Surgical management of paediatric chronic rhinosinusitis: review of 10 years' experience

2014 ◽  
Vol 128 (S2) ◽  
pp. S43-S47 ◽  
Author(s):  
M Barakate ◽  
T Havas
Keyword(s):  
Surgical Treatment ◽  
Chronic Rhinosinusitis ◽  
Surgical Procedures ◽  
Revision Surgery ◽  
Inferior Turbinate ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Middle Meatal Antrostomy ◽  
Effective Option

AbstractObjective:To assess the outcome of children with chronic rhinosinusitis who were managed surgically, over a 10-year study period.Method:From January 1999 to December 2008 inclusive, 136 children diagnosed with chronic rhinosinusitis underwent surgery following unsuccessful medical treatment. The operations ranged from adenoidectomy to functional endoscopic sinus surgery.Results:The surgical procedures performed were: adenoidectomy (n = 69), antral washouts (n = 54), middle meatal antrostomy (n = 82), endoscopic ethmoidectomy (n = 66), nasal septal reconstruction (n = 10), and inferior turbinate outfracture (n = 23) or inferior turbinate reductions (n = 55). Follow-up duration ranged from 6 months to 9 years (average 3.2 years). Three patients required revision surgery: adenoidectomy in two patients and adenoidectomy with turbinate reductions in another.Conclusion:This study demonstrates the benefits of focused surgical treatment for paediatric chronic rhinosinusitis. Surgical treatment can be an appropriate and effective option for children with chronic rhinosinusitis when medical management is unsuccessful.

Predictors of disease progression after endoscopic sinus surgery in patients with chronic rhinosinusitis

2019 ◽  
Vol 133 (8) ◽  
pp. 678-684 ◽  
Author(s):  
K Tsuzuki ◽  
K Hashimoto ◽  
K Okazaki ◽  
H Nishikawa ◽  
M Sakagami
Keyword(s):  
Disease Progression ◽  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Frontal Sinus ◽  
Early Period ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Eosinophilic Chronic Rhinosinusitis ◽  
Operative Findings

AbstractObjectiveThis study aimed to determine the predictors of disease progression after functional endoscopic sinus surgery in patients with chronic rhinosinusitis.MethodA total of 281 adult chronic rhinosinusitis patients who underwent primary bilateral functional endoscopic sinus surgery between 2007 and 2017 and had at least 12 months of follow-up endoscopic evaluation were examined. Patients were divided into eosinophilic (n= 205) and non-eosinophilic chronic rhinosinusitis groups (n= 76). In order to determine adverse factors, post-operative endoscopic appearance scores were analysed in relation to the pre- and intra-operative findings using multiple regression analyses.ResultsThe post-operative course of eosinophilic cases deteriorated over time, like the early period for non-eosinophilic cases. Frontal sinus polyps recurred early in eosinophilic chronic rhinosinusitis. Multivariate analyses indicated young adulthood, asthma, high computed tomography score and frontal sinus polyps as significant adverse predictors.ConclusionEarly, appropriate estimation of sinonasal conditions appears to be crucial for successful surgical management of chronic rhinosinusitis.

scholarly journals Anatomy of Nasal Cavity and Paranasal Sinuses; Surgical Perspective

2020 ◽  
Vol 63 (5) ◽  
pp. 189-198
Author(s):  
Seung-Kyu Chung
Keyword(s):  
Surgical Treatment ◽  
Medical Treatment ◽  
Nasal Cavity ◽  
Chronic Rhinosinusitis ◽  
Paranasal Sinuses ◽  
Endoscopic Sinus Surgery ◽  
Treatment Method ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery

Endoscopic sinus surgery is a treatment method for chronic rhinosinusitis not controlled with medical treatment. It had started with functional endoscopic sinus surgery and the concept of reboot approach was introduced recently. For safe surgical treatment, understanding the anatomy especially personal variations between well-known structures is important. The practical points of surgical concept during endoscopic sinus surgery was suggested.

scholarly journals Efficacy of Mitomycin-C for Prevention of Adhesion Formation after Functional Endoscopic Sinus Surgery in Cases of Chronic Rhinosinusitis: A Prospective Cross-sectional Study

2014 ◽  
Vol 7 (3) ◽  
pp. 100-104 ◽  
Author(s):  
Anilkumar Suryadev Harugop ◽  
Ramesh Mudhol ◽  
Amit Nargund ◽  
Shailaja Hugar ◽  
Amrit Kapoor ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Mitomycin C ◽  
Endoscopic Sinus Surgery ◽  
Adhesion Formation ◽  
Cross Sectional Study ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Sectional Study ◽  
Cross Sectional

