Comparison of Endoscopic Sinus Surgery with and without Image Guidance

2002 ◽  
Vol 16 (4) ◽  
pp. 193-197 ◽  
Author(s):  
Marvin P. Fried ◽  
Vik M. Moharir ◽  
Jennifer Shin ◽  
Marta Taylor-Becker ◽  
Paul Morrison ◽  
...  
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Image Guidance ◽  
Operative Time ◽  
Tertiary Care ◽  
Guidance System ◽  
Sinus Surgery ◽  
Control Group ◽  
Repeat Surgery ◽  
Patient Profile ◽  
Estimated Blood Loss

Background Image guidance based on preacquired computed tomography scans of the patient is a technique used to assist the physician during endoscopic sinus surgery (ESS). This study seeks to compare ESS with and without image guidance, analyzing a number of parameters that can impact on efficacy. Methods Retrospective chart review took place at a tertiary care referral center. The study group consisted of 97 consecutive patients confirmed to have undergone ESS using an electromagnetic intraoperative image guidance system (IGS). The control group consisted of 61 consecutive patients who underwent ESS, before the IGS was available at the study hospital. The main outcomes measured were analysis of patient profile, including coexisting conditions such as asthma and polyposis, assessment of which specific sinuses underwent surgical treatment; major and minor complications; estimated blood loss (EBL); operative time; and the need for repeat surgery. Results The IGS group had 74% of patients with polyposis; more sinuses, on average, which underwent surgical revision; one major and three minor complications; an average EBL of 134 cc, an average procedure time of 154 minutes; and one patient who needed repeat surgery in a 3-month follow-up period. The non-IGS group had 40% of patients with polyposis; seven major complications and one minor complication; an average EBL of 94 cc; and three patients who needed repeat surgery within 3 months. Conclusions The use of an IGS for endoscopic sinus surgery may reduce the complications associated with the procedure and allow for a more thorough operation. However, operative time and EBL may be increased.

New armless image-guidance system for endoscopic sinus surgery

1998 ◽  
Vol 119 (5) ◽  
pp. 528-532 ◽  
Author(s):  
Randal A. Otto ◽  
Marvin P. Fried ◽  
Kleefield Jonathan ◽  
Taylor Rodney
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Image Guidance ◽  
Guidance System ◽  
Sinus Surgery

Effect of Coblation Polypectomy on Estimated Blood Loss in Endoscopic Sinus Surgery

2009 ◽  
Vol 23 (5) ◽  
pp. 535-539 ◽  
Author(s):  
Jean Anderson Eloy ◽  
Thomas J. Walker ◽  
Roy R. Casiano ◽  
Jose W. Ruiz
Keyword(s):  
Blood Loss ◽  
Endoscopic Sinus Surgery ◽  
Nasal Polyposis ◽  
Care Center ◽  
Tertiary Care ◽  
Sinus Surgery ◽  
New Device ◽  
Estimated Blood Loss ◽  
Duration Of Surgery ◽  
University Of Miami

Background We conducted a pilot study comparing estimated blood loss (EBL) using coblation-assisted endoscopic sinus surgery (CAESS) where coblation is used to debulk nasal polyps before microdebridement with a traditional microdebrider technique in chronic rhinosinusitis (CRS) patients with sinonasal polyps undergoing endoscopic sinus surgery (ESS). Methods A retrospective analysis was performed at a tertiary care center on patients with nasal polyposis undergoing ESS between January 2008 and July 2008. The University of Miami CT staging system was used preoperatively to evaluate the extent of sinonasal disease. The duration of surgery, blood loss per minute, total EBL, and demographic data were collected. Results Twenty-one patients underwent nasal polypectomy/ESS using CAESS and 16 patients underwent nasal polypectomy/ESS using microdebridement. The two groups had comparable University of Miami CT staging scores (p > 0.05). The average EBL was 307.1 ± 169.8 mL using coblation compared with 627.8 ± 424.2 mL using microdebridement (p < 0.05). The average duration of surgery using coblation was 116.2 ± 41.7 minutes, compared with 125.3 ± 48.4 minutes using microdebridement (p > 0.05). The average blood loss per minute was 2.8 ±1.7 mL in the coblation group compared with 4.8 ± 2.1 mL in the microdebridement group (p < 0.05). Subgroup analyses showed a significant decrease in average EBL and EBL/minute to be only significant for revision cases (p < 0.05) and not for primary cases (p > 0.05). Conclusion Coblation-assisted nasal polypectomy/ESS is associated with a statistically significant lower EBL and blood loss per minute when compared with traditional microdebridement technique. Coblation represents a new device that can reduce blood loss in patients with nasal polyposis undergoing traditional revision ESS. Further prospective randomized trials are needed to validate these findings.

