scholarly journals Chronic rhinosinusitis: is any indication for Caldwell-Luc approach in endoscopic sinus surgery era?

2021 ◽  
Vol 7 (2) ◽  
pp. 239
Author(s):  
Daniel Lupoi
Keyword(s):  
Surgical Treatment ◽  
Surgical Approach ◽  
Gold Standard ◽  
Endoscopic Sinus Surgery ◽  
Maxillary Sinusitis ◽  
Standard Procedure ◽  
Treatment Method ◽  
Sinus Surgery ◽  
Inclusion Criteria ◽  
Therapeutic Guidelines

<p class="abstract"><strong>Background:</strong> Caldwell-Luc procedure was the gold standard procedure for chronic maxillary sinusitis until the endoscopic sinus surgery developed more and more. The aim of this study was to show the importance of Caldwell-Luc surgical approach in endoscopic sinus surgery era.</p><p class="abstract"><strong>Methods:</strong> Prospective study between 2009 and 2019 in the ENT Department of the Clinical Hospital Sfânta Maria from Bucharest. The inclusion criteria were as follows: adult patients diagnosed clinical and paraclinical with isolated chronic maxillary rhinosinusitis in whom correctly conducted drug treatment failed and, according to current therapeutic guidelines, had indication for surgical treatment. The treatment method consisted of a surgical approach, which was classic or endoscopic, depending on the situation imposed on each patient.  </p><p class="abstract"><strong>Results:</strong> The application of the inclusion criteria in the study led in a group of 521 patients, of which 282 men (54.12%) and 239 women (45.87%). Following the accounting of the days of hospitalization and those of medical leave at discharge, a number of days of absenteeism of 13.85 days resulted in the case of patients treated classically and 8.62 days for those treated endoscopically. Also the endoscopic group had a better endoscopic and VAS score postoperatively.</p><p class="abstract"><strong>Conclusions:</strong> Surgical treatment of maxillary sinus can be minimally invasive- endoscopic, extended endoscopic or classical open surgery. Open classic surgical treatment remains the last treatment alternative, with indication for rhinosinusal recurrences or the imminence of complications. Endoscopic surgery is the “gold standard” for chronic maxillary rhinosinusitis.</p><p> </p>

scholarly journals Anatomy of Nasal Cavity and Paranasal Sinuses; Surgical Perspective

2020 ◽  
Vol 63 (5) ◽  
pp. 189-198
Author(s):  
Seung-Kyu Chung
Keyword(s):  
Surgical Treatment ◽  
Medical Treatment ◽  
Nasal Cavity ◽  
Chronic Rhinosinusitis ◽  
Paranasal Sinuses ◽  
Endoscopic Sinus Surgery ◽  
Treatment Method ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery

Endoscopic sinus surgery is a treatment method for chronic rhinosinusitis not controlled with medical treatment. It had started with functional endoscopic sinus surgery and the concept of reboot approach was introduced recently. For safe surgical treatment, understanding the anatomy especially personal variations between well-known structures is important. The practical points of surgical concept during endoscopic sinus surgery was suggested.

scholarly journals Long-Term Effectiveness of Balloon Catheter Sinuplasty in Pediatric Chronic Maxillary Sinusitis

2019 ◽  
Vol 98 (4) ◽  
pp. 207-211 ◽  
Author(s):  
Habib G. Zalzal ◽  
Chadi A. Makary ◽  
Hassan H. Ramadan
Keyword(s):  
Chronic Rhinosinusitis ◽  
Endoscopic Surgery ◽  
Endoscopic Sinus Surgery ◽  
Pediatric Patients ◽  
Maxillary Sinusitis ◽  
Balloon Catheter ◽  
Sinus Surgery ◽  
Inclusion Criteria ◽  
Chronic Maxillary Sinusitis

