Revision Functional Endoscopic Sinus Surgery: Objective and Subjective Surgical Outcomes

2005 ◽  
Vol 19 (4) ◽  
pp. 344-347 ◽  
Author(s):  
K. Christopher McMains ◽  
Stilianos E. Kountakis
Keyword(s):  
Medical Therapy ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Patient Symptom ◽  
Before And After ◽  
Revision Sinus Surgery ◽  
Preoperative Ct ◽  
The Mean

Background The aim of this study was to report objective and subjective outcomes after revision sinus surgery (RESS) for chronic rhinosinusitis (CRS). Methods We performed a retrospective analysis of prospectively collected data in 125 patients requiring revision functional endoscopic sinus surgery after failing both maximum medical therapy and prior sinus surgery for CRS. Patients were seen and treated over a 3-year period (1999–2001) in a tertiary rhinology setting. Computed tomography (CT) scans were graded as per Lund-MacKay and patient symptom scores were recorded using the Sinonasal Outcome Test 20 (SNOT-20) instrument. Individual rhinosinusitis symptoms were evaluated on a visual analog scale (0–10) before and after surgery. All patients had a minimum 2-year follow-up. Results The mean number of prior sinus procedures was 1.9 ± 0.1 (range, 1–7) and the mean preoperative CT grade was 13.4 ± 0.7. Patients with asthma and polyposis had higher CT scores than those without these processes. Preoperative mean SNOT-20 and endoscopy scores were 30.7 ± 1.3 and 7.3 ± 0.4, respectively. At the 2-year follow-up, mean SNOT-20 and endoscopy scores improved to 7.7 ± 0.6 and 2.1 ± 0.4, respectively (p < 2.8 X 10-10). At 12-month follow-up, each individual symptom score decreased significantly. Overall, 10 patients failed RESS and required additional surgical intervention for an overall failure rate of 8.0%. All patients who failed RESS had nasal polyposis. Conclusion Revision functional endoscopic sinus surgery benefits patients that fail maximum medical therapy and prior sinus surgery for CRS by objective and subjective measures.

Subjective Headache before and after Endoscopic Sinus Surgery

2006 ◽  
Vol 20 (3) ◽  
pp. 305-307 ◽  
Author(s):  
William H. Moretz ◽  
Stilianos E. Kountakis
Keyword(s):  
Retrospective Analysis ◽  
Endoscopic Sinus Surgery ◽  
Nasal Polyps ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Common Symptom ◽  
Analog Scale ◽  
Before And After ◽  
The Mean

Background The aim of this study was to show the effect of endoscopic sinus surgery on subjective headache scores in patients diagnosed with chronic rhinosinusitis (CRS) with or without nasal polyps. Methods We performed a retrospective analysis of prospectively collected data from 201 patients over a 2-year period. Headache and Sino-Nasal Outcomes Test (SNOT-20) mean scores were compared preoperatively and 2 years postoperatively on patients diagnosed with CRS with or without nasal polyps. Results Two hundred one patients underwent surgical management of CRS with or without nasal polyps over a 3-year period. One hundred four patients were men and 97 were women, with a mean age of 49 (range, 18–80 years) years. Polyps were present in 78 patients with CRS. The mean subjective headache score based on a 0–10 visual analog scale improved from 4.7 preoperatively to 0.8 2 years postoperatively (p < 0.0001). The mean headache score of 123 patients without polyps was larger compared with 78 patients with polyps (5.1 versus 4.1, respectively; p < 0.05). As previously reported, the mean overall preoperative and postoperative SNOT-20 scores were 28.7 and 6.7, respectively (p < 0.0001). Conclusion Headache is a common symptom with CRS, present in 73.6% of our patients undergoing functional endoscopic sinus surgery for CRS with or without nasal polyps. An overall decrease in mean headache scores was noted at 2-year follow-up.

scholarly journals Outcome of Functional Endoscopic Sinus Surgery in Patients with Chronic Rhinisinusitis Not Responding to Medical Therapy

2019 ◽  
Vol 15 (4) ◽  
pp. 235-238
Author(s):  
Pradeep Kumar Pyakurel ◽  
Deepak Paudel ◽  
Shyam Thapa Chettri
Keyword(s):  
Chronic Rhinosinusitis ◽  
Medical Therapy ◽  
Medical Management ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Safe Procedure ◽  
Endoscopic Score ◽  
The Mean ◽  
Prospective Longitudinal

