scholarly journals Stent Hypersensitivity and Infection in Sinus Cavities

2013 ◽  
Vol 4 (3) ◽  
pp. ar.2013.4.0071 ◽  
Author(s):  
Nicholas G. Kounis ◽  
George D. Soufras ◽  
George Hahalis
Keyword(s):  
Chronic Rhinosinusitis ◽  
Granulation Tissue ◽  
Endoscopic Sinus Surgery ◽  
Current Knowledge ◽  
Klebsiella Oxytoca ◽  
Sinus Surgery ◽  
Mucosal Inflammation ◽  
Coagulase Negative Staphylococcus ◽  
Moderate Growth ◽  
Beta Hemolytic Streptococcus

Persistent mucosal inflammation, granulation tissue formation, hypersensitivity, and multifactorial infection are newly described complications of retained drug-eluting stents from endoscopic sinus surgery for refractory rhinosinusitis. In an important report published in Allergy and Rhinology, a 45-year-old male patient suffering from recalcitrant chronic rhinosinusitis underwent functional endoscopic sinus surgery and was found, for the first time, to have steroid-eluting catheters that were inadvertently left in the ethmoid and frontal sinuses. The retained catheters had caused persistent mucosal inflammation and formation of granulation tissue denoting hypersensitivity reaction. These consequences had induced perpetuation of symptoms of chronic rhinosinusitis. Meticulous removal of the retained stents with the nitinol wings from inflamed tissues of the frontal, ethmoidal, and sphenoethmoidal recesses in which they were completely imbedded was successfully performed without polypoid regrowth. Cultures of specimens taken from both left and right stents showed heavy growth of Stenotrophomonas maltophilia and moderate growth of Klebsiella oxytoca, coagulase negative Staphylococcus, and beta-hemolytic Streptococcus anginosus. Fungal infection was not detected. The current knowledge and experience regarding stent hypersensitivity and infection in relation with the use of stents in sinus cavities is reviewed.

scholarly journals Inflammatory cytokines gene expression in bone tissue from patients with chronic rhinosinusitis- a preliminary study

2010 ◽  
Vol 48 (4) ◽  
pp. 415-419
Author(s):  
A. Tuszynska ◽  
A. Krzeski ◽  
M. Postuba ◽  
L. Paczek ◽  
A. Wyczalkowska-Tomasik ◽  
...  
Keyword(s):  
Gene Expression ◽  
Bone Tissue ◽  
Chronic Rhinosinusitis ◽  
Inflammatory Cytokines ◽  
Endoscopic Sinus Surgery ◽  
Target Genes ◽  
Sinus Surgery ◽  
Mucosal Inflammation ◽  
Genes Expression ◽  
Factor Α

BACKGROUND: It is unclear whether mucosal inflammation has an effect on the bone under the mucosa in patients with chronic rhinosinusitis (CRS). OBJECTIVES: The aim of this study was evaluation of inflammatory cytokines genes expression in bone tissue taken from the patients who had undergone endoscopic sinus surgery for CRS. METHODS: A total group of a consecutive 49 patients with diagnosis of chronic rhinosinusitis based on EPOS 2007 criteria undergoing endoscopic sinus surgery for CRS were enrolled in the study. Based on histopathologic findings of the mucosal and bone tissues we evaluated the rate of inflammation. Expression of target genes: interleukin 1β (IL1β), interleukin 6 (IL6), interleukin 11 (IL11), tumor growth factor β (TGF β) and tumor necrosis factor α (TNF α) were analysed by real-time PCR method in samples of the ethmoid bone taken during endoscopic sinus surgery for CRS. RESULTS: Based on histopathological findings in the studied population we found symptoms of osteitis in 5 patients. In the studied population we found significant differences between patients with osteitis and without osteitis with respect to IL6 gene expression in bone tissue (p=0.0003), IL11 gene expression (p=0.02) and TNFα gene expression in bone tissue (p=0.0035). CONCLUSION: In our study we have demonstrated that in some patients with CRS and coexisting symptoms of osteitis some inflammatory markers genes expression are increased in this population.

