Combined approach for paediatric recurrent antrochoanal polyp: a single-centre case series of 27 children

2019 ◽  
Vol 133 (7) ◽  
pp. 627-631 ◽  
Author(s):  
E Mantilla ◽  
P Villamor ◽  
C De La Torre ◽  
H Álvarez-Neri
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Case Series ◽  
Complete Removal ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Correct Identification ◽  
Antrochoanal Polyp ◽  
Combined Approach ◽  
Retrospective Case ◽  
Polyp Recurrence

AbstractObjectiveTo compare functional endoscopic sinus surgery with a combined approach (functional endoscopic sinus surgery plus Caldwell–Luc procedure) for the treatment of paediatric antrochoanal polyp, in terms of antrochoanal polyp recurrence and safety.MethodThis retrospective case series comprises 27 paediatric patients with recurrent antrochoanal polyp, treated from January 2010 to January 2018.ResultsThe average age of the patients at the time of diagnosis was 10.4 ± 2.49 years. The recurrence rate after functional endoscopic sinus surgery alone was 72.9 per cent, compared with 12.5 per cent after functional endoscopic sinus surgery plus the Caldwell–Luc procedure (p < 0.00001). No complications were reported during surgery or follow up.ConclusionThe correct identification of the origin of the antrochoanal polyp and an adequate returning of maxillary ventilation by widening the ostium can prevent recurrences. Although functional endoscopic sinus surgery continues to be the ‘gold standard’ for antrochoanal polyp treatment, in cases of revision surgery, a combined approach could ensure the complete removal of the polyp through the two openings.

Bony nasolacrimal duct dehiscence in functional endoscopic sinus surgery: radiological study and discussion of surgical implications

2015 ◽  
Vol 129 (S3) ◽  
pp. S35-S40 ◽  
Author(s):  
M J Ali ◽  
J Murphy ◽  
P J Wormald ◽  
A J Psaltis
Keyword(s):  
Computed Tomography ◽  
Endoscopic Sinus Surgery ◽  
Case Series ◽  
Nasolacrimal Duct ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Retrospective Case ◽  
Computed Tomography Images ◽  
Before And After ◽  
Surgically Induced

AbstractObjectives:To analyse the radiological features of the bony nasolacrimal duct before and after functional endoscopic sinus surgery, and document the incidence of surgically induced dehiscence.Methods:A retrospective case series analysis was conducted of 63 consecutive patients who underwent uncinectomy as a part of 118 functional endoscopic sinus surgical procedures. All patients underwent pre- and post-operative computed tomography scans. Axial computed tomography images at the level of maxillary sinus were evaluated for the presence of bony nasolacrimal duct dehiscence, osteitis and completeness of uncinectomy.Results:The rate of nasolacrimal duct dehiscence prior to surgery was 6.8 per cent (8 out of 118 cases). Nasolacrimal duct dehiscence as a consequence of surgery was observed in 3.3 per cent of cases (4 out of 118), with a further 4.2 per cent (5 out of 118) showing post-operative reactive bony change of the nasolacrimal duct in the absence of dehiscence.Conclusion:The incidence of nasolacrimal duct injury observed was much lower than that previously reported in the literature.

Immunotherapy in Patients Undergoing Functional Endoscopic Sinus Surgery

1994 ◽  
Vol 110 (4) ◽  
pp. 406-412 ◽  
Author(s):  
Gary J. Nishioka ◽  
Paul R. Cook ◽  
William E. Davis ◽  
Joel P. McKinsey
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Chronic Sinusitis ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Outcome Parameters ◽  
Allergic Symptoms ◽  
Polyp Recurrence ◽  
Better Than

A total of 283 consecutive patients with chronic sinusitis underwent functional endoscopic sinus surgery. There were 72 allergic patients and 211 nonallergic patients. Data were collected on the effect of immunotherapy on middle meatotomy patency, synechiae formation, and recurrent polyps in allergic patients. Data supported the following conclusions: (1) Immunotherapy given either before or after surgery does not statistically influence middle meatotomy patency, synechiae formation, or recurrence of polyps after functional endoscopic sinus surgery. However, the data do suggest, for all three outcome parameters, that allergic patients who undergo immunotherapy do better than those who do not undergo immunotherapy and, with the exception of recurrent polyps, do as well as nonallergic patients. (2) The prevalence of preoperative polyps is the same for allergic and nonallergic patients in this study, but polyp recurrence is higher in allergic patients. (3) Approximately 40% of allergic patients who began preoperative immunotherapy stopped immunotherapy after surgery because their allergic symptoms resolved or were minimal. A comment regarding this observation is provided.

