Surgery with Post-Operative Endoscopy Improves Recurrence Detection in Sinonasal Malignancies

Objective: The mainstay of treatment in sinonasal malignancy (SNM) is surgery, and when combined with chemoradiation therapy, often leads to the best overall prognosis. Nasal endoscopy is essential for post-treatment surveillance along with physical exam and radiologic evaluation. The ability to directly visualize the sinus cavities after surgery may also improve early detection of tumor recurrence and is another reason to potentially advocate for surgery in these patients. Methods: A retrospective chart review of medical records of patients with pathologically proven SNM was conducted from 2005 to 2019. Results: The nasal cavity and maxillary sinus were the most common primary tumor sub-sites. The most common pathology was squamous cell carcinoma (42%). The median time to recurrence was 9.8 months. Recurrence was initially detected endoscopically in 34.3% patients, by imaging in 62.7% patients, and by physical exam in 3.0% patients. 67 (29%) total recurrences were detected on follow-up, of which 46 (68.7%) were local. Twenty-three of the local recurrences were identified via nasal endoscopy. Thirteen recurrences were identified via endoscopic surveillance within the surgically patent paranasal sinuses while 13 were identified within the nasal cavity; 5 patients had multiple sites of recurrence. Conclusion: Local recurrence of SNM is the most common site for recurrent disease and nasal endoscopy identified half of these cases. 50% of these recurrences were within the paranasal sinuses and would not have been easily identified if the sinuses were not open for inspection. Thus, open sinus cavities aid in the detection of tumor recurrence and is another advantage of surgery in the management of SNM.

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An overview of common diseases of the nasal cavity and paranasal sinuses

Journal of The Royal Naval Medical Service ◽

10.1136/jrnms-102-117 ◽

2016 ◽

Vol 102 (2) ◽

pp. 117-123

Author(s):

R Easto ◽

R Shukla ◽

R Williams

Keyword(s):

Nasal Cavity ◽

Chronic Rhinosinusitis ◽

Paranasal Sinuses ◽

Background Information ◽

Hospital Treatment ◽

Nasal Bones ◽

Common Complaint ◽

Sinonasal Malignancies ◽

Benign Group ◽

Nose And Throat

AbstractDiseases of the nasal cavity and paranasal sinuses are a common complaint amongst the general population and service personnel. Chronic rhinosinusitis, with or without nasal polyps, and nasal deformity leading to airway obstruction are some of the commonest ear, nose and throat (ENT) conditions encountered. However, hidden within this generally benign group of conditions are some potentially lethal problems that clinicians need to be able to recognise.This article aims to provide an overview of common conditions affecting the nose and paranasal sinuses, including fractured nasal bones, acute rhinosinusitis and its complications, and chronic rhinosinusitis. Epistaxis and sinonasal malignancies are largely outside the scope of this paper. Background information on pathogenesis will be described, along with guidance on diagnosis and management with particular stress on emergency pre-hospital treatment and indications for referral to an ENT specialist.

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The inhalation antibioticotherapy of acute bacterial rhinosinusitis

Medical Council ◽

10.21518/2079-701x-2018-20-50-54 ◽

2018 ◽

pp. 50-54 ◽

Cited By ~ 1

Author(s):

I. B. Angotoeva ◽

D. S. Pshennikov

Keyword(s):