ABSTRACT Objective To determine whether topical application of mitomycin- C at the conclusion of FESS decreases the incidence of postoperative adhesion formation. Study design Prospective cross-sectional study. Materials and methods Between June 2011 and June 2013, 42 patients (65 sides) aged between 16 and 66 years diagnosed to have chronic rhinosinusitis (CRS) underwent FESS. At the conclusion of the ESS, cotton ribbon wick soaked with 1 ml mitomycin-C (0.4 mg/ml) was placed in right/left/ both middle meati, near the widened sinus ostia for a period of 4 minutes. Following application, nasal cavity was irrigated with sterile normal saline. Patients were examined weekly for 1 month after surgery. Additional examinations were done at the end of 2nd and 3rd months postoperatively. At the end of 3 months follow-up, the outcome was assessed subjectively by symptoms and objectively by endoscopic findings. Results At the end of 3 months follow-up, a significant decrease (80%) in symptom scores was observed (6.64 ± 1.80, p < 0.001). Similarly in sinonasal outcome test (SNOT) score we observed a significant reduction (71%) in scores (17.76 ± 8.17, p < 0.001) and 3.1% cases showed adhesions. Conclusion CRS patients have remarkable improvement in their symptoms after FESS. Topical application of mitomycin-C at the conclusion of FESS/ESS has a role in prevention of adhesion formation. How to cite this article Harugop AS, Mudhol R, Nargund A, Hugar S, Kapoor A, Shetty R. Efficacy of Mitomycin-C for Prevention of Adhesion Formation after Functional Endoscopic Sinus Surgery in Cases of Chronic Rhinosinusitis: A Prospective Cross-sectional Study. Clin Rhinol An Int J 2014;7(3):100-104.

Effectiveness of extensive sinus surgery with post-operative medical management for chronic rhinosinusitis

2017 ◽  
Vol 131 (S2) ◽  
pp. S19-S24 ◽  
Author(s):  
A J Wood ◽  
L Zhou ◽  
S Wilkinson ◽  
R G Douglas
Keyword(s):  
Confidence Interval ◽  
Medical Treatment ◽  
Chronic Rhinosinusitis ◽  
Symptom Score ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Symptom Improvement ◽  
Patient Subgroups

AbstractObjective:To prospectively assess treatment outcomes of chronic rhinosinusitis patients undergoing functional endoscopic sinus surgery and post-operative medical treatment over a prolonged follow-up period.Methods:Patients undergoing functional endoscopic sinus surgery in the tertiary referral practice of a single surgeon were studied prospectively. Symptoms were scored by patients pre-operatively and over a minimum follow-up period of 12 months.Results:The study comprised 200 non-consecutive patients. The median pre-operative symptom score was 16 (out of a maximum of 25) (95 per cent confidence interval = 15 to 17). Symptom scores reduced to a median of 7 (95 per cent confidence interval = 6 to 8) after 12 months of follow up (p< 0.0001). The median symptom score improved for all symptoms and across all patient subgroups.Conclusion:Extensive functional endoscopic sinus surgery offers significant and durable symptom improvement in patients with chronic rhinosinusitis refractory to medical treatment. This improvement extends to all patient subgroups. Prolonged medical therapy is recommended after functional endoscopic sinus surgery.

scholarly journals Outcome of computer-assisted surgery in patients with chronic rhinosinusitis

2009 ◽  
Vol 124 (5) ◽  
pp. 500-504 ◽  
Author(s):  
S A Mueller ◽  
M Caversaccio
Keyword(s):  
Chronic Rhinosinusitis ◽  
Revision Surgery ◽  
Endoscopic Sinus Surgery ◽  
Computer Assisted Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Computer Assisted ◽  
Complication Rates ◽  
Computer Assistance ◽  
Significant Difference

AbstractObjective:To compare the complication rates and outcome of computer-assisted versus non-computer-assisted functional endoscopic sinus surgery.Methods:We reviewed retrospectively the medical records of 276 patients who had undergone sinus surgery for chronic rhinosinusitis with (n = 108) or without (n = 168) computer assistance, from 1996 to 2004, to determine the incidence of complications and need for revision surgery.Results:The incidence of complications was 6.5 per cent in the computer-assisted group and 6.0 per cent in the non-computer-assisted group (p = 1.00). In the computer-assisted group, 9.2 per cent needed revision surgery, compared with 10.7 per cent in the non-assisted group (p = 0.84).Conclusions:Although our study found no significant difference in complications or revision rates, computer-assisted surgery serves as an important orientation aid during functional endoscopic sinus surgery.