Background: chronic rhinosinusitis (CRS) is common chronic condition and is treated with antibiotics, nasal irrigation and steroids. Patients who do not respond to medical therapy are subjected to functional endoscopic sinus surgery. The objective of the study is to assess the clinical improvement after functional endoscopic sinus surgery among the patients of chronic rhinosinusitis (CRS) who failed medical management. Methods: A Prospective longitudinal study conducted within a period of 1 year. Patient with CRS who failed with medical management were subjected functional endoscopic sinus surgery (FESS). Pre –operative symptoms score and endoscopic score were assessed and compared with that of post- operative scores at the end of 6 weeks and 12 weeks. Results: Fifty-two patients who completed three months of follow up were included in the study. The mean preoperative VAS symptoms score was 5.7 and was 2.23 after FESS and difference was significant (P <0.01). There was significant improvement of the endoscopic score (ES) after FESS, the mean ES preoperatively was 4.038 and it improved to1.31 at 6 weeks and 0.75 in the 12 postoperative weeks. Post-operative adhesion was the most common complication and occurred in 15% of patients. Conclusions: FESS is a safe procedure. Patients with CRS who don’t respond to medical therapy should undergo this safe surgical procedure FESS with good outcome. Keywords: chronic rhinosinusitis; functional endoscopic sinus surgery; outcome.

Pre- and Postoperative Mucociliary Clearance in Functional Endoscopic Sinus Surgery

1997 ◽  
Vol 76 (12) ◽  
pp. 884-886 ◽  
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.

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.

Balloon catheter sinusotomy: One-year follow-up—Outcomes and role in functional endoscopic sinus surgery

2008 ◽  
Vol 139 (3_suppl_1) ◽  
pp. S27-S37 ◽  
Author(s):  
Frederick A. Kuhn ◽  
Christopher A. Church ◽  
Andrew N. Goldberg ◽  
Howard L. Levine ◽  
Michael J. Sillers ◽  
...  
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Balloon Catheter ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
One Year

scholarly journals Role of Hypotensive Anaesthesia in Functional Endoscopic Sinus Surgery in Private Practice

2020 ◽  
Vol 24 (1) ◽  
pp. 8-13
Author(s):  
Md Nurullah ◽  
Md Arif Hossain Bhuyan ◽  
Syed Ariful Islam ◽  
Md Shah Alam
Keyword(s):  
Heart Rate ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Controlled Hypotension ◽  
Operative Field ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Functional endoscopic sinus surgery (FESS), effective control of bleeding is essential to maintain a clear operative field and to minimize complications. Intraoperative bleeding is one of the major problems in endoscopic surgery of sinuses. Controlled hypotension is a technique used to limit intraoperative blood loss to provide the best possible field for surgery. Objective: The objective of study was role of Hypotensive Anaesthesia in Functional Endoscopic Sinus Surgery and designed to compare intraoperative hemorrhage and the visibility of the operative field during normotension and hypotension anesthesia. Methods: Prospective randomized study includes a total of 60 ASA I-II patients who underwent elective FESS surgery. Patients randomly assigned in two groups the hypotension group (Group A) and the normotension group (Group B). Intraoperative mean arterial pressure (MAP), heart rate (HR) were recorded. Results : This study shows the mean ages of the patients of group A group B were 33.36±7.61 and 32.46±7.73 years respectively. No statistically significant difference was observed among groups at 0.05 level in term of age. The mean heart rate pre-anaesthesia and preoperative among the patients of different groups in different follows up period. Significance differences were observed among groups in term of heart rate at 5 minute, 15 minute, 30 minute, 45 minute and 60 minute. The mean arterial mean blood pressure before pre-anaesthesia and preoperative estimation among the patients of different groups in different follows up period. Significance differences were observed among groups at 5 minute, 15 minute, 30 minute, 45 minute and 60 minute. Conclusion: This study demonstrated that Controlled hypotension can be achieved equally and effectively by nitroglycerin and labetalol reduced significantly intraoperative hemorrhage and produce hypotensive anesthesia. Both are equally effective in providing ideal surgical field during functional endoscopic sinus surgery (FESS). Bangladesh J Otorhinolaryngol; April 2018; 24(1): 8-13

Long-Term Effects of FloSeal™ Packing After Endoscopic Sinus Surgery

2005 ◽  
Vol 19 (3) ◽  
pp. 240-243 ◽  
Author(s):  
Rakesh K. Chandra ◽  
David B. Conley ◽  
G. Kenneth Haines ◽  
Robert C. Kern
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Scar Tissue ◽  
Sinus Surgery ◽  
Tissue Formation ◽  
Long Term Effects ◽  
Study Evaluation ◽  
Long Term Follow Up ◽  
The Mean

