A comparative study between ciliary count and the degree of opacity of paranasal sinus CT scans in chronic sinusitis pre and post FESS

2005 ◽  
Vol 119 (12) ◽  
pp. 950-954 ◽  
Author(s):  
Ahmed Bassiouny ◽  
Mahmoud Abd El Raouf ◽  
Ahmed Atef ◽  
Safaa Nasr ◽  
Soha Talaat ◽  
...  

Objective: To investigate the relationship between the extent of sinus disease in chronic sinusitis as detected radiologically by computed tomography (CT) scan and the population of cilia (ciliary area) both before and after functional endoscopic sinus surgery (FESS). In a simple way this is a trial to statistically prove that the CT scan could be a valid indicator and a mirror of the histological status of the sinus mucosa.Design: Twenty adult patients were enrolled in this study. Radiological extension of the sinus disease was quantitated using the classification proposed by Kennedy in 1992 and the ciliary population was studied using scanning electron microscopy and image analysis softwares.Results and conclusion: The more advanced the sinusitis, as evidenced by CT scans, the more the expected reduction in the ciliary area (CA) and in the ciliary count. But after FESS the degree of ciliary regeneration does not depend statistically on the radiological condition of the sinuses and the degree of opacity prior to intervention, i.e. a statistically valid inverse relationship exists between the radiological stage of sinusitis and the ciliary population pre-operatively but the same relation does not extend to the ciliary population post-operatively.

1997 ◽  
Vol 76 (12) ◽  
pp. 884-886 ◽  
Author(s):  
Shashikant K. Kaluskar

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.


1994 ◽  
Vol 110 (6) ◽  
pp. 494-500 ◽  
Author(s):  
Gary J. Nishoka ◽  
Paul R. Cook ◽  
William E. Davis ◽  
Joel P. McKinsey

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.


2017 ◽  
pp. 114-121
Author(s):  
Xuan Trung Ho ◽  
Van Dung Phan ◽  
Tu The Nguyen ◽  
Thanh Thai Le

Objective: To evaluate the features and CT scan of chronic sinusitis with sphenoid sinusitis. To evaluate the results in patients undergoing Functional Endoscopic Sinus Surgery. Subjects and Method: a prospective descriptive study with intervention was designed for 34 patients at Hue Pharmacy and Medicine University hospital and Da nang hospital. Results: almost all patients presented nasal discharge, headache and nasal obstruction. Endoscopic assessment: grade III-IV 82,3%, grade I-II 17,7%. CT scan assessment: grade III-IV 85,2%, grade I-II 14,8%. 34 patients were followed up after 6 months. Conclusions: almost common presenting complaints were nasal discharge, headache and nasal obstruction. Majority of patients were better in symptoms, endoscopic and CT scan features. Key words: sphenoid sinusitis, chronic sinusitis, endoscopic sinus surgery


1993 ◽  
Vol 7 (3) ◽  
pp. 95-99 ◽  
Author(s):  
Mitchell B. Austin ◽  
Julius N. Hicks

This paper describes clinical outcomes in patients who underwent FESS. The subjects included 64 patients with chronic sinusitis, ranging in age from 11 to 66 years. A total of 44 (68%) underwent bilateral FESS, 16 (25%) underwent unilateral FESS, and 4 (7%) had anterior-posterior removal of tissue. No major complications occurred and minor complications occurred in eight patients (12.3%). At 6 months follow-up, 86% of 57 patients were better, 12% were unchanged, and one patient (1.7%) was worse. After 2 years, 80% of 31 patients available for follow-up were better. The three main complaints of sinus disease in these patients were nasal airflow obstruction, chronic pain, and nasal discharge. Of these symptoms, nasal discharge was the most difficult to reverse. The results of this investigation suggest that limited surgery of the sinuses is efficacious.


1997 ◽  
Vol 11 (4) ◽  
pp. 275-282 ◽  
Author(s):  
Hung Jeff Kim ◽  
Ellen M. Friedman ◽  
Marcelle Sulek ◽  
Newton O. Duncan ◽  
Charles McCluggage

Chronic sinus disease in patients with and without cystic fibrosis may have an impact on the pattern of paranasal sinus pneumatization. Arrest of pneumatization has been reported in both of these conditions. To assess the development of the paranasal sinuses in relationship to chronic sinusitis and cystic fibrosis (CF), a retrospective review of coronal CT scans of the age-matched patients with no previous sinus disease, patients with chronic sinusitis, and cystic fibrosis patients was conducted. The patients’ ages ranged from 4 to 17 years. The maxillary sinus volume, anteroposterior diameter, and greatest transverse diameter and height were determined using image analysis software after the coronal CT scans were scanned into Macintosh computer. The size of the maxillary sinus increased with advancing age in the control and chronic sinusitis group, but not in the patients with cystic fibrosis. The patients with cystic fibrosis had a statistically significant smaller maxillary sinus size. Approximately 50% of the patients with chronic sinusitis had anatomic anomalies, the most common being paradoxical middle turbinates. The CT scans of CF patients were characterized by uncinate process demineralization and medial displacement of the lateral nasal wall in the middle meatus, and decreased maxillary sinus pneumatization.


2019 ◽  
Vol 12 ◽  
pp. 117955061988494
Author(s):  
Seiichiro Makihara ◽  
Shin Kariya ◽  
Mitsuhiro Okano ◽  
Tomoyuki Naito ◽  
Kensuke Uraguchi ◽  
...  

Objective: The agger nasi cell (ANC) is an easily identifiable landmark when approaching the frontal sinus. The success of endoscopic frontal sinus surgery may be influenced by the width of the frontal recess (FR). The aim of this study is to examine the relationship between the FR width and the ANC size in Japanese patients. In addition, the effect of various frontal recess cells (FRCs) on the development of frontal sinusitis has been examined. Materials and methods: Multiplanar computed tomography (CT) scans of the nasal cavities and paranasal sinuses in 95 patients (190 sides) before endoscopic sinus surgery were reviewed. The presence of FRCs, the thickness of the frontal beak (FB), the ANC size, and the anterior-to-posterior (A-P) length of the frontal isthmus (FI) and FR were evaluated in patients with and without frontal sinusitis. Results: The prevalence of the ANC, frontal cell types 1, 2, 3, and 4, frontal bullar cell (FBC), suprabullar cell, supraorbital ethmoid cell, and interfrontal sinus septal cell was 85.3%, 11.6%, 0%, 7.9%, 0%, 25.3%, 45.8%, 16.8%, and 15.3%, respectively. The ANC volume showed a significant positive correlation with the A-P length of the FI and FR. The incidence of frontal sinusitis in the patients with FBCs was significantly higher than that without FBCs. Conclusion: A large ANC offers a greater potential to facilitating the approach to the frontal sinus because of the extensiveness of the FR in Japanese patients. The presence of FBCs may be related to a higher incidence of frontal sinusitis.


Sign in / Sign up

Export Citation Format

Share Document