scholarly journals Correlations and Comparison between Repeat Computed Tomography Scores, Endoscopy Scores and Symptomatic Improvement before and after Endoscopic Sinus Surgery: A Pilot Study

2013 ◽  
Vol 6 (1) ◽  
pp. 32-40 ◽  
Author(s):  
NV Deepthi ◽  
Indudharan R Menon
Keyword(s):  
Computed Tomography ◽  
Pilot Study ◽  
Endoscopic Sinus Surgery ◽  
Medical Center ◽  
Tertiary Care ◽  
Objective Evaluation ◽  
Symptomatic Improvement ◽  
Sinus Surgery ◽  
Tertiary Care Medical Center ◽  
Before And After

ABSTRACT Background Chronic rhinosinusitis (CRS) is diagnosed on the basis of symptoms, nasal endoscopic findings and computed tomography of the paranasal sinuses (CT PNS). Where indicated, functional endoscopic sinus surgery (FESS) is the surgical treatment. Objective To determine correlations between subjective symptom severity and objective endoscopic and radiologic findings in CRS and to compare these before and after FESS. Materials and methods Analysis of prospectively collected data of 20 patients undergoing FESS at a tertiary care medical center followed up for a minimum period of 6 months after surgery. RSI questionnaire-based symptom score, Lund-Mackay system-based endoscopic and CT finding scores were recorded preoperatively and at 8 weeks and 6 months postoperatively. Results Significant positive correlation was noted between the three parameters before surgery, especially endoscopic and radiological scores (r = 0.94 in the latter, p < 0.01 in all three). Postoperative improvement was statistically significant for all three parameters, even at the 6 months stage (p < 0.001). Postoperative correlations reduced significantly, especially between endoscopic and radiological scores. Conclusion This study showed the relevance of objective evaluation of routine parameters of CRS, preoperatively. It also confirmed the usefulness of FESS in indicated cases, in terms of statistical improvement of these parameters. However, repeat CT scans and the methods of scoring used by us may not be equally applicable in the long-term postoperative scenario. How to cite this article Deepthi NV, Menon UK, Menon IR. Correlations and Comparison between Repeat Computed Tomography Scores, Endoscopy Scores and Symptomatic Improvement before and after Endoscopic Sinus Surgery: A Pilot Study. Clin Rhinol An Int J 2013;6(1):32-40.

APPROACH TO UNCINECTOMY BY SWING DOOR TECHNIQUE VS STANDARD TECHNIQUE – A COMPARATIVE STUDY

2021 ◽  
pp. 37-39
Author(s):  
Praveen Singh ◽  
Tarun Ojha ◽  
Shreya Prasad
Keyword(s):  
Complication Rate ◽  
Endoscopic Sinus Surgery ◽  
Maxillary Sinusitis ◽  
Tertiary Care ◽  
Standard Technique ◽  
Symptomatic Improvement ◽  
Sinus Surgery ◽  
Minor Complication ◽  
Tertiary Care Centre ◽  
Group B

Introduction: Uncinectomy is the most important step in endoscopic sinus surgery which can be performed by various methods. The present study aimed to compare the results and complications of performing uncinectomy and middle meatus antrostomy using the standard and swing door techniques during FESS. Methods: In this study, 50 patients of both gender (aged 18–50 years) suffering from chronic maxillary sinusitis underwent functional endoscopic sinus surgery (FESS) from January 2019 to December 2019 at a tertiary care centre. The patients were divided on random basis into two groups of 25. Group Apatients underwent uncinectomy using standard technique while Group B underwent uncinectomy using swing door technique. Results:The mean VAS scores for Group Aand Group B were 78.50 ± 16.63 and 80.58 ± 14.34, respectively, suggesting that Group B patients have better symptomatic improvement. No major complications were observed in both groups. At the end of Week 2, minor complications were observed in 8 (26.7%) of the patients from Group Aand 2 (6.7%) from Group B. By the sixth week, the minor complication rate was 1 (3.3%) and 0 in Group A and Group B, respectively. When compared statistically during the second week using chi-square test, the difference in minor complication rate was found to be statistically signicant (p < 0.05, 2 = 4.81), with lower incidence of complications in Group B. Conclusion: Uncinectomy performed by swing door technique produces better postoperative results, with lesser complications, when compared to the standard technique.

