Traditional endonasal and microscopic sinus surgery complications versus endoscopic sinus surgery complications: a meta-analysis (original) (raw)
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Multiple analyses of factors related to complications in endoscopic sinus surgery
Journal of the Chinese Medical Association : JCMA, 2015
This study was undertaken to evaluate whether endoscopic sinus surgery (ESS) with a microdebrider had an impact on complication rates, and to facilitate the determination of factors associated with complications in patients who underwent ESS at a tertiary referral center in Taiwan. This investigation was a retrospective study and literature review. We analyzed 997 consecutive patients who underwent ESS at Mackay Memorial Hospital in Taipei, Taiwan from January 2006 through February 2010. All data including those of patient medical information, and peri- and postoperative complications were provided by the surgeons involved in patient medical care. We analyzed the complication rates using the following 10 variables by univariate analysis and multivariate logistic regression: gender, age, Lund-Mackay score, polyp grading, previous sinonasal surgery, surgeon skill, adjunctive sinonasal surgery, mesenteric type of anterior ethmoid artery, Keros skull base type, and the use of a microdeb...
3 Objective Outcomes in Endoscopic Sinus Surgery
2012
Use of endoscopes in the sinonasal cavity dates as far back as the turn of the 20th century with Hirschmann and Reichert performing the first sino-endoscopies and sinus surgeries, respectively. Widespread use was limited until H.H. Hopkins helped address illumination difficulties with the rod optic system in the 1960s and Walter Messerklinger began systematic use of the endoscope to evaluate the lateral nasal wall and mucociliary clearance in the late 1970s (Lee & Kennedy 2006). With the advent of modern endoscopic sinus surgery instruments and techniques in the 1980s, the endoscope has radically altered the surgical approach and management of inflammatory and neoplastic sinonasal disease rendering many of the open approaches nearly obsolete. Successful outcomes in endoscopic sinus surgery have often been largely based on subjective qualifiers by the patient. Significant improvements in patient perceived nasal congestion, obstruction, facial pressure, rhinorrhea, headache, postnasal...
A Study on the Endoscopic Sinus Surgery Over the Period of 9 Years
PAFMJ
Objective: To share experience of 1000 patients who underwent functional endoscopic sinus surgery (FESS) in 4different hospitals for various diseases over span of 9 years. Study Design: Prospective observational study. Place and Duration of Study: Sheikh Khalifa Hospital Muzaffarabad, Combined Military Hospital Sialkot, PakEmirates Military Hospital Rawalpindi and CMH Quetta, from Jun 2009 to Jun 2018. Methodology: We included 1000 patients who underwent Functional endoscopic sinus surgery (FESS) in fourdifferent military hospitals, suffering with various diseases discussed later. Patients were operated after failureto get response to medical therapy. All the patients had preoperative endoscopic examination and CT-scan paranasal sinuses (PNS) done for disease assessment. Patients were examined post operatively at 1, 15 days and 2 months. All patients were documented for the level of satisfaction at end of 2 months post-operative period. Results: Most patients were suffering from rhi...
Follow-up results of 415 patients after endoscopic sinus surgery
European Archives of Oto-rhino-laryngology, 1998
Endoscopic sinus surgery (ESS) is a method used with success in the treatment of chronic inflammatory paranasal sinus diseases. Between February 1991 and June 1995 the Messerklinger technique for ESS was used in 415 patients who had been pre-operatively evaluated in detail according to the staging system used in our clinic. Average post-operative follow-up was 23 months. Our general success rate was found to be 86.3% upon evaluating the subjective improvements in the patients’ symptoms in the post-operative period. The major and minor complication rates in our series were 0.24 and 20.24%, respectively.
Review article: outcomes in endoscopic sinus surgery
BMC Ear, Nose and Throat Disorders, 2016
Chronic rhinosinusitis has a significant impact on health-related and generic quality-of-life, has a high cost burden to both society and patients, and may be associated with absenteeism, loss of productivity and poor respiratory function. Though there is a paucity of level 1 evidence, endoscopic sinus surgery may be considered in medically refractory patients and a variety of objective and subjective outcome measures exist to assess the effectiveness of intervention. We outline the outcome measurements available and review in-depth the published outcomes to date. Furthermore we discuss the literature that indicates that endoscopic sinus surgery can have a positive effect on respiratory function in asthma. How patient selection, timing and extent of surgery, and post-operative care interventions may optimise surgical outcomes is explored.
Endoscopic Sinus Surgery: Results at two Year follow-up on 200 patients
2007
Objective: The technique of functional endoscopic sinus surgery (FESS) has been widely accepted and applied to inflammatory diseases of the paranasal sinuses with internationally reported results of this technique having been very good. Our objective was to find out outcome after FESS at our centre. Methodology: Two hundred patients who had undergone FESS during a two year period with an average follow-up period of eleven months were evaluated subjectively regarding the outcome of their endoscopic sinus surgery. Results: An overall subjective improvement of about 94% was documented, with improvement in specific symptoms such as headache, nasal congestion, change in sense of smell, nasal discharge and recurrent infections ranging from 52% to 97%. Conclusion: Our center reports a subjective improvement of symptoms following FESS compatible with results attained internationally.
