Endoscopic Sinus Surgery in Chronic Rhinosinusitis and Nasal Polyposis: A Comparative Study (original) (raw)
Related papers
Endoscopic Sinus Surgery in Chronic Rhinosinusitis and
2011
Nasal polyposis are common presentations in patients of chronic rhinosinusitis and are considered to be associated with more severe forms of disease with poor treatment outcome. The presentation and treatment outcome after endoscopic sinus surgery in patients of chronic rhinosinusitis and nasal polyposis have been analysed in this study. A prospective analysis of 90 patients of chronic rhinosinusitis who were classified into two groups depending on presence and absence of nasal polyps was performed in the study. The two groups were evaluated using subjective (patient complaints) and objective (computed tomography scan and endoscopy scores) criteria. Preoperative data were compared with data obtained 12 months post endoscopic sinus surgery. The study included 38 patients of chronic rhinosinusitis and 52 patients of nasal polyps. The patients of nasal polyp group presented with increased severity of symptoms of nasal blockage, nasal discharge and reduced sense of smell as compared to the chronic rhinosinusitis group who had significantly higher presentation of headache and facial pain. The preoperative CT scan revealed significantly higher bilateral disease with increased involvement of multiple sinuses in nasal polyp group. Post endoscopic sinus surgery both the groups showed significant improvement in their symptoms with the nasal polyp group demonstrating reduction in improvement on 1 year follow up. In our study we have found the patients with chronic rhinosinusitis and nasal polyp have varied severity of symptoms with the nasal polyp group having higher nasal symptoms and increased severity as compared to chronic rhinosinusitis group. Though the universal rationale of management by adequate drainage and ventilation of sinus is similar in both groups, there is a reduction in both objective and subjective scores during 1 year follow up in the nasal polyp group.
Brazilian journal of otorhinolaryngology
Chronic rhinosinusitis (CRS) significantly affects patient quality of life. Medical and surgical treatments aim to clinically manage the condition. To assess the long-term quality of life and clinical management of CRS in patients submitted to endoscopic sinus surgery. This prospective cross-sectional cohort study enrolled 38 patients and looked into the follow-up data of subjects diagnosed with CRS before surgery, three months after surgery, and at least two years after surgery. The Sinonasal Outcome Test 22 (SNOT-22) was used to assess response to treatment and long-term clinical management of the disease. Significant improvements in the SNOT-22 scores were seen between the preoperative (61.3) and postoperative assessments with three (16.9) and 24 (32.3) months. No statistically significant differences were seen when patients with polyps were compared to polyp-free subjects. Few patients were controlled in both groups, and 7.89% of the subjects had revision surgery during the stud...
Clinical and Translational Allergy, 2019
Background: Chronic rhinosinusitis with nasal polyposis (CRSwNP) is a therapeutic challenge because of the high recurrence rate. Surgical intervention should be considered in patients who fail to improve after medical treatment. We monitored recurrence and revision surgery over 12 years after endoscopic sinus surgery in CRSwNP patients. Methods: In this prospective cohort study, 47 patients with CRSwNP, who underwent primary or revision extended endoscopic sinus surgery, were followed. Clinical symptoms and total nasal endoscopic polyp score were evaluated before, 6 years and 12 years after surgery. Results: Twelve years after surgery, 38 out of 47 patients (80.9%) were available for examination. There still was a significantly better symptom score and total nasal endoscopic polyp score compared to before surgery (P < 0.001). Within the 12-year follow-up period, 30 out of 38 patients developed recurrent nasal polyps, of which 14 patients underwent additional revision surgery. Comorbid allergic sensitization and tissue IL-5 levels were found to be significant predictors for the need of revision surgery. Conclusions: This long-term cohort study, investigating the outcome after surgery in CRSwNP, showed that, despite the low number of patients, 78.9% of patients with CRSwNP were subject to recurrence of the disease and 36.8% to revision surgery over a 12-year period.