The Effects of Endoscopic Sinus Surgery on Voice Characteristics in Chronic Rhinosinusitis Patients

2019 ◽  
Vol 128 (12) ◽  
pp. 1129-1133
Author(s):  
Danny B. Jandali ◽  
Ashwin Ganti ◽  
Inna A. Husain ◽  
Pete S. Batra ◽  
Bobby A. Tajudeen
Keyword(s):  
Quality Of Life ◽  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Tertiary Care ◽  
Voice Quality ◽  
Upper Airway ◽  
Sinus Surgery ◽  
Perceptual Evaluation ◽  
Snot 22

Objectives: Functional endoscopic sinus surgery (FESS) is a standard treatment modality for patients with chronic rhinosinusitis (CRS) who have failed appropriate medical therapy. However, FESS entails modification of the upper airway tract that may alter phonatory resonance and produce voice changes. The effects of FESS on postoperative voice characteristics in patients with CRS have yet to be quantitatively assessed. Methods: Patients with severe CRS who underwent FESS at a tertiary care referral center between May and October 2017 were prospectively enrolled. The Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) and the Voice Handicap Index (VHI) were used to quantitatively evaluate voice characteristics and quality of life, respectively. Preoperative and postoperative CAPE-V and VHI scores were compared with postoperative scores for each patient. Sino-Nasal Outcome Test (SNOT-22) scores were also obtained to assess changes in patient symptoms. Results: 18 CRS patients undergoing FESS were enrolled. The average preoperative Lund-Mackay score was 14, indicating baseline severe CRS. Postoperative assessments demonstrated a statistically significant decrease in CAPE-V (45-27, p = .005) and VHI (10-4.7, p < .001) scores. These correlated with a statistically significant decrease in SNOT-22 scores (42-13, p < .001). Conclusions: Patients with CRS experience a significant improvement in voice characteristics and vocal quality of life following FESS. Furthermore, this appears to correlate with a significant decrease in self-reported disease severity. These findings may augment the discussion of potential benefits of FESS to a new potential domain for voice quality.

S289 – Effect of Pterygopalatine Injection on EBL in Sinus Surgery

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P171-P171
Author(s):  
Michael Bublik ◽  
Jean A Eloy ◽  
Brian Tse ◽  
Ruiz Jose W ◽  
Roy R Casiano
Keyword(s):  
Statistical Significance ◽  
Demographic Data ◽  
Pterygopalatine Fossa ◽  
Sinus Surgery ◽  
Control Group ◽  
Simple Method ◽  
Injection Group ◽  
Greater Palatine Foramen ◽  
Estimated Blood Loss ◽  
The Difference

Objectives We compare estimated blood loss (EBL) during functional endoscopic sinus surgery between patients receiving transoral pterygopalatine fossa and transnasal infiltration (combined) to patients receiving only transnasal infiltration. Variables such as CT-stage, revision surgery, presence of polyps, and operative time are considered. Methods Injection with 1% lidocaine with 1:100,000 epinephrine was performed through the greater palatine foramen and transnasally in the “combined” study group (20 patients) and only transnasally in the control group (22 patients). Charts, operative reports, and CT scans were reviewed and demographic data as well as pertinent information were collected. Patients were followed up and all additional procedures and events were recorded. Results 12 females and 8 males, average age of 48, underwent combined injections; 16 males and 6 females (average age of 50) were in the control group. Using the Wilcoxon/ Kruskal-Wallis Tests (Rank Sums), mean EBL calculated for the combined injection group was 347ml and 493ml for the transnasal injection group (CI 0.95, p=0.093). Average ratio of EBL over OR time was 2.89 ml/min for the combined group and 4.11 ml/min for the control group. We also compare EBL between groups in patients with polyps, endoscopic and CT stage, and revision cases. No complications were reported. Conclusions Combined injection of the pterygopalatine fossa and nasal cavity appears to be a safe and relatively simple method to decrease EBL during sinus surgery, but initial data analysis shows that the difference did not reach statistical significance.

Office-Based Sinus Surgery for Cystic Fibrosis Chronic Rhinosinusitis

ORL ◽  
2020 ◽  
pp. 1-4
Author(s):  
Daniel B. Spielman ◽  
David A. Gudis
Keyword(s):  
Cystic Fibrosis ◽  
Mechanical Ventilation ◽  
Chronic Rhinosinusitis ◽  
Local Anesthesia ◽  
Endoscopic Sinus Surgery ◽  
Care Center ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Sinus Surgery ◽  
Office Setting

