scholarly journals Effect of topical furosemide on sinonasal polyposis relapse after endoscopic sinus surgery

2020 ◽  
Vol 7 (1) ◽  
pp. 101
Author(s):  
Souvagini Acharya ◽  
Alka Kapil ◽  
Kamalini Bepari ◽  
Sandrendu Rajan ◽  
Prachi Mohapatra ◽  
...  
Keyword(s):  
Normal Saline ◽  
Endoscopic Sinus Surgery ◽  
Nasal Polyposis ◽  
Statistical Significance ◽  
Saline Group ◽  
Sinus Surgery ◽  
Randomised Control Trial ◽  
Normal Saline Group ◽  
Sinonasal Polyposis

<p class="abstract"><strong>Background: </strong>Chronic rhinosinusitis with nasal polyposis (CRSwNP) relapse is commonly seen during follow up period after endoscopic sinus surgery. Some studies claim the credibility of topical furosemide in preventing the polyposis recurrence after surgery. This randomised control trial was done to check the effectiveness of topical furosemide on sinonasal polyposis relapse after the endoscopic sinus surgery.</p><p class="abstract"><strong>Methods:</strong> In the current study, 44 patients, attending ENT department, VSSIMSAR, for follow up after endoscopic sinus surgery, were evaluated clinically and endoscopically to demonstrate the prevalence and severity of polyposis relapse using Visual analogue scale (VAS) and meltzer endoscopic grading, before initiating the intervention. Patients were then randomised in two groups- one receiving topical furosemide nebulization and other intranasal normal saline spray, respectively. All patients were evaluated again at 1st, 2nd, 4th and 6th month follow-ups by VAS and MEG, setting statistical significance at p&lt;0.05.</p><p class="abstract"><strong>Results:</strong> The MEG was grade 0 in 77% (17) patients of furosemide group and 32% (7) of normal saline group (p=0.0147). Statistically significant improvement was also observed in VAS for nasal symptoms in former group (p=0.028) than latter. The rate of relapse was less (23.81%) in furosemide group as compared to normal saline group (65%) but result not statistically significant at p&lt;0.05.</p><p class="abstract"><strong>Conclusions:</strong> Topical furosemide can be used as a valid therapeutic approach for reducing the severity of sinonasal polyposis relapse after endoscopic sinus surgery with no known side effects of furosemide when administered topically.</p><p> </p>

Meticulous endoscopic sinus surgery to prevent recurrence of massive nasal polyposis

2012 ◽  
Vol 126 (8) ◽  
pp. 789-794 ◽  
Author(s):  
S M S Hoseini ◽  
B Saedi ◽  
K Aghazadeh
Keyword(s):  
Endoscopic Surgery ◽  
Endoscopic Sinus Surgery ◽  
Nasal Polyposis ◽  
Demographic Data ◽  
Effective Means ◽  
Sinus Surgery ◽  
Previous Surgery ◽  
Endoscopic Findings ◽  
History Of

AbstractObjective:To evaluate the effect of meticulous endoscopic surgery, including opening of all involved sinus cells, on the subsequent symptoms and endoscopic findings of patients with massive nasal polyposis.Study design and method:One hundred patients with massive nasal polyposis resistant to medical treatment were selected. We documented each patient's demographic data, associated diseases, endoscopic findings, Lund–Mackay score and Sino-Nasal Outcome Test 22 (SNOT22) symptom score. All patients were followed up for at least two years to evaluate any recurrence.Results:Of the 100 patients, 20 per cent had a history of asthma and 27 per cent had undergone previous surgery. All underwent endoscopic sinus surgery. After two years of follow up, 8 per cent had recurrence requiring surgery. Recurrence was significantly associated with a history of asthma (p < 0.001) and the histopathological presence of eosinophilia (p = 0.014).Conclusion:Meticulous endoscopic opening of all involved sinus cells can be a safe and effective means of controlling massive nasal polyposis, with an acceptable recurrence rate.

