Cytokine production in the sinus mucosa is correlated to clinical parameters of chronic sinusitis before and after sinus surgery

Objective: To investigate the relationship between the extent of sinus disease in chronic sinusitis as detected radiologically by computed tomography (CT) scan and the population of cilia (ciliary area) both before and after functional endoscopic sinus surgery (FESS). In a simple way this is a trial to statistically prove that the CT scan could be a valid indicator and a mirror of the histological status of the sinus mucosa.Design: Twenty adult patients were enrolled in this study. Radiological extension of the sinus disease was quantitated using the classification proposed by Kennedy in 1992 and the ciliary population was studied using scanning electron microscopy and image analysis softwares.Results and conclusion: The more advanced the sinusitis, as evidenced by CT scans, the more the expected reduction in the ciliary area (CA) and in the ciliary count. But after FESS the degree of ciliary regeneration does not depend statistically on the radiological condition of the sinuses and the degree of opacity prior to intervention, i.e. a statistically valid inverse relationship exists between the radiological stage of sinusitis and the ciliary population pre-operatively but the same relation does not extend to the ciliary population post-operatively.

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Pre- and Postoperative Mucociliary Clearance in Functional Endoscopic Sinus Surgery

Ear Nose & Throat Journal ◽

10.1177/014556139707601211 ◽

1997 ◽

Vol 76 (12) ◽

pp. 884-886 ◽

Cited By ~ 21

Author(s):

Shashikant K. Kaluskar

Keyword(s):

Endoscopic Sinus Surgery ◽

Chronic Sinusitis ◽

Functional Endoscopic Sinus Surgery ◽

Sinus Surgery ◽

Controlled Study ◽

Symptom Profile ◽

Before And After ◽

Prospective Controlled Study ◽

Results Of Surgery ◽

Nose And Sinuses

The advent of functional endoscopic sinus surgery (FESS) has revolutionized the treatment of chronic sinusitis over the last decade. Although it has been well-established that FESS is more efficacious than conventional surgery, the lack of a quantifiable means of assessing results remains one of the major shortcomings of the technique, and hence a source of criticism. Since the pathophysiology of chronic sinusitis is intimately related to the mucociliary mechanism of the nose and sinuses, it seems logical to use this parameter as a yardstick of success. We undertook a prospective, controlled study of 40 patients and measured their “saccharin times” before and after surgery. The results show a marked reduction in clearance times postoperatively, corresponding well with improvement in symptom profile. We therefore propose this technique as a simple, safe and reliable method of assessing the results of surgery. Furthermore, the method could act as a preoperative indicator of ciliary motility disorders, as the prognosis in these patients is distinctly poor.

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Healing Process of Sinus Mucosa after Endoscopic Sinus Surgery

American Journal of Rhinology ◽

10.2500/105065896781795067 ◽

1996 ◽

Vol 10 (2) ◽

pp. 61-66 ◽

Cited By ~ 47

Author(s):

Hiroshi Moriyama ◽

Kiyoshi Yanagi ◽

Nobuyoshi Ohtori ◽

Kazuyasu Asai ◽

Masaya Fukami

Keyword(s):

Endoscopic Sinus Surgery ◽

Chronic Sinusitis ◽

Healing Process ◽

Complete Removal ◽

Mucosal Surface ◽

Sinus Surgery ◽

Ciliated Cells ◽

Sinus Mucosa

In the treatment of chronic sinusitis, the mucosa should be preserved, or, when severely damaged, only the mucosal surface removed with cutting forceps. It is especially important not to expose the surface of the bone by complete removal of the mucosa. When the mucosa is conserved, or excision is limited to only the mucosal surface, ciliated cells regenerate within 6 months. However, where the mucosa was completely removed during surgery and the bone was exposed, the area was covered with nonciliated cells, and only scattered cilia were present.