Desmopressin effects on bleeding during functional endoscopic sinus surgery on patients with chronic rhinosinusitis

2021 ◽  
pp. 103024
Author(s):  
Fatemeh Hajimohamadi ◽  
Jawad Hosseini ◽  
Farrokh Heidari ◽  
Sepideh Alvandi ◽  
Shahin Bastaninezhad ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery

scholarly journals Factors Affecting the Control of Chronic Rhinosinusitis With Nasal Polyps: A Comparison in Patients With or Without NERD

2021 ◽  
Vol 12 ◽  
pp. 215265672110038
Author(s):  
Markus Jukka Lilja ◽  
Anni Koskinen ◽  
Paula Virkkula ◽  
Seija Inkeri Vento ◽  
Jyri Myller ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Female Gender ◽  
Sinus Surgery ◽  
Logrank Test ◽  
Free Survival ◽  
Factors Affecting ◽  
Advanced Therapy ◽  
And Gender

Objectives The aim was to compare the control of chronic rhinosinusitis with nasal polyps (CRSwNP) after endoscopic sinus surgery (ESS), in patients with/without nonsteroidal anti-inflammatory drug exacerbated respiratory disease (NERD). Study Desing: A retrospective hospital-based sample of CRSwNP patients with/without NERD with follow-up. Setting Tertiary rhinology centers. Methods Electronic patient record data from 116 CRSwNP patients (46 with NERD and 70 without NERD) undergoing ESS during 2001–17 were studied. Mean follow-up time was 9.9 years (range 1.1–15.3). Endpoints reflecting uncontrolled CRSwNP were revision ESS, and need for rescue/advanced therapy (e.g. antibiotics, oral corticosteroids and/or biological therapy) during follow-up. NERD was variable of interest and gender, age, asthma, allergic rhinitis (AR), smoking, Lund-Mackay (LM) score of sinus computed tomography scans previous ESS and baseline total ethmoidectomy were used as covariates. Results Twenty-one (49.7%) NERD patients and 18 (25.7%) non-NERD patients underwent revision ESS within a mean ± SD of 4.3 ± 2.8 and 3.7 ± 2.6 years, respectively (p = .013, by Logrank test). In Cox´s regression models, NERD, female gender, young age, asthma, AR, previous ESS, and lack of total ethmoidectomy were associated with revision-ESS. In adjusted model, only the total ethmoidectomy predicted revision-free survival. In adjusted logistic regression model, there was an insignificant trend that NERD and LM score were associated with the need for rescue/advanced therapy in the follow-up. Conclusions Patients with NERD had higher risk of uncontrolled CRSwNP than patient group without NERD, as measured by revision ESS and/or need for rescue/advanced therapy in the follow-up. In addition, baseline total ethmoidectomy was associated with revision-free survival.

scholarly journals Long-Term Follow-Up After Maxillary Sinus Balloon Sinuplasty and ESS

2021 ◽  
pp. 014556132098603
Author(s):  
Anni Koskinen ◽  
Marie Lundberg ◽  
Markus Lilja ◽  
Jyri Myller ◽  
Matti Penttilä ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Revision Surgery ◽  
University Hospital ◽  
Sinus Surgery ◽  
Control Group ◽  
University Hospitals ◽  
Balloon Sinuplasty ◽  
Long Term Follow Up

Objectives: The aim of this controlled follow-up study was to compare the need for revision surgery, long-term efficacy, and satisfaction in chronic rhinosinusitis patients who had undergone maxillary sinus operation with either balloon sinuplasty or traditional endoscopic sinus surgery (ESS) technique. Methods: Thirty-nine ESS patients and 36 balloon patients of our previously described cohort, who had been primarily operated in 2008 to 2010, were contacted by phone. Symptoms, satisfaction, and need for revision surgery were asked. In addition, we collected data of patients who had undergone primary maxillary sinus balloon sinuplasty in the Helsinki University Hospital during the years 2005 to 2019. As a control group, we collected data of patients who had undergone primary maxillary sinus ESS at 3 Finnish University Hospitals, and 1 Central Hospital in years 2005, 2008, and 2011. Results: Altogether, 77 balloon patients and 82 ESS patients were included. The mean follow-up time was 5.3 years in balloon group and 9.8 years in ESS group. Revision surgery was performed on 17 balloon patients and 6 ESS patients. In the survival analysis, the balloon sinuplasty associated significantly with a higher risk of revision surgery compared to ESS. According to the phone interviews, 82% of ESS patients and 75% of balloon patients were very satisfied with the primary operation. Conclusion: Although the patient groups expressed equal satisfaction and change in symptoms after the operations, the need for revision surgery was higher after balloon sinuplasty than after ESS. This should be emphasized when counselling patients regarding surgical options.

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