Allergic Rhinitis and Aspirin-Exacerbated Respiratory Disease as Predictors of the Olfactory Outcome after Endoscopic Sinus Surgery

2009 ◽  
Vol 23 (3) ◽  
pp. 348-353 ◽  
Author(s):  
Michael Katotomichelakis ◽  
Maria Riga ◽  
Spyridon Davris ◽  
Gregorios Tripsianis ◽  
Maria Simopoulou ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Respiratory Disease ◽  
Endoscopic Sinus Surgery ◽  
Nasal Polyposis ◽  
Sinus Surgery ◽  
Olfactory Acuity ◽  
Aspirin Exacerbated Respiratory Disease ◽  
Negative Effect ◽  
Time Frames

Background Unlike the functional outcomes of endoscopic sinus surgery, which have been thoroughly studied, the effect of the surgery on olfactory performance and the relative predictive factors have not been adequately assessed by literature. Allergic rhinitis and aspirin-exacerbated respiratory disease (AERD) are examined as potential confounding factors of the olfactory outcome in patients with extensive nasal polyposis and rhinosinusitis treated with functional endoscopic sinus surgery (FESS). Methods A population of 116 adults with severe nasal polyposis was subjected to FESS after failure of the appropriate medical treatment. The olfactory outcome was quantified by Sniffin’ Sticks at the 1st, 3rd, and 6th postoperative month in relation to the concomitant presence of allergic rhinitis (n = 62) or AERD (n = 18). Results Allergic patients seemed to perform worse than nonallergic patients at all time frames. However, when patients with similar olfactory acuity, age, and medical history are compared, allergic rhinitis does not seem to affect the postoperative improvement of the composite threshold-discrimination-identification scores. The same seems to apply for the likelihood of acquiring normosmia after surgery. On the contrary, AERD significantly limits the recovery of olfactory function at all follow-up examinations and patients with AERD are unlikely to become normosmic. Conclusion The olfactory recovery after FESS for nasal polyposis is significantly affected by the concomitant presence of AERD. Although allergy seems to have a general negative effect on olfactory acuity, it was not found to affect the extent of the olfactory improvement, when patients with comparable preoperative characteristics are addressed.

scholarly journals A comparative study on the effectiveness of budesonide nasal irrigation versus normal saline nasal irrigation in post endoscopic sinus surgery patients

2021 ◽  
Vol 4 (3) ◽  
pp. 98-105
Author(s):  
U. Srinivasa Rao ◽  
S. A. S Farooq ◽  
J. Ranga Lakshmi
Keyword(s):  
Normal Saline ◽  
Comparative Studies ◽  
Saline Group ◽  
Sinus Surgery ◽  
Normal Saline Group ◽  
Nasal Irrigation ◽  
Budesonide Group ◽  
The Difference ◽  
Group B ◽  
Snot 22

: Comparative studies evaluating budesonide and saline nasal irrigations for patients with polyposis/ rhinosinusitis are deficient in the current literature. This study aimed to evaluate the effectiveness of budesonide nasal irrigations compared with saline irrigations during postoperative care of patients with rhinosinusitis.: A total of 100 patients who underwent functional Endoscopic Sinus SurgeryESS) were randomly divided into two groups (A and B) of 50 participants each (normal saline [NS] + budesonide irrigation and NS irrigation alone, respectively). Pre- and post operative evaluation was done with a 22-item sinonasal outcomes test (SNOT-22), and Lund Kennedy endoscopic (LKE scores) in second and sixth week. : The condition of the patients significantly improved in both intervention arms related to SNOT-22 and LKE score at each postoperative visit (Group A: p&#60;0.001, Group B: p&#60;0.001). The reduction of SNOT 22 score was higher in budesonide group by 10% (mean SNOT 22 score from 33.31 to 15.84) compared to normal saline group (mean SNOT 22 score from 37.49 to 22.24). The reduction of LKEscore was higher in budesonide group by 18.69% (mean LKE score from 4.49 to 2.71) compared to normal saline group (mean LKE score from 5.02 to 4). : Steroid nasal irrigation is a good option in postoperative EES patients. The difference of reduction of both SNOT 22 score and LKEscore was statistically significant (p &#60;0.05 and p&#60;0.01 respectively) by repeated contrast test. This study is one of the few comparative studies evaluating budesonide and saline nasal irrigations in post-ESS patients.