Chronic Rhinosinusitis

2021 ◽  
Author(s):  
Bobby Tajudeen
Keyword(s):  
Chronic Rhinosinusitis ◽  
Medical Therapy ◽  
Endoscopic Sinus Surgery ◽  
Chronic Sinusitis ◽  
Topical Therapy ◽  
Topical Steroid ◽  
Functional Endoscopic Sinus Surgery ◽  
Microbial Colonization ◽  
Sinus Surgery ◽  
Mucosal Inflammation

Chronic sinusitis (CRS) is a long-standing mucosal inflammatory disease of the sinonasal tract that results in significant impairment in patient quality of life. The pathogenic determinants of disease include chronic mucosal inflammation, local microbial colonization, and mucociliary dysfunction. A thorough understanding of this tripartite model allows for endotyping and tailored therapy. Medical therapy in the form of oral and/or topical therapy is imperative to reduce mucosal inflammation, treat microbial infection, and enhance mucociliary function. Functional endoscopic sinus surgery (FESS) serves to surgically reduce inflammatory load, ventilate the sinuses, augment installation of topical therapy, and provide tissue for endotyping. The end result of well-performed surgery is a unified sinus cavity augmented for improved medical therapy. Newer therapeutics, such as biologic therapies, target TH-2 driven mucosal inflammation and are gaining an emerging role in the management of CRS; however, the role of these therapies is not well defined in the current treatment paradigm. This review contains figures, tables and references Key words: chronic sinusitis, chronic rhinosinusitis, functional endoscopic sinus surgery, topical steroid therapy, endotype, structured histopathology, nasal polyps, biologic therapy, mucociliary dysfunction, biofilms

Is Add-on Budesonide-Impregnated Nasal Dressing Useful Following Endoscopic Sinus Surgery with Perioperative Oral Steroid?

2021 ◽  
Vol 104 (2) ◽  
pp. 293-299
Keyword(s):  
Chronic Rhinosinusitis ◽  
Polyurethane Foam ◽  
Endoscopic Sinus Surgery ◽  
Nasal Polyps ◽  
Sinus Surgery ◽  
Mucosal Inflammation ◽  
Oral Steroid ◽  
Control Side ◽  
Short Course ◽  
Significant Difference

Background: Some chronic rhinosinusitis with nasal polyps patients undergoing endoscopic sinus surgery (ESS) have unfavorable results despite proper postoperative treatments including oral and topical steroids. Steroid-impregnated absorbable nasal dressing has been shown to improve outcomes of the surgery. In some clinical practices, budesonide-impregnated nasal dressing is used together with perioperative oral steroid but the additional benefits of it are still unknown. Objective: To determine whether budesonide-impregnated nasal dressing had any benefits following ESS when a short course of oral steroid was given in perioperative period. Materials and Methods: The present study was a prospective, double-blinded, randomized, placebo-controlled study conducted in tertiary care hospital. Eighteen consecutive patients (36 nostrils) with chronic rhinosinusitis with nasal polyps underwent bilateral ESS were enrolled. At the end of the surgery for each patient, one side of the ethmoid cavity and middle meatus was randomly given polyurethane foam soaked with 2 mL of budesonide inhalation solution (0.5 mg/2 mL) (budesonide side), while the contralateral side received 2 mL of normal saline-soaked polyurethane foam (control side). Postoperative care included a short course of oral steroid and budesonide nasal irrigations. Single assessor blinded to the randomize allocation evaluated mucosal inflammation and wound healing at 2 and 4 weeks after surgery using Perioperative Sinus Endoscopy (POSE) score. Results: A total of 36 nostrils were randomized into two groups: 18 to the budesonide side and 18 to the control side. All of them were analyzed. The preoperative Lund-Mackay computed tomography score did not show a significant difference between the groups. There was no significant difference in POSE score between budesonide and control sides at 2 and 4 weeks after surgery. Conclusion: Budesonide-impregnated polyurethane foam did not provide additional benefits on mucosal inflammation and wound healing in the patients who underwent ESS and received a short course of oral steroid perioperatively. Keywords: Chronic rhinosinusitis, Nasal polyps, Nasal dressing/packing, Budesonide, Endoscopic sinus surgery

scholarly journals What is the optimal outcome after endoscopic sinus surgery in the treatment of chronic rhinosinusitis? A consultation of Canadian experts

2021 ◽  
Vol 50 (1) ◽  
Author(s):  
Nadim Saydy ◽  
Sami P. Moubayed ◽  
Marie Bussières ◽  
Arif Janjua ◽  
Shaun Kilty ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Patient Reported Outcome ◽  
Sinus Surgery ◽  
Structured Interviews ◽  
Subjective Data ◽  
Operative Outcomes ◽  
Patient Reported ◽  
Definition Of Success ◽  
Reported Data