Background A previous study by our group showed increased adhesions and granulation tissue in ethmoid cavities packed with FloSeal (FS) compared with those packed with thrombin-soaked gelatin foam after endoscopic sinus surgery (ESS). That study included 20 patients whose cavities were graded 6–8 weeks postoperatively. The goal of this study was to report long-term follow-up on this cohort. Methods At least 1 year follow-up was available in 18/20 patients. The number of office procedures required to lyse adhesions during the follow-up period was tabulated also. Pathology was available from one patient who underwent lysis of adhesions on an FS side. The histopathological findings are presented. Results The mean follow-up period was 21.4 (±2.3) months, and none of the 18 patients required revision ESS during this interval. The overall incidence of adhesions (p = 0.013) and the number requiring lysis of adhesions (p = 0.046) were both greater in the FS group. During the interval between previous study evaluation (6–8 weeks postop) and last follow-up, five FS sides required a total of seven procedures to lyse adhesions. Silent adhesions were observed in an additional five FS sides. Although asymptomatic adhesions were observed in two thrombin-soaked gelatin sides at last examination, none underwent lysis. Biopsy of an adhesion from a patient packed with FS 25 months earlier revealed incorporated foreign material. Conclusion FS appears to be associated with scar tissue formation and may be incorporated into recovering mucosa. Use of FS may increase the degree of postoperative care required after ESS.

Evaluation of effectiveness of single-stage septoplasty during endoscopic rhinosinus surgery in children

2021 ◽  
Vol 19 (2) ◽  
pp. 8-13
Author(s):  
S. I. Alekseenko ◽  
◽  
S. A. Karpishchenko ◽  
S. A. Artyushkin ◽  
A. A. Korneenkov ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Single Stage ◽  
Sinus Surgery ◽  
Secretory Otitis Media ◽  
Endoscopic Septoplasty ◽  
Low Degree ◽  
Mucosal Edema

The purpose of this study was to analyze results of simultaneous septoplasty and functional endoscopic sinus surgery in children. The study included 341 children who underwent endoscopic functional sinus surgery. The average age of patients was 11.2 ± 0.4 years. The follow – up period was 33.06 ± 6.9 months. Endoscopic septoplasty was performed simultaneously with FESS (functional endoscopic sinus surgery) in 72 children (21.1%). A comparative analysis of the results of FESS and endoscopic septoplasty showed a statistically significant association for 15 indicators on the SNOT 20 scale (p < 0.05). Significant differences were found both in general symptoms: sleep disturbance, cough, irritability, dizziness, decreased concentration, fatigue, emotional depression, sadness, grief, and local: nasal obstruction, post-nasal drip, hyposmia, mucosal edema, secretory otitis media, rhinorrhea, dry throat. Correlation analysis of the results of FESS and endoscopic septoplasty in relation to the child’s age did not reveal statistically significant differences: chi2 = 3.42 p = 0.33. The results of the study showed the efficacy of single-stage septoplasty when performing endoscopic rhinosinus surgery in childhood in improving local and general symptoms and a low degree of complications in the postoperative period.

The Incidence of Concurrent Osteitis in Patients with Chronic Rhinosinusitis: A Clinicopathological Study

2006 ◽  
Vol 20 (3) ◽  
pp. 278-282 ◽  
Author(s):  
Jivianne T. Lee ◽  
David W. Kennedy ◽  
James N. Palmer ◽  
Michael Feldman ◽  
Alexander G. Chiu
Keyword(s):  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Critical Role ◽  
Clinical Findings ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
The Past ◽  
The Mean ◽  
A Prospective Study ◽  
Inflammatory Changes

Background The pathogenesis of chronic rhinosinusitis (CRS) has been found to be multifactorial, with environmental, general host, and local anatomic factors all contributing to its development. Recent studies have indicated that local osteitis of the underlying bone also may play a critical role in the elaboration of CRS by inducing persistent inflammatory changes in the surrounding mucosa. The purpose of this study was to determine the clinical incidence rate of osteitis in patients with CRS undergoing functional endoscopic sinus surgery. Methods From January to July 2003, a prospective study was performed on 121 patients undergoing functional endoscopic sinus surgery for CRS. Age, number of previous surgeries, radiographic bony characteristics, and pathological findings were all documented. The presence of concurrent osteitis was assessed using both radiographic (neoosteogenesis) and pathological (bony remodeling) criteria. Results The mean age of the patients was 44.3 years. Fifty-eight percent of the cases were revision surgeries, with each patient having an average of 2.2 operative procedures in the past. Computed tomography (CT) showed neoosteogenesis in 36% of patients, and 53% showed pathological evidence of osteitis on histological analysis of surgical specimens. Conclusion Concurrent osteitis can be found in 36–53% of patients with CRS, using both radiographic and pathological criteria, respectively. Although a causal relationship between osteitis and CRS can not be inferred from this data, these clinical findings correlate well with previous evidence of bone involvement in CRS found in animal models, further reaffirming the association between underlying osteitis and the pathogenesis of CRS.

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.

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