scholarly journals Nimodipine reduces delayed cerebral vasospasm after intracranial tumor surgery: a retrospective study

2020 ◽  
Author(s):  
Ying Yu ◽  
Yunqian Li ◽  
Zheng Jin ◽  
Fan Chen
Keyword(s):  
Retrospective Study ◽  
Normal Saline ◽  
Saline Group ◽  
Intracranial Tumor ◽  
Tumor Surgery ◽  
Normal Saline Group ◽  
Mortality And Morbidity ◽  
Delayed Cerebral Vasospasm ◽  
Significant Difference

Abstract Background：Cerebral vasospasm (CVS) is a serious neurosurgical complication. This retrospective study was performed to analyze if nimodipine can improve prognosis and reduces ischemia secondary to delayed CVS after intracranial tumor surgery.Methods：Retrospective analysis of 94 patients with an anterior cranial fossa tumor and underwent intracranial tumor surgery was performed, with 42 cases treated with normal saline and 52 cases treated with nimodipine solution. Transcranial Doppler ultrasonography was used to measure velocity in the middle cerebral artery (MCA) and the distal extracranial internal carotid artery (eICA). An examination was conducted 1 day before surgery and 1, 3, 5, 7, and 14 days after surgery. Follow-up was performed using the Glasgow Outcome Scale (GOS) 3 months after discharge.Results：We showed that in the nimodipine group, CVS occurred in 13 (25%) patients who did not have CVS in the first three days after operation; nine patients had CVS between 4 and 7 days, and 4 had CVS between 8 and 14 days. In the normal saline group, nineteen (45%) patients had CVS, 3 presented with CVS within 3 days, 11 between 4-7 days and 5 between 8-14 days. A significant difference in the occurrence of CVS was observed between the two groups. Preoperative and postoperative the MCA velocities were compared, revealing a significant change in the normal saline group (P < 0.05) but not in the nimodipine group. Furthermore, significant differences in the outcome were observed between the two groups at the 3-month follow-up (P < 0.05).Conclusions：Nimodipine markedly improves prognosis and significantly reduces ischemia secondary to delayed CVS after intracranial tumor surgery, as well as the risks of mortality and morbidity.

Pediatric Endoscopic Nasal and Sinus Surgery

1995 ◽  
Vol 113 (3) ◽  
pp. 204-210 ◽  
Author(s):  
James A. Stankiewicz
Keyword(s):  
Patient Selection ◽  
Endoscopic Sinus Surgery ◽  
Nasal Polyposis ◽  
Chronic Sinusitis ◽  
Subjective Evaluation ◽  
Choanal Atresia ◽  
Sinus Surgery ◽  
Term Objective

A total of 83 children and teenagers underwent endoscopic nasal and sinus surgery. Six patients had surgery for choanal atresia (4) and adenoid hypertrophy (2) and will only be briefly mentioned. Seventy-seven children and teenagers underwent endoscopic sinus surgery for acute and chronic sinusitis, choanal polyposis, and nasal polyposis with a minimum 2-year follow-up. One hundred thirty-three ethmoidectomies, 37 sphenoidotomies, and 119 maxillary antrostomies were performed. Subjective evaluation of the sinus surgery patients indicated that 38% of patients were cured and 55% improved during an average of 3.5 years of follow-up. The number cured and number improved are lower and higher, respectively, than in other reports of results because of the longer follow-up and patient selection. In addition, objective data were obtained on 34 patients with a second- or third-look procedure 2 weeks to 2 months after surgery. These examinations found significant granulation tissue, and almost 50% of patients had at least one maxillary ostia closed. Long-term objective results, however, are not available to determine whether the ostia remained closed. Problems with healing in children's endoscopic sinus surgery are unpredictable compared those in adult surgery because postoperative debridement and examination are often difficult to perform, thus allowing tissue to heal without control. In this series, other factors such as the increased risks of cystic fibrosis, allergy, and immunodeficiency were also more prevalent and compromised healing. The best way to achieve good results in pediatric endoscopic sinus surgery requires appropriate patient selection, careful techniques, spacers or stents that don't cover the antrostomy, appropriate second- or third-look procedures for debridement and examination, and judicious postoperative medical therapy.

