Usefulness of our proposed olfactory scoring system during endoscopic sinus surgery in patients with chronic rhinosinusitis

Objective: To evaluate the effects of Dexamethasone-impregnated absorbable nasal pack versus saline-impregnated nasal packing on postoperative outcome of nasal cavities after endoscopic sinus surgery using the Perioperative Sinus Evaluation Scoring System (POSE) and Lund and Kennedy Endoscopic Scoring System. Methods: Study Design: Prospective, randomized, double blinded, placebo-controlled trial Setting: Single Center Tertiary Government Hospital Population: Nineteen patients aged 15 years old and above, diagnosed with chronic rhinosinusitis, with nasal polyposis grade 3, who underwent endoscopic sinus surgery from January 2015 to August 2015 Results: Nasal cavities that received postoperative dexamethasone-impregnated nasal packs showed significantly lower POSE scores than placebo on post-op Days 14 (p value 0.0022; 95% CI: -2.113 to -0.5116) as well as lower Lund-Kennedy Scores on post-op day 14 (p value of 0.0180; 95% CI: -2.493 to – 0.2571) and day 28 (p value of 0.007; 95% CI: -1.56275 to -0.2832) Conclusion: Dexamethasone-impregnated absorbable nasal packing affords better postoperative outcomes: less edema, crusting, secretions, and synechiae, than saline-impregnated absorbable packing in later postoperative days. Keywords: Dexamethasone, endoscopy, nasal polyp, nasal cavity, intranasal absorption

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A comparative study and correlation between preoperative computed tomogram and endoscopic sinus surgery in chronic rhinosinusitis

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20194943 ◽

2019 ◽

Vol 5 (6) ◽

pp. 1652

Author(s):

Mithra Sara John ◽

N. Gopinathan Pillai

Keyword(s):

Ct Scan ◽

Chronic Rhinosinusitis ◽

Endoscopic Sinus Surgery ◽

Scoring System ◽

Pearson Correlation ◽

Middle Turbinate ◽

Sinus Surgery ◽

Common Disease ◽

Nasal Discharge ◽

Excellent Correlation

Background: Chronic rhinosinusitis (CRS) with its classical symptoms of nasal obstruction, nasal discharge, and headache is relatively a common disease in otorhinolaryngology practice. The objectives of the present study was to correlate the operative findings in such patients with the CT findings, using the Perioperative sinus endoscopy (POSE) scoring system and to correlate the maximum scores obtained in the POSE scoring system and Lund-Mackay scoring system.Methods: A prospective study was conducted from January 2014 to March 2015 in 50 patients suffering from chronic rhinosinusitis who underwent endoscopic sinus surgery in the age group of 36-60 years of age. Results: Agger nasi cells were the most common wandering ethmoid cell detected (90%) followed by various types of frontal cells (54%), Haller cells (26%) and least commonly Onodi cells (12%). Almost perfect agreement was obtained for rest of the criteria which included middle turbinate status, ethmoid cavity mucosal edema and ethmoid cavity polypoid change. Lund-Mackay scoring system was used to score findings in the CT scan and POSE scoring system used to score peroperative findings in the study and this study reveals excellent correlation (Pearson correlation value of 0.879).Conclusions: Novel POSE scoring is a new entity which has the potential to be a valid system to score preoperative and perioperative findings. In the current study POSE scoring shows excellent correlation with Lund Mackay scoring which is an established scoring system used in the evaluation CT scan.

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A COMPARATIVE STUDY OF LUND-MACKAY SCORING AND POSE SCORING IN CHRONIC RHINO-SINUSITIS PATIENTS.

10.36106/ijsr/8305540 ◽

2021 ◽

pp. 1-2

Author(s):

Arun Nair ◽

Swaroop Dev

Keyword(s):

Standard Deviation ◽

Ct Scan ◽

Chronic Rhinosinusitis ◽

Endoscopic Sinus Surgery ◽

Scoring System ◽

Mean Value ◽

Sinus Surgery ◽

Medical College ◽

Operative Endoscopy ◽

Chronic Rhino Sinusitis

INTRODUCTION: To compare preoperative Computed Tomography scan ndings of Para nasal sinuses using Lund-Mackay scoring and intra operative Functional endoscopic sinus surgery ndings in patients with Chronic Rhino-sinusitis using the POSE scoring and to correlate maximum scores obtained in Perioperative sinus endoscopy (POSE) scoring system and Lund-Mackay scoring system. MATERIALS AND METHODS:AProspective study was done for 1 year on 48 patients attending outpatient department of ENT, Sri Siddhartha Medical College aged between 18-60 years, who were clinically diagnosed to have Chronic Rhino-sinusitis, underwent pre-operative CT scan of nose and paranasal sinuses and thereafter FESS were enrolled for the study after obtaining the due consent. RESULTS: From our study group of 48 patients who underwent endoscopic sinus surgery for CRS, the minimum value of Lund-MacKay Scoring was 3 whereas the maximum was 18 (maximum obtainable is 24) with a mean value of 12.02 and standard deviation of 3.987. The minimum POSE Score obtained was 7 and the maximum POSE Score obtained was 37 (maximum obtainable being 40), with a mean value of 16.31 and standard deviation of 5.095. CONCLUSION: Pre operative CT scan combined with per operative endoscopy ndings has made the approach to Chronic rhinosinusitis more specic, rational and accurate. The results of our study highlights that CT scan is an important investigation tool to detect Chronic rhinosinusitis . CT scan has very much emerged as the gold standard in preoperative diagnosis and allows for accurate patient selection for FESS. In our study, POSE Scoring has shown a good correlation with Lund MacKay scoring system