2021
Chronic Rhinosinusitis (CRS) is a common disease that affects a large percentage of the population, Nasal obstruction, nasal discharge, headache and the decline in quality of life are all symptoms that have social and economic consequences. CRS with nasal polyps is a common problem, it is a subgroup of CRS in which polyps in the middle meatus can be seen. It has a high social impact because of its chronic disease burden. Due to a large number of people with medically refractory rhinosinusitis, it is now widely accepted to use functional endoscopic sinus surgery (FESS) and the number of FESS procedures that are performed has increased. The study aimed to assess nasal polyps in chronic rhinosinusitis patients who underwent FESS. A retrospective study was conducted among patients aged between 18 and 86 years. The clinical records of patients who underwent functional endoscopic sinus surgery over the two years (2019-2020) were carefully reviewed and pertinent information was extracted from the database. Overall, 1671 patients underwent FESS, 1197 of them were for CRS. We found 165 (13.78%) patients with nasal polyps and 1032 (86.21%) of them were without nasal polyps. The study group's mean age was 38.87±14.74 years. The mean age of patients for CRS with nasal polyps and without nasal polyps was 50.53±16.13 and 37±13.61 years respectively, which was statically significant (χ2 =216.303; p < 0.001). Most of the patients with nasal polyps (43%) were aged between 41-60 years. In the subgroup of CRS with nasal polyp females and males were 79 (47.88%) and 86 (52.12%) respectively. In our study, both CRS with nasal polyps and without nasal polyps showed significant age differences. In CRS with nasal polyp, males were more affected than females. More research is needed to assess demographic variables and outcomes of nasal polyps after FESS.
Impact of endoscopic sinus surgery on the quality of life of patients with nasal polyposis
2014
OBJECTIVES Chronic sinusitis with polyposis (CSWP) is associated with high direct and indirect annual costs. This condition affects several aspects of daily life, and CSWP patients usually suffer from decreased quality of life (QOL). Treatment with functional endoscopic sinus surgery (FESS) is reported to improve the QOL of patients with CS. Here we evaluated the factors that affected QOL improvement in CSWP patients who were candidates for FESS. METHODS All patients with CSWP who were treated at the Imam Khomeini Hospital Complex in Tehan, Iran that were candidates for FESS were recruited. Patients with systemic or neurologic diseases that could affect their QOL were excluded. Clinical signs were recorded before and after FESS using the sinonasal outcome test (SNOT-22) and QOL questionnaires. The patient's history of allergic rhinitis, aspirin sensitivity, asthma and smoking was recorded. QOL and associations with clinical features were evaluated within twelve months after FESS...
European Archives of Oto-Rhino-Laryngology, 2014
Endoscopic score was on average significantly lower after 6 and 12 months of FESS (p < 0.05), but the mean score value after 12 months of operation was significantly higher in relation to that after 6 months of surgery (p < 0.05). nevertheless, the recurrence of nP was observed in 28 patients (32.9 %) in the follow-up period. In conclusion, FESS in nP patients results in significant improvement of symptom intensity, Qol and endoscopic score. While the intensity of symptoms and Qol showed a tendency to maintain between 6 and 12 months after surgery, endoscopic score showed a tendency of exacerbation in the same period.
https://www.ijrrjournal.com/IJRR\_Vol.6\_Issue.2\_Feb2019/Abstract\_IJRR001.html, 2019
Introduction – In setting of severe scarcity of Indian literature on impact of disease and whether there should be any variation in treatment in view of tropical climate, with this prospective cohort study, we aim to bring some clarity on role of surgery, perioperative management, and its impact on Quality of Life of patients suffering from Chronic Rhinosinusitis with Nasal Polyps (CRSwNP). Methods – 60 cases of CRSwNP were included as per the inclusion and exclusion criteria of this study. They were randomised into two groups after continued medical management with intranasal corticosteroid sprays (INCS) for 12 weeks. Group A was continued with INCS while Group B was scheduled for Endoscopic Sinus Surgery and postoperatively continued with same medical management. Visual Analogue Scores (VAS), Lund and Mackay endoscopic appearance scores were taken at baseline and on follow ups at 1, 3 and 6 months. Lund and Mackay radiological scores were recorded at baseline and at 6 months. Results – Mean VAS scores at baseline and 6 months were 6.83 ± 1.12 and 3.83 ± 0.83 for Group A, and 7.27 ± 1.11 and 2.3 ± 0.79 for Group B. Mean Lund and Mackay Endoscopic appearance scores at same follow up period were 8.33 ± 1.03 and 4.73 ± 1.11 for Group A and 8.63 ± 1.13 for Group B. Mean Lund and Mackay Radiological scores at same follow up period were 15.43 ± 1.89 and 9.77 ± 2.56 for Group A and 18.37 ± 3.54 and 2.13 ± 1.28 for Group B. Statistical analysis revealed that there was significant improvement in Group B in terms of all three parameters as compared to Group A. Conclusion – Carefully selected cases of Chronic Rhinosinusitis with Nasal polyps who have undergone Endoscopic Sinus Surgery with continued medical management with INCS has been proven to have significantly more benefited than those patients who were continued with medical management alone.