NASAL POLYPS;

2018 ◽  
Vol 25 (08) ◽  
pp. 1213-1217
Author(s):  
Farhan Salam ◽  
Damish Arslan ◽  
Muhammad Salman Haider Qureshi ◽  
Ejaz Ahmad
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Nasal Polyps ◽  
Nasal Polyposis ◽  
Postoperative Bleeding ◽  
Case Series ◽  
Operational Definition ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Male Patients ◽  
Age Of Majority

Introduction: Functional Endoscopic Sinus Surgery (FESS) is now undoubtedlythe procedure of choice for surgical treatment of chronic sinusitis and nasal polyposis afterfailure of medical treatment. In order to present the formation of synechie nasal packing isperformed. Moreover, it also helps in supporting the process of wound healing and preventionof postoperative bleeding. Objectives: To determine the frequency of synechiae formation afterfunctional endoscopic sinus surgery (FESS) in patients presenting with nasal polyps. StudyDesign: Descriptive case series. Setting: Department of Otorhinolaryngology at ServicesHospital Lahore. Period: Six months from 03-10-2013 to 02-04-2014. Methodology: A total of150 cases were included in this study. Patients were treated by functional endoscopic sinussurgery (FESS) and were followed at the end of 1st, 2nd, 3rd and 4th week postoperatively forthe development of synechiae (as per operational definition). Results: The age of majority ofpatients was from 20 to 40 years and minimum patients were < 20 years old. Mean age of thepatients was 35.30±10.54 years. Male patients were 80 (53.3%) while female patients were 70(46.7%). Synechiae formation was observed in 28 patients (18.7%). Conclusion: Synechiaeformation was developed in 18.4% of the patients after functional endoscopic sinus surgery.

Bilateral Antrochoanal Polyp with Diabetes: A Rare Presentation of Cystic Fibrosis

2010 ◽  
Vol 3 (3) ◽  
pp. 173-176
Author(s):  
Monica Gupta ◽  
Manish Gupta
Keyword(s):  
Cystic Fibrosis ◽  
Endoscopic Sinus Surgery ◽  
English Literature ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Adolescent Male ◽  
Antrochoanal Polyp ◽  
Rare Presentation ◽  
First Case

Abstract Bilateral antrochoanal (AC) polyps have been rarely reported in english literature. Here we report the first case of an adolescent male with bilateral AC polyps, cystic fibrosis and diabetes. The case was managed successfully by functional endoscopic sinus surgery (FESS). The patient has been under follow-up for the last six months with no signs of recurrence.

Identification and Treatment of Nontuberculous Mycobacterium Sinusitis

2011 ◽  
Vol 25 (6) ◽  
pp. 421-424 ◽  
Author(s):  
Jeffrey D. Suh ◽  
Vijay R. Ramakrishnan ◽  
Bobby Tajudeen ◽  
Christine Reger ◽  
David W. Kennedy ◽  
...  
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Case Series ◽  
Sinus Surgery ◽  
Nontuberculous Mycobacterium ◽  
Mycobacterium Fortuitum ◽  
Retrospective Case ◽  
Mycobacterium Chelonae ◽  
Atypical Mycobacterium ◽  
Retrospective Case Series ◽  
Positive Culture Result