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Normalization of maxillary sinus mucosa after functional endoscopic sinus surgery in pediatric chronic sinusitis

International Journal of Pediatric Otorhinolaryngology ◽

10.1016/j.ijporl.2005.03.031 ◽

2005 ◽

Vol 69 (9) ◽

pp. 1219-1223 ◽

Cited By ~ 7

Author(s):

Hung-Meng Huang ◽

Hey-Ping Lee ◽

Chia-Ming Liu ◽

Kai-Nan Lin

Keyword(s):

Maxillary Sinus ◽

Endoscopic Sinus Surgery ◽

Chronic Sinusitis ◽

Functional Endoscopic Sinus Surgery ◽

Sinus Surgery ◽

Sinus Mucosa

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Use of Nebulized Antibiotics for Acute Infections in Chronic Sinusitis

Otolaryngology ◽

10.1067/mhn.2002.129738 ◽

2002 ◽

Vol 127 (6) ◽

pp. 558-568 ◽

Cited By ~ 94

Author(s):

Winston C. Vaughan ◽

Gerard Carvalho

Keyword(s):

Standard Therapy ◽

Outcome Measure ◽

Chronic Sinusitis ◽

Acute Infection ◽

Sinus Surgery ◽

Nasal Discharge ◽

Sensitivity Testing ◽

Novel Therapy ◽

Acute Infections ◽

Before And After

OBJECTIVE: Infections in patients with chronic sinusitis after surgery can be difficult to treat. Nebulized antimicrobial therapy was studied as a treatment option. STUDY DESIGN: Patients with chronic sinusitis, previous sinus surgery, and an acute infection were offered nebulized antibiotics or standard therapy. Cultures were taken and sensitivity testing was performed. Retrospective chart reviews were also performed. RESULTS: Forty-two patients were included. The most common side effects were sore throat and cough. Symptomatic and endoscopic data before and after nebulized therapy showed a longer infection-free period (average, 17 weeks) compared with standard therapy (average, 6 weeks). Improvements in posterior nasal discharge, facial pain/pressure, and emotional consequences were noted. CONCLUSION: Nebulized therapy was safe and effective in this cohort. Endoscopy and outcome measure changes showed consistent improvements. SIGNIFICANCE: A novel therapy for acute sinus infections in patients with chronic sinusitis and previous endoscopic sinus surgery is presented.

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Effect of endoscopic sinus surgery on irradiation-induced rhinosinusitis in patients with nasopharyngeal carcinoma

Otolaryngology ◽

10.1016/j.otohns.2008.07.006 ◽

2008 ◽

Vol 139 (4) ◽

pp. 575-579 ◽

Cited By ~ 13

Author(s):

Ko-Hsin Hu ◽

Ching-Ting Tan ◽

Kai-Nan Lin ◽

Ya-Jian Cheng ◽

Hung-Meng Huang

Keyword(s):

Nasopharyngeal Carcinoma ◽

Transit Time ◽

Endoscopic Sinus Surgery ◽

Chronic Sinusitis ◽

Sinus Surgery ◽

Antral Mucosa ◽

Submucosal Gland ◽

Initial Surgery ◽

Sinus Mucosa ◽

Maxillary Sinuses

Objectives We evaluated the effect of endoscopic sinus surgery on irradiation-induced rhinosinusitis of the maxillary-sinus mucosa among patients with nasopharyngeal carcinoma (NPC). Design Surgical outcomes were evaluated by changes to the ultrastructure of the antral mucosa and nasomucociliary clearance. Methods Twenty-one NPC patients with irradiation-induced chronic sinusitis were enrolled in the study, along with five controls. Specimens were taken from 42 maxillary sinuses during surgery and 1 year after surgery. Saccharin transit time was measured before the initial surgery and 1 year after surgery. Results In the postoperative cases, we found a decrease in the number of the submucosal gland openings ( P < 0.05), the cilia in the antral mucosa regenerated ( P < 0.05), and the saccharin transit time reduced ( P < 0.05); the number of goblet cells did not change. Conclusion Endoscopic sinus surgery is an effective treatment for irradiation-induced rhinosinusitis in NPC patients, improving ventilation and drainage of the paranasal sinuses, and facilitating regeneration of the sinus mucosa.