Antibiotic Therapy ◽

Nasal Cavity ◽

Paranasal Sinuses ◽

Hospital Admissions ◽

Treatment Options ◽

Nasal Endoscopy ◽

Inhalation Therapy ◽

Systemic Antibiotic Therapy ◽

Acute Bacterial Rhinosinusitis ◽

Active Anterior Rhinomanometry

Epidemiological studies conducted throughout the world show that the inflammatory diseases of the nasal cavity and paranasal sinuses are the leading cause of otorhinolaryngology (ENT) hospital admissions and outpatient clinic referral. Although the most common cause of acute rhinosinusitis is viral infection, antibiotics are prescribed in more than 80% of cases, which may lead to the development of antimicrobial resistance. The topical inhalation therapy with the inhalation Complex «PARI SINUS device» (сompressor and nebulizer) may provide better treatment options for patients who suffer from the diseases of the nasal cavity and paranasal sinuses. Purpose of the study is to evaluate the efficacy of topical inhalation treatment of acute bacterial rhinosinusitis using pulsating aerosol in comparison with systemic antibiotic therapy. Materials and methods. 60 adult patients at the age from 19 to 62 years with the diagnosis uncomplicated moderate acute bacterial rhinosinusitis has been included in opened randomized controlled trial. 30 patients have been with the inhalation therapy by the combined drug Fluimucil® antibiotic IT (thiamphenicol glycinate acetylcystein, Zambon) using PARI SINUS device during 7 days. Controls – 30 patients have been treated with antibiotic therapy of acute bacterial rhinosinusitis using 875/125 mg oral amoxicillin/clavulanate twice daily for 7 days. The result was evaluated by the dynamics of the symptoms of acute bacterial rhinosinusitis (nasal congestion, blockage, facial pain and reduction of smell), active anterior rhinomanometry and nasal endoscopy. Results. For main symptoms of acute bacterial rhinosinusitis was no significant benefit of antibiotic therapy as compared to topical inhalation therapy using pulsating aerosol. Both treatment options were effective against acute bacterial rhinosinusitis, which is confirmed by the improvement of symptoms, active anterior rhinomanometry and nasal endoscopy. Conclusion. The topical nebulizer therapy of acute bacterial rhinosinusitis may provide better treatment options, because systemic antibiotics can be associated with different adverse effects.

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A Cadaveric Model for Measuring Continuous Positive Airway Pressure (CPAP) in the Nasal Cavity and Paranasal Sinuses: A Proof of Concept Study

10.1055/s-0039-1679476 ◽

2019 ◽

Author(s):

Ryan Rimmer ◽

Chandala Chitguppi ◽

Hermes Garcia ◽

Ian Koszewski ◽

Gurston Nyquist ◽

...

Keyword(s):

Continuous Positive Airway Pressure ◽

Nasal Cavity ◽

Paranasal Sinuses ◽

Airway Pressure ◽

Positive Airway Pressure ◽

Proof Of Concept ◽

Concept Study ◽

Cadaveric Model

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Anterior Craniofacial Resection: Progress in Treating Widespread Tumors of the Nasal Cavity, Paranasal Sinuses, and Orbit

Skull Base ◽

10.1055/s-2008-1093100 ◽

2008 ◽

Vol 18 (S 01) ◽

Author(s):

Rzayev Rafik ◽

Verdiyev Nazim

Keyword(s):

Nasal Cavity ◽

Paranasal Sinuses ◽

Craniofacial Resection

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CT evaluation of inverted papilloma in nasal cavity and paranasal sinuses

Journal of the Korean Radiological Society ◽

10.3348/jkrs.1991.27.2.206 ◽

1991 ◽

Vol 27 (2) ◽

pp. 206

Author(s):

Eun Young Kim ◽

Dong Ik Kim ◽

Jung Ho Suh ◽

Tae Sub Chung

Keyword(s):

Nasal Cavity ◽

Paranasal Sinuses ◽

Inverted Papilloma ◽

Ct Evaluation

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Percutaneous glycerol rhizotomy for trigeminal neuralgia in patients with multiple sclerosis: a long-term retrospective cohort study

Journal of Neurosurgery ◽

10.3171/2019.1.jns183093 ◽

2020 ◽

Vol 132 (5) ◽

pp. 1405-1413 ◽

Cited By ~ 1

Author(s):

Michael D. Staudt ◽

Holger Joswig ◽

Gwynedd E. Pickett ◽

Keith W. MacDougall ◽

Andrew G. Parrent

Keyword(s):