The objective of our study was to assess the long-term effectiveness of balloon catheter sinuplasty in the treatment of pediatric chronic maxillary sinusitis following failed first-line medical and surgical management with adenoidectomy. Pediatric patients younger than 12 years were reviewed for having failed previous adenoidectomy and undergone a balloon catheter sinuplasty between August 2006 and March 2011 for chronic rhinosinusitis. Demographic data and clinical characteristics were recorded in patients who met inclusion criteria. Outcomes were assessed by need for functional endoscopic sinus surgery and persistence of chronic infection within at least 5 years of follow-up. Failure was defined by any child who was rediagnosed with chronic sinus disease after balloon catheter sinuplasty or who required endoscopic sinus surgery within 5 years. Sixty-two children were reviewed, with 38 patients meeting inclusion criteria (prior adenoidectomy, a preoperative Lund-Mackay score of ≥5, and balloon catheter sinuplasty). The mean age (standard deviation) was 6.76 (2.27) years with an age range of 2 to 11 years. Eight children (21.1%, P < .01) continued to have chronic sinus complaints following balloon procedure, with 5 (13.1%) individuals requiring eventual endoscopic surgery within 5 years. Age, asthma, allergy, and gender did not have any statistically significant impact on outcome. Balloon catheter sinuplasty is an effective long-term alternative for the treatment of chronic rhinosinusitis in pediatric patients, hoping to avoid further infections and eventual endoscopic surgery.

scholarly journals Chronic rhinosinusitis in adult patients with cystic fibrosis: clinical manifestation and therapeutic approaches

2019 ◽  
Vol 29 (3) ◽  
pp. 311-320
Author(s):  
G. L. Shumkova ◽  
E. L. Amelina ◽  
V. M. Svistushkin ◽  
E. V. Sin’kov ◽  
S. A. Krasovskiy ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Surgical Treatment ◽  
Treatment Group ◽  
Chronic Rhinosinusitis ◽  
Paranasal Sinuses ◽  
Endoscopic Sinus Surgery ◽  
Nasal Polyps ◽  
Adult Patients ◽  
Sinus Surgery ◽  
Markers Of Inflammation

The aim of this study was to evaluate prevalence of chronic rhinosinusitis (CRS) and nasal polyps in adult patients with cystic fibrosis (CF) in Russian Federation. Additionally, we investigated the clinical course of CRS and developed the optimal therapeutic strategy.Methods. Three hundred and forty eight CF patients were involved in the study. Physical examination, computed tomography (CT) of paranasal sinuses and audiometry, if needed, were used. CRS and bilateral nasal polyps were diagnosed in 28 patients. Nasal endoscopy, SNOT-20 questionnaire, rhinomanometry, micro - biological examination of sputum and mucus from paranasal sinuses (obtained during puncture or surgery), spirometry, and measurement of serum markers of inflammation were used. Endoscopic sinus surgery was used in 14 patients (the group 1) and others were treated non-surgically (the group 2). Both group were treated during 6 months using intranasal mometasone, mucolytics and antibiotics via PARI SINUSTM nebulizer.Results. An improvement in symptoms, CT signs, rhinomanometry parameters and endoscopic signs was seen in both groups after treatment and was more prominent in the surgical treatment group compared to the non-surgical treatment group. Bacterial load reduction in nasal sinuses, decrease in the rate of pulmonary disease exacerbations, and an improvement in oxygen blood saturation were found in the surgical treatment group only. Treatment of CRS did not affect lung function, sputum microbiology and serum inflammatory markers.Conclusion. Endoscopic sinus surgery followed by intranasal mucolytics and antibacterials is an effective and well-tolerated treatment in adult CF patients with CRS. 

Remodeling of the Paradoxical Middle Turbinate: Preserving Function While Gaining Access

2018 ◽  
Vol 32 (2) ◽  
pp. 98-100
Author(s):  
Ryan H. Belcher ◽  
Allison K. Ikeda ◽  
John M. DelGaudio
Keyword(s):  
Medical Treatment ◽  
Chronic Rhinosinusitis ◽  
Surgical Approach ◽  
Endoscopic Sinus Surgery ◽  
Middle Turbinate ◽  
Sinus Surgery ◽  
Middle Meatus ◽  
Anatomic Variant ◽  
And Function ◽  
Improve Access

Background Endoscopic sinus surgery is performed for many reasons, most commonly for chronic rhinosinusitis refractory to medical treatment. A paradoxical middle turbinate is an anatomic variant that can hinder endoscopic access to the sinuses. No publication has addressed how to surgically treat a paradoxical middle turbinate. Method We present a basic endoscopic surgical approach to conservatively resect a paradoxical middle turbinate in order to improve access to the middle meatus and the sinuses while preserving support and function. Conclusion Conservative remodeling of the paradoxical middle turbinate can provide access to the sinuses while maintaining a significant portion of the middle turbinate.

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.