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Outcomes of Endoscopic Sinus Surgery in Chronic Sinusitis Cases Complicated/Not Complicated by Bronchial Asthma and Eosinophilic Infiltration of the Sinus Mucosa

Nippon Jibiinkoka Gakkai Kaiho ◽

10.3950/jibiinkoka.111.58 ◽

2008 ◽

Vol 111 (2) ◽

pp. 58-64 ◽

Cited By ~ 1

Author(s):

Kenji Dejima ◽

Naoko Adachi ◽

Akihiro Oshima ◽

Yasuhiko Nishimura ◽

Chihisa Ushijima ◽

...

Keyword(s):

Bronchial Asthma ◽

Endoscopic Sinus Surgery ◽

Chronic Sinusitis ◽

Sinus Surgery ◽

Eosinophilic Infiltration ◽

Sinus Mucosa

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Changes of TNF-α, PDGF and HA in nasal secretions and olfactory function of patients with chronic sinusitis before and after endoscopic sinus surgery

Experimental and Therapeutic Medicine ◽

10.3892/etm.2018.6611 ◽

2018 ◽

Author(s):

Linqi Wei ◽

Yonghong Zhang ◽

Huazhang Tan

Keyword(s):

Endoscopic Sinus Surgery ◽

Chronic Sinusitis ◽

Olfactory Function ◽

Sinus Surgery ◽

Tnf Α ◽

Before And After ◽

Nasal Secretions

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Evaluation of Nasal Resistance by Rhinomanometry before and after Endoscopic Sinus Surgery

International Journal of Practical Otolaryngology ◽

10.1055/s-0039-1695715 ◽

2019 ◽

Vol 02 (01) ◽

pp. e18-e25

Author(s):

Shoji Kaneda ◽

Motoki Sekine ◽

Kousuke Saito ◽

Tomoaki Murakami ◽

Hikaru Yamamoto ◽

...

Keyword(s):

Nasal Obstruction ◽

Endoscopic Sinus Surgery ◽

Chronic Sinusitis ◽

Sinus Surgery ◽

Nasal Resistance ◽

Factors Affecting ◽

Future Studies ◽

Before And After ◽

Almost All

AbstractWith the objective of identifying the factors affecting the nasal resistance in patients undergoing sinus surgery, we evaluated the data of 95 patients with chronic sinusitis who underwent endoscopic sinus surgery (ESS) between 2015 and 2018 at our hospital. We determined the nasal resistance by rhinomanometry and also patients' sensation of nasal obstruction before surgery and 3 months after the ESS. In total, 49 bilateral and 46 unilateral ESS procedures were performed, including ESS alone, ESS + septoplasty, and ESS + septoplasty + conchotomy. In addition, the surgical cases were classified into single sinus or polysinus surgery, and groups with or without polyps. We compared the nasal resistance and degree of change in the nasal resistance among the groups. The same comparisons were also conducted separately in cases with nasal resistance levels of >0.25 Pa/cm3/s. Nasal resistance improved following the ESS in both the bilateral and unilateral cases. In almost all the subgroups, the nasal resistance improved following ESS with the exception of the ESS with septoplasty group with nasal resistance levels of >0.25 Pa/cm3/s. The degree of change in the nasal resistance was not significantly different between the ESS alone, ESS + septoplasty, and ESS + septoplasty + conchotomy groups. Similarly, the degree of change in the nasal resistance was also not significantly different between the single sinus and polysinus surgery or between patients with and without polyps. Furthermore, there were no differences among the above groups of patients with >0.25 Pa/cm3/s either. The patients' sensation of nasal obstruction improved following the ESS. The nasal resistance measured by rhinomanometry was weakly correlated with the sensation of nasal obstruction prior to the ESS; however, the nasal resistance following the ESS and the degree of change of the nasal resistance following the ESS were not correlated with the sensation of nasal obstruction or the degree of change in the sensation of nasal obstruction. Future studies are needed for a precise clarification of the factors that affect nasal resistance.

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