Initial Report on Postoperative Healing after Endoscopic Sinus Surgery With the Microdebrider

1998 ◽  
Vol 118 (6) ◽  
pp. 800-803 ◽  
Author(s):  
JOSEPH M. BERNSTEIN ◽  
RICHARD A. LEBOWITZ ◽  
JOSEPH B. JACOBS
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Chronic Sinusitis ◽  
Middle Turbinate ◽  
Mucosal Healing ◽  
Sinus Surgery ◽  
Crust Formation ◽  
Initial Report ◽  
Low Incidence ◽  
Head Neck

Synechiae formation is a frequent occurrence after endoscopic sinus surgery and may cause symptomatic sinus outflow tract obstruction. Various means are used to reduce the incidence of synechiae formation. These include meticulous operative technique, partial middle turbinate resection, middle meatus spacers or stents, and postoperative debridement. The microdebrider is a powered rotary shaving device that precisely resects tissue, minimizing inadvertent mucosal trauma and stripping. We present 40 cases of endoscopic sinus surgery performed with the microdebrider. Patients had at least a 5-month follow-up and demonstrated rapid mucosal healing, minimal crust formation, and a low incidence of synechiae formation. These initial data suggest that the microdebrider may be advantageous in surgery for chronic sinusitis. (Otolaryngol Head Neck Surg 1998;118:800–3.

scholarly journals Quality of Life after Functional Endoscopic Sinus Surgery

1970 ◽  
Vol 1 (2) ◽  
pp. 6-8 ◽  
Author(s):  
DK Mishra ◽  
R Bhatta ◽  
LR Verma
Keyword(s):  
Quality Of Life ◽  
Key Words ◽  
Endoscopic Sinus Surgery ◽  
Chronic Sinusitis ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Key Words Chronic Sinusitis ◽  
Head Neck

Key words: Chronic sinusitis; sinus surgery; outcomeDOI: 10.3126/njenthns.v1i2.4754 Nepalese J ENT Head Neck Surg Vol.1 No.2 (2010) p.6-8

Scarring in Endoscopic Ethmoidectomy

1994 ◽  
Vol 8 (6) ◽  
pp. 271-274 ◽  
Author(s):  
Ralph E. Gaskins
Keyword(s):  
Retrospective Analysis ◽  
Revision Surgery ◽  
Endoscopic Sinus Surgery ◽  
Middle Turbinate ◽  
Surgical Techniques ◽  
Sinus Surgery ◽  
Postoperative Adhesions ◽  
Frequent Complication ◽  
Subsequent Revision

The formation of postoperative adhesions is perhaps the most frequent complication of endoscopic sinus surgery: These incidents may vary from trivial, small strands of scar to serious obstructive situations that mandate further surgery. This study is a retrospective analysis of 970 endoscopic ethmoidectomies performed in 535 patients over a 5-year period and followed by a single surgeon. Postoperative follow-up ranged from 6 to 70 months. The overall incidence of postoperative adhesions of all types was 10.5% and involving 102 cases. Of these, 40 cases (4.1%) of the total required subsequent revision surgery due to obstructive scarring. Further analysis is presented, showing the effects of various surgical techniques on the development of adhesions. The incidence of postsurgical lateral adhesion of the middle turbinate was reduced in this series in procedures that incorporated partial middle turbinate resection.

Pediatric Endoscopic Nasal and Sinus Surgery

1995 ◽  
Vol 113 (3) ◽  
pp. 204-210 ◽  
Author(s):  
James A. Stankiewicz
Keyword(s):  
Patient Selection ◽  
Endoscopic Sinus Surgery ◽  
Nasal Polyposis ◽  
Chronic Sinusitis ◽  
Subjective Evaluation ◽  
Choanal Atresia ◽  
Sinus Surgery ◽  
Term Objective

A total of 83 children and teenagers underwent endoscopic nasal and sinus surgery. Six patients had surgery for choanal atresia (4) and adenoid hypertrophy (2) and will only be briefly mentioned. Seventy-seven children and teenagers underwent endoscopic sinus surgery for acute and chronic sinusitis, choanal polyposis, and nasal polyposis with a minimum 2-year follow-up. One hundred thirty-three ethmoidectomies, 37 sphenoidotomies, and 119 maxillary antrostomies were performed. Subjective evaluation of the sinus surgery patients indicated that 38% of patients were cured and 55% improved during an average of 3.5 years of follow-up. The number cured and number improved are lower and higher, respectively, than in other reports of results because of the longer follow-up and patient selection. In addition, objective data were obtained on 34 patients with a second- or third-look procedure 2 weeks to 2 months after surgery. These examinations found significant granulation tissue, and almost 50% of patients had at least one maxillary ostia closed. Long-term objective results, however, are not available to determine whether the ostia remained closed. Problems with healing in children's endoscopic sinus surgery are unpredictable compared those in adult surgery because postoperative debridement and examination are often difficult to perform, thus allowing tissue to heal without control. In this series, other factors such as the increased risks of cystic fibrosis, allergy, and immunodeficiency were also more prevalent and compromised healing. The best way to achieve good results in pediatric endoscopic sinus surgery requires appropriate patient selection, careful techniques, spacers or stents that don't cover the antrostomy, appropriate second- or third-look procedures for debridement and examination, and judicious postoperative medical therapy.