Abstract Objectives Many experts feel that in the absence of well-defined goals for success, they have an easier time identifying failure. As success ought to not be defined only by absence of failure, we aimed to define optimal outcomes for endoscopic sinus surgery (ESS) in chronic rhinosinusitis (CRS) by obtaining expert surgeon perspectives. Methods A total of 12 surgeons participated in this targeted consultation. Face to face semi-structured interviews were performed with expert surgeons in the field of CRS and ESS. General impressions and personal definitions of acceptable operative success and optimal operative outcomes were compiled and summarized. Results According to an expert survey, patients’ main objectives are an improvement in their chief complain, a general improvement in quality of life (QoL), and a better overall symptomatic control. The most important aspects of endoscopy for defining a successful intervention were an adequate mucus circulation, a healthy mucosa, minimal edema, and patency of all explored cavities or ostia. In the assessment of surgical outcomes, it was determined that both objective and patient reported data must be carefully examined, with more attention given to subjective outcomes. Conclusions According to data gathered from a Canadian expert consultation, a definition of success must be based on both subjective data and nasal endoscopy. We propose to define an acceptable outcome as either a subjective improvement of at least the minimal clinically improvement difference of a validated patient reported outcome questionnaire, along with a satisfactory endoscopic result (1) or a complete subjective resolution with a sub-optimal endoscopy (2). Graphical abstract

Desmopressin effects on bleeding during functional endoscopic sinus surgery on patients with chronic rhinosinusitis

2021 ◽  
pp. 103024
Author(s):  
Fatemeh Hajimohamadi ◽  
Jawad Hosseini ◽  
Farrokh Heidari ◽  
Sepideh Alvandi ◽  
Shahin Bastaninezhad ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery

Risk factors for postoperative bleeding after endoscopic sinus surgery to treat chronic rhinosinusitis

2021 ◽  
Vol 141 (4) ◽  
pp. 392-396
Author(s):  
Xuemei Qin ◽  
Qing Sun ◽  
Guohui Chen ◽  
Jian Liu ◽  
Tianle Gao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Postoperative Bleeding ◽  
Sinus Surgery

Efficacy of hypertonic (2.3%) sea water in patients with aspirin-induced chronic rhinosinusitis following endoscopic sinus surgery

2019 ◽  
Vol 139 (6) ◽  
pp. 529-535 ◽  
Author(s):  
Aleksandar Perić ◽  
Sandra Vezmar Kovačević ◽  
Aleksandra Barać ◽  
Dejan Gaćeša ◽  
Aneta V. Perić ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Sea Water ◽  
Sinus Surgery

Complications in endoscopic sinus surgery for chronic rhinosinusitis

2011 ◽  
Vol 121 (12) ◽  
pp. 2684-2701 ◽  
Author(s):  
James A. Stankiewicz ◽  
Devyani Lal ◽  
Matthew Connor ◽  
Kevin Welch
Keyword(s):  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery

Endoscopic Sinus Surgery Improves Sleep Quality in Chronic Rhinosinusitis: A Systematic Review and Meta-analysis

2017 ◽  
Vol 158 (2) ◽  
pp. 249-256 ◽  
Author(s):  
Daniel C. Sukato ◽  
Jason M. Abramowitz ◽  
Marina Boruk ◽  
Nira A. Goldstein ◽  
Richard M. Rosenfeld
Keyword(s):  
Systematic Review ◽  
Sleep Quality ◽  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Meta Analysis ◽  
Research Direction ◽  
Sinus Surgery ◽  
Future Research ◽  
Apnea Hypopnea Index ◽  
Poor Sleep

Objective Up to 75% of patients with chronic rhinosinusitis (CRS) suffer with poor sleep quality and reduced quality of life. Endoscopic sinus surgery has demonstrated encouraging results in improving sleep function. The aim of this systematic review is to assess the change in sleep quality after surgery for CRS. Data Sources PubMed, Web of Science, EMBASE. Review Methods An electronic search was conducted with the keywords “sinusitis” or “rhinosinusitis” and “sleep.” Studies were included only when adults underwent endoscopic sinus surgery and were evaluated pre- and postoperatively by the Epworth Sleepiness Scale (ESS), the Pittsburgh Sleep Quality Index (PSQI), the Apnea-Hypopnea Index (AHI), the sleep domain of Sino-Nasal Outcome Test–22, or the sleep domain of Rhinosinusitis Disability Index. Results The database search yielded 1939 studies, of which 7 remained after dual-investigator screening. The standardized mean differences (95% CI) for the ESS, PSQI, and AHI were −0.94 (−1.63 to −0.26), −0.80 (−1.46 to −0.14), and −0.20 (−0.32 to −0.07), indicating large, moderate to large, and small improvements, respectively. All analyses displayed high heterogeneity ( I2 = 95%-99%). Conclusion Sleep quality, as measured by the ESS and PSQI surveys, shows substantial improvement after surgery for CRS, with smaller improvement seen for AHI. Generalizability of our results is limited by high heterogeneity among studies and by broad confidence intervals that cannot exclude small to trivial changes. The findings of this meta-analysis provide insight into the effect of CRS-related endoscopic sinus surgery on sleep quality, which should guide future research direction and counseling of patients in the clinical setting.

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