<b><i>Objective:</i></b> Chronic rhinosinusitis (CRS) is nearly ubiquitous in the cystic fibrosis (CF) population, and many patients require multiple endoscopic sinus surgeries throughout their lifetime. Recent studies have demonstrated the profound pulmonary and systemic health benefits of comprehensive CRS treatment. Both endotracheal intubation with mechanical ventilation and inpatient hospital care represent significant risks for CF patients. The goal of this study is to evaluate the safety and feasibility of performing revision endoscopic sinus surgery for CF patients in the outpatient office setting using only local anesthesia to decrease the need for mechanical ventilation and inpatient hospitalization. <b><i>Methods:</i></b> This is a prospective cohort study conducted at a tertiary care academic medical center with a CF Foundation-accredited care center. Patients with CF and refractory CRS despite prior surgery and medical therapy were eligible for inclusion. Comprehensive revision ESS was performed in the office using only local anesthesia. <b><i>Results:</i></b> Five patients were enrolled and underwent revision endoscopic sinus surgery without complication. The average preoperative Sinonasal-Outcome Test-22 score was 52.0 ± 12.1 and the average preoperative Lund-Mackay score was 15.2 ± 3.8. No patients requested aborting the procedure early due to pain, discomfort, or any other reason. No subjects required prolonged observation or postoperative hospital admission. <b><i>Conclusion:</i></b> This prospective pilot study is the first to demonstrate the safety and feasibility of performing comprehensive revision endoscopic sinus surgery for CF patients in the outpatient office setting using only local anesthesia.

Hyaluronic acid for post sinus surgery care: systematic review and meta-analysis

2017 ◽  
Vol 131 (S1) ◽  
pp. S2-S11 ◽  
Author(s):  
E Fong ◽  
M Garcia ◽  
C M Woods ◽  
E Ooi
Keyword(s):  
Systematic Review ◽  
Hyaluronic Acid ◽  
Endoscopic Sinus Surgery ◽  
Meta Analysis ◽  
Adhesion Formation ◽  
Sinus Surgery ◽  
Current Evidence ◽  
Secondary Outcome ◽  
Control Group ◽  
Patient Reported

AbstractBackground:Wound healing after endoscopic sinus surgery may result in adhesion formation. Hyaluronic acid may prevent synechiae development. A systematic review was performed to evaluate the current evidence on the clinical efficacy of hyaluronic acid applied to the nasal cavity after sinus surgery.Methods:Studies using hyaluronic acid as an adjunct treatment following endoscopic sinus surgery for chronic rhinosinusitis were identified. The primary outcome was adhesion formation rates. A meta-analysis was performed on adhesion event frequency. Secondary outcome measures included other endoscopic findings and patient-reported outcomes.Results:Thirteen studies (501 patients) met the selection criteria. A meta-analysis of adhesion formation frequency on endoscopy demonstrated a lower risk ratio in the hyaluronic acid intervention group (42 out of 283 cases) compared to the control group (81 out of 282) of 0.52 (95 per cent confidence interval = 0.37–0.72). Hyaluronic acid use was not associated with any significant adverse events.Conclusion:Hyaluronic acid appears to be clinically safe and well tolerated, and may be useful in the early stages after sinus surgery to limit adhesion rate. Further research, including larger randomised controlled trials, is required to evaluate patient- and clinician-reported outcomes of hyaluronic acid post sinus surgery.

scholarly journals Effect of Sphenopalatine Ganglion Block With Bupivacaine on Postoperative Pain in Patients Undergoing Endoscopic Sinus Surgery

2019 ◽  
Vol 10 ◽  
pp. 215265671882128 ◽  
Author(s):  
Ahmad Rezaeian ◽  
Seyed Mostafa Hashemi ◽  
Zeinab Sadat Dokhanchi
Keyword(s):  
Postoperative Pain ◽  
Endoscopic Sinus Surgery ◽  
Intervention Group ◽  
Sinus Surgery ◽  
Control Group ◽  
Sphenopalatine Ganglion ◽  
Ganglion Block ◽  
Rescue Analgesia ◽  
Sphenopalatine Ganglion Block ◽  
And Control

Background Postoperative pain is one of the most complications in endoscopic sinus surgery. We aimed to evaluate the effect of the sphenopalatine ganglion block (SPGB) with bupivacaine on postoperative pain in patients undergoing endoscopic sinus surgery. Methods and Materials: In this clinical trial, 40 patients who indicated functional endoscopic sinus surgery were selected and then divided into 2 parallel groups as intervention and control. The intervention group was received 1.5 mL of bupivacaine 0.5% (injected to sphenopalatine ganglion) and while control was injected 1.5 mL of normal saline at the same injection site. Also, the visual analogue scale (VAS) was recorded immediately after anesthesia, along with 6, 12, 24, 48 h, 7 days, and 21 days after the operation for all patients. Results Immediately after anesthesia, as well as 6, 12, and 24 h after the operation, VAS in the intervention group was significantly lower than in the control group ( P < .05, for all). However, there were no significant differences between the 2 groups regarding VAS 48 h as well as 7 and 21 days after surgery ( P > .05, for both). Also, the rescue analgesia in the intervention group was significantly lower than in the control group ( P = .01). Conclusion SPGB with bupivacaine 0.5% (1.5 mL) was a simple, effective, safe, and noninvasive method for the management of postoperative pain in the patients undergoing endoscopic sinus surgery.

Sign in / Sign up

Export Citation Format

Share Document