Long-term outcomes of endoscopic sinus surgery for chronic rhinosinusitis with and without nasal polyps (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.
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.
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...
Endoscopic Sinus Surgery in Chronic Rhinosinusitis and Nasal Polyposis: A Comparative Study
Indian Journal of Otolaryngology and Head & Neck Surgery, 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.
Rhinology, 2015
Patients with chronic rhinosinusitis refractory to medical management undergo elective surgery. The time from initial diagnosis to surgery varies considerably. The impact of this delay on surgical success has never previously been evaluated. First-time patients within the National Comparative Audit of Surgery for Nasal Polyposis and Chronic Rhinosinusitis were grouped based on time to surgery: 1) Early cohort: %lt; 12 months; 2) Mid cohort: 12-60 months; and 3) Late cohort: > 60 months. Co-morbidities and preoperative CT scores were analysed for all patients. The 22-item Sino-Nasal Outcome Test scores (SNOT-22) were collected at 0, 3, 12 and 60-months. Absolute and relative SNOT-22 changes from baseline were evaluated. Asthma and allergies were significantly more prevalent in the Late versus the Early and Mid-cohorts. In addition, patients in the Late cohort had greater symptom burden on the SNOT-22 and more extensive preoperative radiographic disease as determined by Lund-Mackay...
International Journal of Otorhinolaryngology and Head and Neck Surgery
Background: Chronic rhino sinusitis (CRS) is a common health problem affecting around 5-12% of the general population in a year. Treatment of CRS consist of medical and surgical management. Surgical management is considered when patient is not responding to maximal medical treatment or in case of complication. Sino nasal outcome test 22 (SNOT- 22) is considered as the most appropriate instrument in the evaluation of HRQOL impairment in CRS patients. This study evaluated general health related quality of life (QOL) domains of SNOT- 22 changes following endoscopic sinus surgery.Methods: This study was conducted in 53 subjects who underwent endoscopic sinus surgery for chronic rhino sinusitis in Department of otorhinolaryngology, Government Medical College, Kottayam over a period of one year. Detailed history including SNOT-22 questionnaire enquired. Clinical, radiological and endoscopic examinations were performed. This patient followed up after 1 week, 1month and 3 months. SNOT-22 sc...
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.
The Laryngoscope, 2002
The study was conducted between September 2007 and March 2009 at Maulana Azad Medical College to compare the pulmonary function of patients with chronic rhinosinusitis presurgically and postsurgically. Thirty patients between 18 and 55 years of age with no prior history of respiratory illness were selected and pulmonary function test was conducted pre and post surgically. There was a significant difference between the pre and postoperative FEV 1 and FEV 1 /FVC with the reading taken at 1 and 3 months post-surgically. The improvement in the PFT values signifies a decrease in the bronchial hyperresponsiveness as compared to the pre-operative condition.