Background The purpose of this study was to identify the incidence of atypical Mycobacterium identified by routine sinus cultures and review the recent literature on management. Methods A retrospective case series was performed in a tertiary academic hospital. A retrospective case series of all patients treated with atypical Mycobacterium rhinosinusitis from 2005 to 2010 was performed. Cases were identified from a prospective database of 676 endoscopically guided sinus cultures. Results Eight patients with atypical Mycobacterium sinusitis were identified. There were five women and three men. Median age was 63 years (range, 55–71 years). All patients had prior endoscopic sinus surgery a median of 14 months (range, 0.8–162 months) before a positive culture result. Species identified included Mycobacterium chelonae, Mycobacterium fortuitum, Mycobacterium abscessus, and Mycobacterium avium complex. Chief presenting symptoms were postnasal discharge (88%), followed by decreased smell and taste (63%), and facial pain/pressure (38%). Patients were treated based on sensitivity results with long-term oral antibiotics for at least 2 months based on improvements on endoscopy. Median follow-up for patients in this study after treatment was 1.3 years (range, 0.6–4.6 years). Conclusion In this study, atypical mycobacteria were identified in < 1% of sinus cultures. Prolonged, culture-directed antibiotic therapy remains the mainstay of treatment when there is clinical evidence of infection. Previous endoscopic sinus surgery may represent a risk factor for colonization and subsequent infection. Further research is necessary to determine the optimal treatment duration and management to prevent disease relapse

The Role of Endoscopic Sinus Surgery in Children Undergoing External Drainage of Non-Medial Subperiosteal Orbital Abscess

2020 ◽  
pp. 194589242095379
Author(s):  
Stephen R. Chorney ◽  
Adva Buzi ◽  
Mark D. Rizzi
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Case Series ◽  
Primary Objective ◽  
Acute Sinusitis ◽  
Sinus Surgery ◽  
Symptom Duration ◽  
Retrospective Case ◽  
Orbital Abscess ◽  
Significant Difference ◽  
Subperiosteal Orbital Abscess

Background The extent of surgery required in the management of pediatric non-medial subperiosteal orbital abscess (SPOA) due to medically refractory complicated acute sinusitis is unknown. Objectives The primary objective is to compare operative outcomes of children treated with combined endoscopic sinus surgery (ESS) and external orbital drainage (EOD) versus those treated with EOD alone. Methods Retrospective case series from a tertiary children’s hospital analyzing outcomes in children requiring surgical management for acute sinusitis complicated by non-medial SPOA between November 2007 and September 2019. Results Sixteen children with a mean age of 9.4 years (95% CI: 7.3–11.4) met inclusion. Eleven (68.8%) underwent combined EOD and ESS, while five (31.2%) underwent EOD alone. Groups were similar in age, symptom duration, white blood cell count, C-reactive protein level, intraocular pressure, Lund-Mackay score, and abscess volume. There was no significant difference in median length of stay between patients treated with a combined approach versus those treated by EOD alone. Cultures identified non-beta-hemolytic Streptococcus species in 56.3% of patients, with Streptococcus intermedius representing the most common organism in 37.5%. In one case, ESS identified a pathogen not acquired via concomitant EOD, which did influence management. No child required a subsequent surgical procedure and there were no operative complications. Conclusions The addition of ESS in the management of pediatric non-medial SPOA was not associated with a statistically different duration of hospitalization. Cultures from concomitant ESS rarely aided in diagnosis or antibiotic therapy. Further study should delineate the indications for ESS in these cases.

Evidence Supporting Endoscopic Sinus Surgery in the Management of Adult Chronic Rhinosinusitis: A Systematic Review

2005 ◽  
Vol 19 (6) ◽  
pp. 537-543 ◽  
Author(s):  
Timothy L. Smith ◽  
Pete S. Batra ◽  
Allen M. Seiden ◽  
Maureen Hannley
Keyword(s):  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Critical Evaluation ◽  
Case Series ◽  
Adult Patients ◽  
Sinus Surgery ◽  
Future Research ◽  
Case Control Studies ◽  
Retrospective Case ◽  
Level 2