Outcomes of Endoscopic Sinus Surgery for Chronic Rhinosinusitis associated with Sinonasal Polyposis
American Journal of Rhinology, 2007
Background The aim of this study was is to investigate the outcomes of endoscopic sinus surgery (ESS) when performed for chronic rhinosinusitis associated with sinonasal polyps. Methods Forty-three patients with polyps were compared with 76 patients without polyps before and after ESS. Mean follow-up was 1.5 years. Patients were analyzed prospectively based on computed tomography (CT), endoscopy, quality-of-life (QOL) assessment, and visual analog scales (VASs). Univariate analyses were performed to evaluate whether the presence of polyps was predictive of outcome. Results Patients with polyps had worse CT and endoscopy scores both pre- and postoperatively when compared with patients without polyps (p < 0.0001 for each). All patients, regardless of polyps, improved on endoscopic exam; however, patients with polyps showed a greater degree of improvement (p = 0.002). Despite this, postoperative endoscopic scores in patients with polyps were worse than those without polyps (p < 0...
2020
Context: Endoscopic sinus surgery is a minimally invasive and currently the treatment of choice for acute/intermittent and chronic/persistent rhinosinusitis (RS) unresponsive to conservative medical treatment. Aims: To evaluate the indications and outcomes of treatment of RS with or without nasal polyps. Methods and Material: This was a retrospective review of all cases of endoscopic sinus surgery done at the National Ear Care Centre. The information extracted from the case notes of patientsincluded the demographic profile, clinical radiologic and endoscopic findings, the surgery offered and outcome of surgery. Statistical analysis used: All information was entered into SPSS version 20.0. Results: Out of 116 patients had endoscopic sinus surgery, only 107 (92%) had complete information for the analysis. Their age ranged from 9 to 72 years with a mean age of 35.9 ± 1.9 years. Up to 105 of the patients presented nasal discharge alternating with nasal obstruction while 65% (70) of them had bilateral disease. Computed tomography scan revealed abnormalities in 66.4% (71) patients. The preoperative diagnosis of chronic RS (CRS) with simple nasal polyp was made in 66 patients, had functional endoscopic sinus surgery with polypectomy in 64.5% (69) patients and intraoperative findings revealed a mixture of mucosal diseases with sinonasal polyps in 73.8% and fungal sinus diseases in 18 (16.8). Majority of the patients (53.3%) were discharged home on the 2nd postoperative day. About 71% of the patients had resolution of their disease after months of followup. Conclusion: Endoscopic sinus surgery is higher among young adult in third and fourth decades of life. There is female preponderance and preoperative radiology assessment and the intraoperative findings revealed strong relationship. The outcome of treatment revealed recurrent disease in 10.5% with nasal adhesion, epistaxis and excessive nasal crust formation
Nigerian Journal of Basic and Clinical Sciences, 2020
Context: Endoscopic sinus surgery is a minimally invasive and currently the treatment of choice for acute/intermittent and chronic/persistent rhinosinusitis (RS) unresponsive to conservative medical treatment. Aims: To evaluate the indications and outcomes of treatment of RS with or without nasal polyps. Methods and Material: This was a retrospective review of all cases of endoscopic sinus surgery done at the National Ear Care Centre. The information extracted from the case notes of patients included the demographic profile, clinical radiologic and endoscopic findings, the surgery offered and outcome of surgery. Statistical analysis used: All information was entered into SPSS version 20.0. Results: Out of 116 patients had endoscopic sinus surgery, only 107 (92%) had complete information for the analysis. Their age ranged from 9 to 72 years with a mean age of 35.9 ± 1.9 years. Up to 105 of the patients presented nasal discharge alternating with nasal obstruction while 65% (70) of them had bilateral disease. Computed tomography scan revealed abnormalities in 66.4% (71) patients. The preoperative diagnosis of chronic RS (CRS) with simple nasal polyp was made in 66 patients, had functional endoscopic sinus surgery with polypectomy in 64.5% (69) patients and intraoperative findings revealed a mixture of mucosal diseases with sinonasal polyps in 73.8% and fungal sinus diseases in 18 (16.8). Majority of the patients (53.3%) were discharged home on the 2nd postoperative day. About 71% of the patients had resolution of their disease after months of followup. Conclusion: Endoscopic sinus surgery is higher among young adult in third and fourth decades of life. There is female preponderance and preoperative radiology assessment and the intraoperative findings revealed strong relationship. The outcome of treatment revealed recurrent disease in 10.5% with nasal adhesion, epistaxis and excessive nasal crust formation.