Polyurethane Versus Chitosan-Based Polymers Nasal Packs After Functional Endoscopic Sinus Surgery: A Prospective Randomized Double-Blinded Study

2021 ◽  
pp. 194589242098364
Author(s):  
Ahmed Gamal Khafagy ◽  
Ahmed Mahmoud Maarouf
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Middle Turbinate ◽  
Mucosal Healing ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Middle Meatus ◽  
Packing Materials ◽  
Nasal Pack ◽  
Significant Difference ◽  
Double Blinded

Background Different packing materials are applied to the nose at the end of surgery to maintain drainage and sinus ventilation of the paranasal sinuses and avoid some complications such as bleeding, infection, crustations, adhesions in the middle meatus and lateralization of the middle turbinate. Objective The study aims to compare the clinical outcomes of two absorbable packing materials, the synthetic polyurethane, and the naturally occurring Chitosan-based polymers (CBP) nasal packs, after functional endoscopic sinus surgery. Methods Fifty patients with bilateral chronic rhinosinusitis with nasal polypi were operated with 100 surgical cavities. At the end of the surgery, one side was randomly packed with synthetic polyurethane and the opposite side with CBP nasal pack. Measure their outcomes at week 1, 2, 4, 8 and 12 as the presence of remnants materials in the middle meatus, crustations, adhesions, bleeding, granulations, infection, and general satisfaction of patients. Results CBP nasal pack shows a statistically significant advantage only in the first two weeks as regard remnants material, crusting and bleeding. All over the 12 weeks, there was no statistically significant difference between the two types of packs as regard granulations, adhesions and infection. In the first month, eight patients of the CBP group experienced bad smell and two patients had watery rhinorrhea as adverse reaction without a statistically significant difference. Patients were generally satisfied without a statistically significant difference between the two types of packs. Conclusion Synthetic polyurethane and Chitosan-based polymers nasal packs are safe and efficient regarding; the mucosal healing, bleeding control, and the overall satisfaction of patients. The CBP showed a higher statistically significant advantage in the first two weeks only regarding the amount of the retained material, crusting as well as bleeding. Patients packed with CBP experienced fish-like smelly odor and watery rhinorrhea but there is no statistically significant difference.

scholarly journals Endoscopic Medialization Middle Turbinoplasty in Endoscopic Sinus Surgery

2018 ◽  
Vol 97 (12) ◽  
pp. 404-410 ◽  
Author(s):  
Elie Rebeiz ◽  
Mihaela Smith
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Effective Means ◽  
Middle Turbinate ◽  
Sinus Surgery ◽  
Effective Solution ◽  
Study Population ◽  
A Prospective Study ◽  
Ethmoid Sinuses ◽  
Sinonasal Disease

Recurrence of sinonasal disease can be caused by many factors, including lateralization of the middle turbinate as a complication of endoscopic sinus surgery (ESS). Different ESS procedures have been tried to prevent this complication. We conducted a prospective study to determine if medialization is an effective means of lateralizing the middle turbinate. Our study population was made up of 142 adults who underwent ESS from July 2013 through December 2014. A total of 235 sides were operated on; the middle turbinate was medialized in 90 patients (145 sides) and not medialized in 52 patients (90 sides). Follow-up ranged from 6 to 12 months. At 3 months postoperatively, the middle turbinate position was satisfactory on 210 sides (89%) and remained lateralized on the other 25 (11%). Among the latter, the turbinate obstructed the middle meatus in 16 patients and did not obstruct it in 9 patients. The 16 patients with obstruction required revision in the form of either a partial or complete turbinectomy, depending on the severity of the scarring. No complications were associated with middle turbinate medialization. We conclude that medialization middle turbinoplasty is an effective solution to a problem faced by many sinus surgeons. It is safe, quick, and easy to perform, and it is associated with minimal morbidity without adding to cost. It provides postoperative access to the ethmoid sinuses for debridement, and it reduces the risk of middle meatal stricture.

Endoscopic sinus surgery as day-case procedure

2008 ◽  
Vol 123 (6) ◽  
pp. 619-622 ◽  
Author(s):  
Y Bajaj ◽  
N Sethi ◽  
S Carr ◽  
L C Knight
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Chronic Sinusitis ◽  
Demographic Data ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Successful Outcome ◽  
Day Case ◽  
Retrospective Case ◽  
Patients Âgés