International Forum of Allergy & Rhinology, 2017
Background: The endoscopic modified Lothrop procedure (EMLP) has been used as a salvage technique for frontal sinusitis following failed endoscopic sinus surgery (ESS). We aim to examine the safety and efficacy of the EMLP following failure of primary ESS. Methods: All English-language publications from 2000 to 2016 reporting the use of EMLP a er primary ESS were identified using the PubMed database and evaluated per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Random effects summaries of patient demographics, comorbidities, and surgical outcomes were obtained through meta-analysis. Results: Eleven studies constituting 778 patients were included and 86.5% had chronic rhinosinusitis (CRS). Mean follow-up duration was 28.4 months. The mean number of surgeries prior to EMLP was 3.5. Symptom improvement was reported in 82.3%. Subgroup analysis of 7 studies in which all 357 patients had CRS revealed a mean follow-up of 31.5 months. Symptom improvement occurred in 75.9% of cases and 23.1% experienced polyp recurrence. The cerebrospinal fluid leak rate was 2.5%. Restenosis of the neoostium occurred in 17.1% with complete closure occurring in 3.9% of cases. The reoperation rate a er EMLP was 9.0%. Aspirin sensitivity was associated with an increased risk of cerebrospinal fluid (CSF) leak (p = 0.0339) and a reduced incidence of neo-ostium closure (p = 0.0001). Aspirin sensitivity and asthma were associated with a reduced incidence of reoperation (p ࣘ 0.001) and increased symptom improvement (p < 0.005). Restenosis or closure of the frontal neo-ostium was associated with less symptom improvement (p < 0.04) but not with reoperation. Conclusion: The EMLP is an effective salvage procedure for refractory frontal sinusitis based on data from highervolume centers.
Evaluating the Efficacy and Trend of Sinus Surgery
International Archives of Otorhinolaryngology, 2020
Introduction From April 2009 to December 2016, 661 consecutive patients undergoing sinus surgery completed a quality of life (QOL) questionnaire (SNOT-22) preoperatively and at 3, 6, and 12 months postoperatively. Objective (1) To evaluate the long-term efficacy of sinus surgery using QOL instruments. (2) To determine the optimal evaluation time for surgical efficacy. (3) To determine if surgical results improve with yearly experience. Methods The prospective study patients were split into two groups: Group A, those who completed the initial preoperative evaluation and all postoperative evaluations, and Group B, who completed the preoperative questionnaire and at least one but not all of the postoperative questionnaires. Group A included 93 patients. Group B included 240 patients at 3 months, 180 at 6 months, and 121 at 12 months postoperatively. Results Group A efficacy reported at 3 months was 82.8%, 80.6% at 6 months, and 84.9% at 12 months postoperatively. Group B efficacy repor...
Symptom Outcomes in Endoscopic Sinus Surgery: A Systematic Review of Measurement Methods
The Laryngoscope, 2007
Objective: To determine the type and prevalence of measurement methods used to analyze symptom outcomes after endoscopic sinus surgery (ESS). Data Sources: Data were derived from PubMed, MEDLINE, EMBASE, Web of Science, Cochrane databases, Google Scholar, and manual searches. Study Selection: All English-language studies consisting of more than 10 adult patients from January 1980 to December 2006 reporting ESS symptom outcome results were reviewed. Studies of radical surgery and studies involving patients with significant comorbidities were excluded. Results: The ESS symptom outcome results of 29,333 patients were reported in 204 studies. Symptom outcome was determined by survey instruments in 47 (23.0%) studies and individual symptom scoring in 63 (31%) studies. Of 18 validated instruments used, almost two thirds of studies that reported results by survey measures used the following three instruments: Chronic Sinusitis Survey (12 studies), Sinonasal Outcome Test-20 (11 studies), and Medical Outcomes study 36-Item Short-Form Health Survey (10 studies). The percentages of studies that reported specific results of the 1997 American Academy of Otolaryngology-Head Neck Surgery Rhinosinusitis Task Force (RSTF) chronic rhinosinusitis symptom criteria varied as follows: facial pain/pressure, 35%; facial congestion/fullness, 10%; nasal obstruction/ blockage, 42%; nasal discharge/purulence/discolored postnasal discharge, 47%; hyposmia/anosmia, 35%; fever, 2%; halitosis, 4%; fatigue, 11%; dental pain, 3%; cough, 10%; and ear pain/pressure/fullness, 6%. Conclusions: ESS symptom outcome is assessed inconsistently by numerous measures. Individual reporting of all RSTF chronic rhinosinusitis symptom criteria, as recommended by the RSTF and by subsequent consensus conferences, is rarely noted. Many RSTF symptom criteria are seldom studied.