Functional Endoscopic Sinus Surgery in Patients with Chronic Sinusitis and Asthma

Twenty asthma patients who underwent functional endoscopic sinus surgery for chronic sinusitis were studied. Medical records and questionnaire data for these 20 patients were studied regarding the Impact of sinus disease and functional endoscopic sinus surgery on their asthma. We found that 95% reported that their asthma was worsened by their sinus disease (95% confidence interval, 0.74 to 0.99+), and 85% reported that functional endoscopic sinus surgery improved their asthma (0.60 to 0.97). Of the 13 patients who used both inhalers and systemic medication, 53.8% were able to eliminate some of their medication (0.21 to 0.79). Furthermore, 61.5% of these patients had a concomitant reduction in their inhaler use (0.28 to 0.85). All patients (six) who used only inhalers experienced a reduction in their inhaler use (0.54 to 1.00), and two patients were able to eliminate their inhalers completely. One of two patients who were steroid dependent was able to discontinue steroids after surgery. Of patients who used steroids intermittently (13), 53.8% were able to eliminate the use of steroids after surgery (0.21 to 0.79). Patients who required preoperative hospital admissions (4) and emergency room or urgent physician office visits (18) had a 75.0% and 81.3% ( p < 0.001) reduction in visits, respectively, after surgery. Because 43% of the cost of asthma is the result of hospitalizations and emergency department/urgent physician office visits, a significant Impact on health care costs can be realized with functional endoscopic sinus surgery in this patient population.

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Endoscopic sinus surgery: evolution and technical innovations

The Journal of Laryngology & Otology ◽

10.1017/s0022215109991368 ◽

2009 ◽

Vol 124 (3) ◽

pp. 242-250 ◽

Cited By ~ 38

Author(s):

S Govindaraj ◽

N D Adappa ◽

D W Kennedy

Keyword(s):

Endoscopic Sinus Surgery ◽

Mucociliary Clearance ◽

Functional Endoscopic Sinus Surgery ◽

Sinus Surgery ◽

Sinus Disease ◽

Endoscopic Study ◽

Technological Advances ◽

Technical Innovations ◽

The Impact ◽

Nose And Sinuses

AbstractPrior to the introduction of functional endoscopic sinus surgery, several surgeons had begun to use telescopes to perform surgical procedures in the nose and sinuses. However, the central concepts of functional endoscopic sinus surgery evolved primarily from Messerklinger's endoscopic study of mucociliary clearance and endoscopic detailing of intranasal pathology. The popularity of a combination of endoscopic ethmoidectomy plus opening of secondarily involved sinuses grew rapidly during the latter part of the twentieth century, and endoscopic intranasal techniques began to expand to deal with pathology other than inflammation. We present a review of the evolution of knowledge regarding the pathogenesis of inflammatory sinus disease since that point in time, and of the impact that this has had on the management of inflammatory sinus disease. We also detail the technological advances that have allowed endoscopic intranasal techniques to expand and successfully treat other pathology, including skull base and orbital disease. In addition, we describe evolving technologies which may further influence development within this field.

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The Effect Of Functional Endoscopic Sinus Surgery On Lung Function In Patients With Chronic Sinusitis And Nasal Polyps Without Asthma

ENT Updates ◽

10.32448/entupdates.459007 ◽

2018 ◽

pp. 93-99

Author(s):

Metin Yıldırım ◽

Seyda Belli ◽

Cemal Ozyilmaz ◽

Ozcan Ogurlu

Keyword(s):

Lung Function ◽

Endoscopic Sinus Surgery ◽

Nasal Polyps ◽

Chronic Sinusitis ◽

Functional Endoscopic Sinus Surgery ◽

Sinus Surgery

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Functional endoscopic sinus surgery- a newer surgical concept in the management of chronic sinusitis

Indian Journal of Otolaryngology and Head & Neck Surgery ◽

10.1007/bf02996424 ◽

1999 ◽

Vol 52 (1) ◽

pp. 13-16

Author(s):

V. P. Venkatachalam ◽

Arun Bhat

Keyword(s):

Endoscopic Sinus Surgery ◽

Chronic Sinusitis ◽

Functional Endoscopic Sinus Surgery ◽

Sinus Surgery

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Partial Endoscopic Middle Turbinectomy Augmenting Functional Endoscopic Sinus Surgery

Otolaryngology ◽

10.1177/019459989210700307 ◽

1992 ◽

Vol 107 (3) ◽

pp. 382-389 ◽

Cited By ~ 49

Author(s):

