 39 - 80 min. with mean = 54.93 min, with a P < 0.0001; and this showed significant differences between both groups A and B.
It is now clearly established that intravenous tranexamic acid reduces blood loss in patients with surgical bleeding and the need for transfusion, also improves quality of surgical field. It can also be used topically to reduce bleeding.
Its use is being explored further in large pragmatic trials in traumatic head injury, postpartum haemorrhage and in upper gastro-intestinal haemorrhage.
This trial clearly showed no increase in thrombotic events after its use.