Background Evidence-based medicine calls for a critical evaluation of the scientific evidence for treatments of disease. This report synthesizes the available evidence on the use of endoscopic sinus surgery (ESS) in the management of adult chronic rhinosinusitis (CRS) examining the clinical question: “In adults with CRS who have failed medical management, does ESS improve symptoms and/or quality of life (QOL)?” Methods The American Rhinologic Society and the American Academy of Otolaryngology–Head and Neck Surgery convened a steering committee composed of the authors. Primary research articles evaluated for this report were identified using appropriate search terms and a Medline search. Two authors independently reviewed each article. Articles were assigned an evidence level based on accepted guidelines (level 1 = randomized trials; level 2 = prospective cohort studies with comparison group; level 3 = case-control studies; level 4 = retrospective case series; level 5 = expert opinion). Results We identified 886 abstracts to review, retrieved 75 articles for full review, and included 45 articles in our report. The vast majority of articles represented level 4 evidence (n = 42) and two articles represented level 5 evidence. One article was identified that qualified for level 2 evidence. All of these articles generally supported the finding that ESS improves symptoms and/or QOL in adult patients with CRS. Conclusion There is substantial level 4 evidence with supporting level 2 evidence that ESS is effective in improving symptoms and/or QOL in adult patients with CRS. Future research efforts should focus on prospective studies that include appropriate comparison groups in their design.

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.

Uncommon anatomic variations in patients with chronic paranasal sinusitis

2005 ◽  
Vol 132 (2) ◽  
pp. 221-225 ◽  
Author(s):  
Ting-Kuang Chao
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Middle Turbinate ◽  
Uncinate Process ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Correct Identification ◽  
Anatomic Variations ◽  
Paranasal Sinusitis ◽  
Number Of Patients ◽  
Tomography Scan

OBJECTIVE: Some uncommon anatomic variations would be encountered with the increasing number of patients with chronic paranasal sinusitis who have undergone functional endoscopic sinus surgery. The correct identification and proper treatment for these variations are important. STUDY DESIGN AND SETTING: A retrospective study of serial computed tomography scan images was conducted in 100 patients collected randomly. Uncommon anatomic variations were recorded and clinical features were analyzed. RESULTS: Five (5%) cases with uncommon anatomic variations were found. These variations included bilateral pneumatization of uncinate process (1%), large uncinate process mimics the middle turbinate (1%), nontraumatic protrusion of orbital contents through dehiscence of lamina papyracea (1%), and nasal septal pneumatization (2%). Two of these 5 cases caused some modifications of routine functional endoscopic sinus surgery procedures and another 2 variants commanded further caution during routine uncinectomy. CONCLUSION AND SIGNIFICANCE: Uncommon anatomic variations, though unusual, are not rare in chronic paranasal sinusitis patients. Procedures should be tailored for most of these special conditions.

scholarly journals Extraocular muscle injury during endoscopic sinus surgery: a series of 10 cases at a single center

2014 ◽  
Vol 52 (3) ◽  
pp. 238-245
Author(s):  
J.H. Sohn ◽  
S.D. Hong ◽  
J.H. Kim ◽  
H.-J. Dhong ◽  
S.-K. Chung ◽  
...  
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Extraocular Muscle ◽  
Muscle Injury ◽  
Case Series ◽  
Rectus Muscle ◽  
Strabismus Surgery ◽  
Sinus Surgery ◽  
Medial Rectus ◽  
Inferior Rectus ◽  
Retrospective Case

Background: Extraocular muscle (EOM) injury is a rare but serious complication of endoscopic sinus surgery (ESS). The aim of this study is to describe the clinical characteristics and course of EOM injury occurring during ESS. Design: Retrospective case series. Methods: Medical records and CT images of patients who suffered from EOM injury after ESS between 2006 and 2012 were retrospectively reviewed. Patient demographics, endoscopic anatomy, type of surgery (primary or revision), predisposing risk factors, site and extent of injury on CT imaging, and associated complications were evaluated. In addition, data regarding ophthalmologic management and clinical outcomes were collected. Results: Ten patients with EOM injuries after ESS were included in this study. One patient was undergoing revision ESS. All patients sustained medial rectus muscle injury and one patient suffered concurrent ipsilateral inferior rectus muscle injury. A microdebrider was used in nine cases. Right-sided injury (90% of patients) was more prevalent than left-sided injury, and 70% of injured medial rectus muscles were completely transected. After subsequent strabismus surgery, 8/9 patients regained binocular single vision in primary gaze despite residual diplopia in some gaze positions. Conclusion: Although proper ophthalmologic surgery after EOM injury may improve deviation in the primary gaze position, none of the patients regained normal EOM movement. Therefore, prevention of this complication through adequate surgical technique and precautions is important.

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