William R. Lamear ◽

William E. Davis ◽

Jerry W. Templer ◽

Joel P. Mckinsey ◽

Herbierto Del Porto

Keyword(s):

Endoscopic Sinus Surgery ◽

Underlying Disease ◽

Functional Endoscopic Sinus Surgery ◽

Sinus Surgery ◽

Atrophic Rhinitis ◽

Standard Component ◽

Patients At Risk ◽

Nasal Physiology ◽

Middle Meatus Antrostomy ◽

The Impact

Endoscopic sinus surgery has gained acceptance in the otolaryngologic community as an effective and safe method of treating inflammatory disease of the paranasal sinuses. At our institution, partial endoscopic middle turbinectomy has become a standard component of the procedure and our experience is reported. Middle turbinectomy enhances surgical exposure, specific anatomic anomalies are more completely corrected, and subpopulations of patients at risk for failure because of their underlying disease enjoy decreased rates of synechiae formation and closure of the middle meatus antrostomy when followed over time. Photodocumentation of the surgical technique and a discussion regarding the impact of middle turbinectomy on normal nasal physiology are presented. It is reported that the procedure is safe, and no complications directly attributable to middle turbinectomy (including atrophic rhinitis) are reported in a series of 298 patients.

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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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Functional Endoscopic Sinus Surgery in the Immunocompromised Child

Otolaryngology ◽

10.1177/019459989110500608 ◽

1991 ◽

Vol 105 (6) ◽

pp. 818-825 ◽

Cited By ~ 31

Author(s):

Brian J. Wiatrak ◽

Paul Willging ◽

Charles M. Myer

Keyword(s):

Endoscopic Sinus Surgery ◽

Fatal Outcome ◽

Chemotherapeutic Agents ◽

Functional Endoscopic Sinus Surgery ◽

Sinus Surgery ◽

Fungal Sinusitis ◽

Sinus Disease ◽

Immunocompromised Child ◽

Surgical Modality ◽

Sinonasal Disease

Fungal sinusitis in the immunocompromised child is an aggressive, invasive process that may result in a fatal outcome if not diagnosed early. As a result of increasing use of bone marrow transplantation and new cytotoxic chemotherapeutic agents resulting in severe agranulocytopenia, more patients have become susceptible to fungal sinus disease. Functional endoscopic sinus surgery has emerged recently as an important surgical modality in the treatment of sinus disease in adults and children. Use of this technique in immunosuppressed children has allowed early diagnosis of fungal sinonasal disease, resulting in earlier surgical intervention. The high-quality fiberoptic capability of nasal endoscopes allows very detailed visualization of the internal anatomy of the nose and detects early mucosal changes as a result of intranasal fungal disease. Our experience using functional endoscopic sinus surgery in immunocompromised children over an 18-month period is reviewed. Our philosophy for diagnosis and management of immunocompromised children with suspected fungal sinonasal disease is discussed.

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Immunotherapy in Patients Undergoing Functional Endoscopic Sinus Surgery

Otolaryngology ◽

10.1177/019459989411000410 ◽

1994 ◽

Vol 110 (4) ◽

pp. 406-412 ◽

Cited By ~ 71

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.

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Clinical Evaluation of Maxillary Diffuse Polypoid Sinusitis after Functional Endoscopic Sinus Surgery

American Journal of Rhinology ◽

10.2500/105065894781882666 ◽

1994 ◽

Vol 8 (1) ◽

pp. 7-12 ◽

Cited By ~ 7

Author(s):

Chia-Ming Liu ◽

Te-Huei Yeh ◽

Mow-Ming Hsu

Keyword(s):

Clinical Evaluation ◽

Endoscopic Sinus Surgery ◽

Chronic Sinusitis ◽

Functional Endoscopic Sinus Surgery ◽

Sinus Surgery ◽

Maxillary Sinuses

Functional endoscopic sinus surgery (FESS) for chronic sinusitis has become popular as a substitution for radical operations. We selected 24 patients with diffuse polypoid rhinosinopathy who had been admitted for FESS and followed up for at least 6 months. The recovery of 39 maxillary sinuses was inspected with endoscopy through the enlarged middle meatal antrostomies. We found that of 8 sinuses recovered, 19 still had diffuse polypoid change, and another 12 had focal polypoid sinuses. We conclude that for diffuse polypoid rhinosinopathy, management of maxillary polypoid mucosa is complicated, and recovery of polypoid mucosa is dependent not only on the patency of the sinus ostia, but also on other factors such as alterations of mucosal, glandular, and epithelial changes by chronic stimuli.

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