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Efficacy of Carragelose® Nasal Spray Impregnated Versus Mupirocin Ointment Impregnated Nasal Packs on Mucosal Healing after Endoscopic Sinus Surgery: A Double-Blind, Non-Randomized, Right-Left Side Comparison

Philippine Journal of Otolaryngology Head and Neck Surgery ◽

10.32412/pjohns.v35i2.1503 ◽

2020 ◽

Vol 35 (2) ◽

pp. 11

Author(s):

Joseph Bernard Lo ◽

Emmanuel Tadeus Cruz

Keyword(s):

Chronic Rhinosinusitis ◽

Nasal Spray ◽

Endoscopic Sinus Surgery ◽

Scoring System ◽

Nasal Polyposis ◽

Mucosal Healing ◽

Sinus Surgery ◽

Double Blind ◽

Mupirocin Ointment ◽

Sinus Endoscopy

ABSTRACTObjective: To determine the efficacy of carragelose® nasal spray versus mupirocin ointment impregnated nasal packs on postoperative mucosal healing among chronic rhinosinusitis with nasal polyposis (CRSwNP) patients after endoscopic sinus surgery (ESS). Methods:Design: Double-Blind, Non-Randomized, Right-Left Side ComparisonSetting: Tertiary Government Training HospitalParticipants: Fifteen (15) patients diagnosed with chronic rhinosinusitis with nasal polyposis (CRSwNP) who had ESS were included in the study. Nasal packs (Netcell®) impregnated with carragelose® nasal spray or mupirocin ointment were respectively applied in right and left nostrils. Postoperative mucosal healing was graded by a blinded consultant using the Lund-Kennedy Endoscopic Scoring System and Perioperative Sinus Endoscopy (POSE) scoring system. Results: Six patients (12 nasal sides) completed the study. Comparing nasal packs impregnated with carragelose® nasal spray mupirocin ointment, the carragelose® group had lower Lund- Kennedy median scores than the mupirocin group on the 7th post-operative day; and this was statistically significant (p = .027). There were no significant differences in Lund-Kennedy postoperative scores on days 4 (p = .217), 14 (p = .171) and 28 (p = .151). Conclusion: Carragelose® nasal spray impregnated nasal packs may be comparable with, and may be an alternative to mupirocin ointment impregnated nasal packs in terms of postoperative mucosal healing among ESS patients with CRSwNP.

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What is the optimal outcome after endoscopic sinus surgery in the treatment of chronic rhinosinusitis? A consultation of Canadian experts

Journal of Otolaryngology - Head and Neck Surgery ◽

10.1186/s40463-021-00519-9 ◽

2021 ◽

Vol 50 (1) ◽

Author(s):

Nadim Saydy ◽

Sami P. Moubayed ◽

Marie Bussières ◽

Arif Janjua ◽

Shaun Kilty ◽

...

Keyword(s):

Chronic Rhinosinusitis ◽

Endoscopic Sinus Surgery ◽

Patient Reported Outcome ◽

Sinus Surgery ◽

Structured Interviews ◽

Subjective Data ◽

Operative Outcomes ◽

Patient Reported ◽

Definition Of Success ◽

Reported Data

Abstract Objectives Many experts feel that in the absence of well-defined goals for success, they have an easier time identifying failure. As success ought to not be defined only by absence of failure, we aimed to define optimal outcomes for endoscopic sinus surgery (ESS) in chronic rhinosinusitis (CRS) by obtaining expert surgeon perspectives. Methods A total of 12 surgeons participated in this targeted consultation. Face to face semi-structured interviews were performed with expert surgeons in the field of CRS and ESS. General impressions and personal definitions of acceptable operative success and optimal operative outcomes were compiled and summarized. Results According to an expert survey, patients’ main objectives are an improvement in their chief complain, a general improvement in quality of life (QoL), and a better overall symptomatic control. The most important aspects of endoscopy for defining a successful intervention were an adequate mucus circulation, a healthy mucosa, minimal edema, and patency of all explored cavities or ostia. In the assessment of surgical outcomes, it was determined that both objective and patient reported data must be carefully examined, with more attention given to subjective outcomes. Conclusions According to data gathered from a Canadian expert consultation, a definition of success must be based on both subjective data and nasal endoscopy. We propose to define an acceptable outcome as either a subjective improvement of at least the minimal clinically improvement difference of a validated patient reported outcome questionnaire, along with a satisfactory endoscopic result (1) or a complete subjective resolution with a sub-optimal endoscopy (2). Graphical abstract

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