Effect of Functional Endoscopic Sinus Surgery on the Symptom Profile in Patients with Chronic Rhino-Sinusitis: Our Experience

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.

Download Full-text

Functional endoscopic sinus surgery in the management of chronic rhinosinusitis. An objective assessment

The Journal of Laryngology & Otology ◽

10.1017/s0022215100117463 ◽

1991 ◽

Vol 105 (10) ◽

pp. 832-835 ◽

Cited By ~ 102

Author(s):

Valerie J. Lund ◽

Mats Holmstrom ◽

Glenis K. Scadding

Keyword(s):

Endoscopic Sinus Surgery ◽

Clinical Success ◽

Objective Assessment ◽

Beat Frequency ◽

Ciliary Beat Frequency ◽

Functional Endoscopic Sinus Surgery ◽

Sinus Surgery ◽

Quantitative Evidence ◽

Chronic Rhino Sinusitis ◽

Ciliary Beat

AbstractConsiderable clinical success has been claimed for functional endoscopic sinus surgery but objective assessment of prospective series is lacking in the literature. Twenty-four patients with chronic rhino-sinusitis underwent assessment of symptoms by visual analogue scoring, nasomucociliary function by ciliary beat frequency, olfaction by qualitative olfactometry and nasal airway resistance by anterior rhinomanometry pre- and post-operatively. This demonstrated a significant improvement in all symptoms examined and in ciliary beat frequency. Quantitative olfaction and anterior rhinomanometry were not improved despite diminished symptoms. These results offer quantitative evidence of clinical improvement following functional endoscopic sinus surgery which supports the pathophysiological concepts on which the technique is based.

Download Full-text

Effect of functional endoscopic sinus surgery on the symptom profile in chronic rhinosinusitis cases

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20200154 ◽

2020 ◽

Vol 6 (2) ◽

pp. 375

Author(s):

G. Syam Manohar ◽

Khan Majid Jabbar

Keyword(s):

Quality Of Life ◽

Chronic Rhinosinusitis ◽

Nasal Obstruction ◽

Endoscopic Sinus Surgery ◽

Facial Pain ◽

Functional Endoscopic Sinus Surgery ◽

Sinus Surgery ◽

Nasal Discharge ◽

Symptom Profile

Background: Chronic rhinosinusitis (CRS) is a common chronic disease, that have considerable impact on quality of life, functional and emotional impairments of affected beings. Post-surgical improvement of quality of life indicates the surgical success. Functional endoscopic sinus surgery (FESS) is the dominating surgical procedure for CRS. This study was designed to assess the symptom profile of patient before and after surgery and the complications after FESS in the post-operative period.Methods: A total of 50 cases attending ENT outpatient department with clinical features and investigations suggestive of chronic sinusitis with infective pathology were randomly considered for this study. Cases were assessed for CRS symptoms pre and post operatively using grading symptoms. Results: Common major symptom was nasal obstruction (93.3%, N=28) followed by post nasal drip (83.33%, N=25), purulent nasal discharge (76.66%, N=23), facial pain/pressure (66.66%, N=20) and hyposmia (60%, N=18). None of the patients reported fever and facial congestion or fullness. Post operatively, cases with nasal obstruction (92.8%), purulent nasal discharge (86.9%), facial pain or pressure (85%), headache (81.8%), post nasal drip (84%), ear pain or fullness or pressure (92.8%) and hyposmia (61.1%) showed improvement after FESS at the end of three follow-up.Conclusions: The most common symptom pre operatively was nasal obstruction which also responded best to FESS, along with all the other minor symptoms including headache. The results of this study confirm that FESS is an excellent method of treatment in patients with CRS refractory to medical treatment.

Download Full-text