Multiple Sclerosis ◽

Pain Relief ◽

Trigeminal Neuralgia ◽

Retrospective Chart Review ◽

Medication Usage ◽

Free Response ◽

Free Survival ◽

Time To Recurrence ◽

Significant Difference

OBJECTIVEThe prevalence of trigeminal neuralgia (TN) in patients with multiple sclerosis (MS-TN) is higher than in the general population (idiopathic TN [ITN]). Glycerol rhizotomy (GR) is a percutaneous lesioning surgery commonly performed for the treatment of medically refractory TN. While treatment for acute pain relief is excellent, long-term pain relief is poorer. The object of this study was to assess the efficacy of percutaneous retrogasserian GR for the treatment of MS-TN versus ITN.METHODSA retrospective chart review was performed, identifying 219 patients who had undergone 401 GR procedures from 1983 to 2018 at a single academic institution. All patients were diagnosed with medically refractory MS-TN (182 procedures) or ITN (219 procedures). The primary outcome measures of interest were immediate pain relief and time to pain recurrence following initial and repeat GR procedures. Secondary outcomes included medication usage and presence of periprocedural hypesthesia.RESULTSThe initial pain-free response rate was similar between groups (p = 0.726): MS-TN initial GR 89.6%; MS-TN repeat GR 91.9%; ITN initial GR 89.6%; ITN repeat GR 87.0%. The median time to recurrence after initial GR was similar between MS-TN (2.7 ± 1.3 years) and ITN (2.1 ± 0.6 years) patients (p = 0.87). However, there was a statistically significant difference in the time to recurrence after repeat GR between MS-TN (2.3 ± 0.5 years) and ITN patients (1.2 ± 0.2 years; p < 0.05). The presence of periprocedural hypesthesia was highly predictive of pain-free survival (p < 0.01).CONCLUSIONSPatients with MS-TN achieve meaningful pain relief following GR, with an efficacy comparable to that following GR in patients with ITN. Initial and subsequent GR procedures are equally efficacious.

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Application of Nasomer in surgical treatment of patients with polyposis rhinosinusitis

OTORHINOLARYNGOLOGY 2-3(2) 2019 - OTORHINOLARYNGOLOGY ◽

10.37219/2528-8253-2018-2-39 ◽

2018 ◽

pp. 39-42

Author(s):

Vladimir Bereznyuk ◽

Alexander Chernokur ◽

Oleg Gospod

Keyword(s):

Nasal Cavity ◽

Postoperative Period ◽

Paranasal Sinuses ◽

Standard Treatment ◽

Surgical Intervention ◽

Sodium Hyaluronate ◽

Main Group ◽

Control Group ◽

Nasal Breathing ◽

Minimal Invasiveness

Relevance: Modern endonasal surgery allows to remove polyps from all affected paranasal sinuses, following the principles of minimal invasiveness. Minimal traumatic of surgical intervention gives the best results, accompanied by less progression of the disease. Minimal invasiveness of surgical intervention and its obligatory combination with postoperative medical treatment are common practice in many countries. One of the drugs that actively effect the restoration of the mucous membrane of the nasal cavity and paranasal sinuses in the early postoperative period is Nazomer, which includes sodium hyaluronate and dexpanthenol in saline solution. The purpose of the study is to investigate the effectiveness of the drug Nazomer in patients with polyposis rhinosinusitis after endoscopic polyposynosotomy. Results and discussion: The main group consisted of 30 patients with polyposis rhinosinusitis, who were prescribed Nasomer in addition to standard treatment in the postoperative period. The control group included 30 patients who underwent standard treatment in the postoperative period. As criteria for clinical efficacy, data from endoscopic examination of the nasal cavity and indicators of anterior rhinomatometry, measured by the «Optimus» device, were selected. In the main group, the index of nasal breathing according to rhinomatometry was better than the results of patients in the control group on the 3rd and 5th day of the postoperative period by 26% and 24%, respectively. Conclusion: The use of the drug Nazomer in the postoperative period in patients with polyposis rhinosinusitis contributes to more active restoration of respiratory function of the nasal cavity compared with the control group, according to rhinomatometry, up to 26%. Based on the results obtained, the drug Nazomer is an effective anti-inflammatory and regenerative agent in the postoperative period in patients with polyposis rhinosinusitis.

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