scholarly journals Twelve-year follow-up study after endoscopic sinus surgery in patients with chronic rhinosinusitis with nasal polyposis

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Lien Calus ◽  
Nicholas Van Bruaene ◽  
Cedric Bosteels ◽  
Sarah Dejonckheere ◽  
Thibaut Van Zele ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Nasal Polyposis ◽  
Sinus Surgery ◽  
Follow Up Study

scholarly journals A randomized control study to compare the efficacy of intranasal fluticasone propionate and intranasal budesonide in controlling postoperative symptoms in patients with nasal polyposis after endoscopic sinus surgery

2019 ◽  
Vol 9 (36) ◽  
pp. 182-186
Author(s):  
Kiruba Shankar ◽  
Satvinder Singh Bakshi ◽  
Sunil Kumar Saxena ◽  
Suriyanarayanan Gopalakrishnan
Keyword(s):  
Fluticasone Propionate ◽  
Nasal Spray ◽  
Endoscopic Sinus Surgery ◽  
Nasal Polyposis ◽  
Sinus Surgery ◽  
Endoscopic Polypectomy ◽  
Chronic Inflammatory Condition ◽  
Intranasal Steroids ◽  
Postoperative Symptoms ◽  
Sinonasal Polyposis

Abstract BACKGROUND. Sinonasal polyposis represents a chronic inflammatory condition characterized by nasal obstruction, reduction in the sense of smell and impaired quality of life. Intranasal steroids play an important role in preventing the postoperative recurrences in these cases. We carried out a study to evaluate and compare intra nasal budesonide and intranasal fluticasone propionate in the postoperative management of ethmoidal nasal polyposis. MATERIAL AND METHODS. 106 patients with ethmoidal polyposis were treated with endoscopic polypectomy and were postoperatively started and maintained on intranasal steroids. 54 patients were managed with budesonide and 52 patients maintained on fluticasone propionate nasal spray. The patients were followed-up for 6 months and recurrences and control of symptoms evaluated. RESULTS. There was a statistical difference in the SNOT-22 (p<0.0001) and Lund-Kennedy scores (p=0.015) between patients using fluticasone propionate as compared to those using budesonide intra nasal spray by the end of the 6th month. CONCLUSION. Both intranasal budesonide and fluticasone propionate are effective in controlling symptoms after endoscopic sinus surgery in patients with sinonasal polyposis; however, intranasal fluticasone propionate was more efficacious than budesonide in the control of postoperative symptoms.

scholarly journals Mucocele Development after Endoscopic Sinus Surgery for Nasal Polyposis: A Long-Term Analysis

2018 ◽  
Vol 97 (9) ◽  
pp. 284-294 ◽  
Author(s):  
Hakim Benkhatar ◽  
Idir Khettab ◽  
Philippe Sultanik ◽  
Ollivier Laccourreye ◽  
Pierre Bonfils
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Nasal Polyposis ◽  
Sinus Surgery ◽  
Multivariate Statistical ◽  
Radiologic Evaluation ◽  
Mean Delay ◽  
Aspirin Intolerance ◽  
The Mean