AbstractObjective:Functional endoscopic sinus surgery is the mainstay of surgical treatment for chronic sinusitis. Day-case surgery has the advantage over in-patient surgery of being cost-effective and resource sparing. The objectives of this study were to assess our results for day-case functional endoscopic sinus surgery.Methods:This was a retrospective case note review of day-case functional endoscopic sinus surgery procedures performed at Leeds General Infirmary from February 2004 to February 2007. We recorded patients' demographic data, operative details, post-operative course and follow-up results.Results:A total of 105 day-case functional endoscopic sinus surgery procedures were included in the study. Patients' ages ranged from 16 to 93 years; 44 (41.9 per cent) were female and 61 (58.1 per cent) were male. Of these patients, 39 (37.1 per cent) had chronic sinusitis and the rest (66; 62.8 per cent) had nasal polyposis and sinusitis. Sixty-one patients (58.1 per cent) underwent surgery on the morning operating list, while the rest (44; 41.9 per cent) underwent surgery in the afternoon. Of the 105 patients, 24 (22.8 per cent) had undergone previous nasal surgery. The majority of patients (90/105; 85.7 per cent) were discharged on the same day as surgery. The only complication recorded in this study was bleeding, noted in seven patients (6.7 per cent). At the follow-up appointment, 90/105 (85.7 per cent) patients were satisfied with their post-operative results.Conclusions:Day-case endoscopic sinus surgery can be performed safely as a day-case procedure. The most important factors for a successful outcome are correct patient selection, in terms of general health and social circumstances, and a dedicated day-case team.

scholarly journals Incidence of sinonasal anatomical variations associated with chronic sinusitis by CT scan in Karaikal, South India

2017 ◽  
Vol 3 (3) ◽  
pp. 576 ◽  
Author(s):  
Kranti Gouripur ◽  
Udaya Kumar M. ◽  
Anand B. Janagond ◽  
S. Elangovan ◽  
V. Srinivasa
Keyword(s):  
Ct Scan ◽  
Endoscopic Sinus Surgery ◽  
Frontal Sinus ◽  
Chronic Sinusitis ◽  
Middle Turbinate ◽  
Anatomical Variations ◽  
Uncinate Process ◽  
Sinus Surgery ◽  
Nasal Endoscopy ◽  
Deviated Nasal Septum

<p class="abstract"><strong>Background:</strong> Variations in sinonasal anatomy of adults<strong> </strong>are common and vary among different populations. Their role in development of pathological conditions such as sinusitis, epistaxis, etc is debated. Having clear picture of sinonasal anatomy of a person is essential in avoidance of complications during surgery. This study was done<strong> </strong>to<strong> </strong>analyze<strong> </strong>sinonasal anatomy in adults from Karaikal region having chronic sinusitis by nasal endoscopy and CT scan imaging.</p><p class="abstract"><strong>Methods:</strong> A total of 50 patients undergoing endoscopic sinus surgery were studied by preoperative nasal endoscopy, CT scanning and endoscopy at the time of definitive surgery and variations recorded and analyzed.  </p><p class="abstract"><strong>Results:</strong> The incidence of the sinonasal anatomical variations in CT scan study were – discharge in the frontal sinus (100%), agger nasi cells (96%), deviated nasal septum (70%), anterior ethmoidal cells (86%), posterior ethmoidal cells (58%), sinus lateralis (52%), frontal cells (50%), discharge in sphenoid sinus (50%), pneumatised superior turbinate (46%), INSA (34%), prominent bulla ethmoidalis (30%), supra orbital cells (26%), pneumatised septum(16%), medialised uncinate process (16%), paradoxical middle turbinate (16%), Haller cells (14%), supreme turbinate (14%), pneumatised inferior turbinate (12%), frontal recess obliteration (12%), absent pneumatisation of frontal sinus (12%), pneumatised middle turbinate (10%), Onodi cells (6%), pneumatised uncinate process (2%), maxillary sinus septation (2%).</p><p><strong>Conclusions:</strong> The high incidence of variations emphasises the need for proper preoperative assessment for safe and effective endoscopic sinus surgery. </p>

Endoscopic Septal Spur Resection

1993 ◽  
Vol 7 (5) ◽  
pp. 213-216 ◽  
Author(s):  
Donald C. Lanza ◽  
Deborah Farb Rosin ◽  
David W. Kennedy
Keyword(s):  
Surgical Technique ◽  
Endoscopic Sinus Surgery ◽  
Chronic Sinusitis ◽  
Sinus Surgery ◽  
Surgical Approaches ◽  
Postoperative Results ◽  
Valuable Alternative ◽  
Perioperative Morbidity ◽  
The Past ◽  
Septal Spur

A variety of surgical approaches exists for the management of nasal septal spurs in patients who undergo endoscopic sinus surgery (ESS). Treatment of septal spurs in the past has been frequently addressed by septoplasty which can result in increased bleeding and length of surgical procedure as well as mandate postoperative nasal packing. Individually each of these problems can jeopardize the success of endoscopic sinus surgery. An endoscopic approach, which targets the septal spur alone, can minimize perioperative morbidity. The purpose of this paper is to demonstrate the effectiveness of endoscopic septal spur resection (ESSR) for the management of significant septal spurs in 8 patients who underwent concurrent ESSR during ESS for chronic sinusitis. Surgical technique and postoperative results are discussed and suggest that ESSR is a valuable alternative to more traditional techniques.

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