Does surgical treatment of nasal airway obstruction improve sexual functions?

2019 ◽  
Vol 133 (09) ◽  
pp. 805-809 ◽  
Author(s):  
S Cayir ◽  
O Hizli ◽  
M Gul
Keyword(s):  
Surgical Treatment ◽  
Nasal Obstruction ◽  
Endoscopic Sinus Surgery ◽  
Erectile Function ◽  
Sinus Surgery ◽  
Concha Bullosa ◽  
Sexual Performance ◽  
Symptom Evaluation ◽  
Operative Evaluation ◽  
Operative Assessment

AbstractObjectiveTo investigate the effects of surgical treatment for nasal obstruction on sexual functions, regardless of the condition causing the nasal obstruction.MethodsOf 238 patients identified with nasal obstruction, 57 complained of erectile dysfunction and were included in the analysis. Patients underwent septoplasty, functional endoscopic sinus surgery, concha bullosa excision or radiofrequency ablation of the inferior turbinates, depending on their obstruction-causing disease. Pre- and post-operative evaluation of perceived nasal obstruction was performed using the Nasal Obstruction Symptom Evaluation questionnaire. Pre- and post-operative assessment of sexual functions was performed using the International Index of Erectile Function.ResultsMean post-operative scores for erectile function, orgasmic function, sexual desire, intercourse satisfaction and overall sexual satisfaction were significantly higher compared to the pre-operative scores (p = 0.022, p = 0.036, p = 0.033, p = 0.016 and p = 0.029, respectively).ConclusionSurgical treatment of nasal obstruction by septoplasty, endoscopic sinus surgery, concha bullosa excision or radiofrequency can significantly improve sexual performance.

Powered Instrumentation in Dissection of the Frontal Recess

1996 ◽  
Vol 75 (6) ◽  
pp. 359-364 ◽  
Author(s):  
Dewey A. Christmas ◽  
John H. Krouse
Keyword(s):  
Surgical Treatment ◽  
Surgical Approach ◽  
Normal Mucosa ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Frontal Sinusitis ◽  
Frontal Recess ◽  
Anatomic Location ◽  
Postoperative Risk ◽  
Standard Techniques

The use of powered instrumentation in functional endoscopic sinus surgery has become very popular due to its safety and thoroughness. An area which has been more problematic in the use of this technique has been the frontal recess, due to its anatomic location and associated risk of serious complications. We have done a number of powered dissections of the frontal recess as a surgical treatment of refractory frontal sinusitis, and find that it is extremely safe and effective. The ability of the powered devices to preserve normal mucosa allows an adequate surgical approach while significantly decreasing the postoperative risk of frontal recess stenosis and reocclusion. We feel that powered dissection of the frontal recess offers a significant advantage over standard techniques in this anatomic location.

Ultrastructural ciliary changes of maxillary sinus mucosa following functional endoscopic sinus surgery: an image analysis quantitative study

2003 ◽  
Vol 117 (4) ◽  
pp. 273-279 ◽  
Author(s):  
Ahmed Bassiouny ◽  
Ahmed M. Atef ◽  
Mahmoud Abdel Raouf ◽  
Safaa Mohamed Nasr ◽  
Magdy Nasr ◽  
...  
Keyword(s):  
Image Analysis ◽  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Quantitative Methods ◽  
Maxillary Sinusitis ◽  
Functional Endoscopic Sinus Surgery ◽  
University Hospital ◽  
Sinus Surgery ◽  
Chronic Maxillary Sinusitis ◽  
Sinus Mucosa

This was a study of the effect of functional endoscopic sinus surgery (FESS) on the ciliary regeneration of maxillary sinus mucosa in patients with chronic maxillary sinusitis, using objective quantitative methods. Twenty specimens from the mucosa of both the superolateral wall and the ostium of the maxillary sinus were sampled during FESS and then six to 12 months later. They were light examined first by light microscopy and then by scanning electron microscopy in combination with image analysis software in order to study the cilia under higher magnification and to calculate proportion of the field that was ciliated. Samples were taken and studied at Cairo University hospital. This study showed that the maxillary sinus mucosa in chronic sinusitis is capable of regeneration and could return towards normal with the improvement of ventilation and drainage of the maxillary sinus following FESS. There were no significant changes in the degree of glandular hyperplasia, goblet cells or pathological glands after surgery.

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