The aim of the present study was to determine the prevalence of long-term mucocele development after functional endoscopic sinus surgery (FESS) for nasal polyposis, to search for a statistical relationship with preoperative variables and to analyze the management of this complication. A retrospective analysis of 153 patients who underwent FESS for nasal polyposis, with a minimum of 7 years of follow-up, was performed. Mucocele diagnosis was based on regular clinical and radiologic evaluation. Univariate and multivariate statistical analysis was performed. The postoperative mucocele rate was 13.1% (20 patients). The mean delay between surgery and mucocele diagnosis was 6.25 years. A high preoperative Lund-Mackay score (>19) was a risk factor for postoperative mucocele (p = 0.04). Asthma and aspirin intolerance did not increase the risk of this complication. Endoscopic marsupialization of mucoceles was successful in 19 patients, with only one recurrent frontal mucocele. One patient required external approaches for two frontal mucoceles. In conclusion, mucocele risk after FESS for nasal polyposis is significant, especially in case of a high preoperative Lund-Mackay score (>19). Long-term clinical follow-up is recommended, imaging being prescribed based on symptoms or abnormal findings on clinical examination. Endoscopic marsupialization is very effective, but frontal mucoceles are more likely to recur.

scholarly journals Comparison of microdebrider-assisted endoscopic sinus surgery and conventional endoscopic sinus surgery for chronic rhinosinusitis with nasal polyps

2019 ◽  
Vol 9 (34) ◽  
pp. 91-95
Author(s):  
Ramiya Ramachandran Kaipuzha ◽  
Nirmal Coumare Venkataramanujam ◽  
Padmanabhan Karthikeyan ◽  
Davis Thomas Pulimoottil
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Mucosal Injury ◽  
Sinus Surgery ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Mean Time ◽  
Sinonasal Polyposis

AbstractOBJECTIVE. To study and compare the benefits of microdebrider-assisted endoscopic sinus surgery and conventional endoscopic sinus surgery in terms of subjective and objective improvement in symptoms of nasal polyposis.MATERIAL AND METHODS. This study involved 60 patients with bilateral sinonasal polyposis scheduled to undergo Endoscopic Sinus Surgery. The patients were randomized into two groups: Group A -Conventional endoscopic sinus surgery and Group B -Microdebrider-assisted endoscopic sinus surgery.RESULTS. There was a significant difference in the mean VAS at 3 months postoperatively in Group B, but no significant difference at 6 months postoperatively following either of the two methods. The mean time for surgery (p<0.01) and the mean intraoperative blood loss (p<0.01) were significantly lower in Group B.CONCLUSION. A well-trained surgeon with proper anatomical knowledge, good instruments, hypotensive anaesthesia, minimal mucosal injury and regular proper follow-up will have similar postoperative results with both methods.

Evaluation of endoscopic sinus surgery by Glasgow benefit inventory

2008 ◽  
Vol 122 (4) ◽  
pp. 357-360 ◽  
Author(s):  
J R Newton ◽  
M Shakeel ◽  
B Ram
Keyword(s):  
Quality Of Life ◽  
Endoscopic Sinus Surgery ◽  
Statistical Difference ◽  
Nasal Polyposis ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Time Period ◽  
Glasgow Benefit Inventory

AbstractIntroduction:Functional endoscopic sinus surgery is a common adjunct to medical therapy in cases of chronic rhinosinusitis and nasal polyposis.Aim:The objective of this study was to assess patients' quality of life up to two years after endoscopic sinus surgery.Method:Fifty consecutive patients attending a rhinology clinic filled in the Glasgow benefit inventory. The patients were divided into three groups according to the time period elapsed since surgery (i.e. six months, 12 months or up to two years).Results:The results showed that, generally, the Glasgow benefit inventory scores indicated a benefit from the procedure. Overall, surgery led to statistically significant improvements in both total and general scores (p < 0.05). Comparison of endoscopic sinus surgery with nasal polypectomy (plus endoscopic sinus surgery) indicated a greater benefit for polyp disease. No statistical difference was observed between the scores for females vs males or for various post-operative follow-up periods.

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