scholarly journals Comparison by Objective Parameters in Patients with Chronic Rhinosinusitis Managed Medically and Surgically (with and without Powered Instruments)

2016 ◽  
Vol 7 (3) ◽  
pp. ar.2016.7.0169
Author(s):  
Samarendra Behera ◽  
Satyawati Mohindra ◽  
Sourabha K. Patro ◽  
Ashok K. Gupta
Keyword(s):  
Chronic Rhinosinusitis ◽  
Test Scores ◽  
Mucociliary Clearance ◽  
Sinus Surgery ◽  
Clearance Time ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Treatment Surgery

Objective To compare mucociliary clearance time and quality of life in patients who underwent sinus surgery using conventional and powered instruments, and in patients who were treated nonsurgically. Methods A total of 151 patients with chronic rhinosinusitis were included. Fifty-four patients were treated conservatively, 48 patients were managed surgically by using conventional instruments and 49 patients were managed by using a microdebrider. Kupferberg nasal endoscopy grades, 20-item Sino-Nasal Outcome Test scores, Lund-Mackay scores, and mucociliary clearance time were analyzed. Results On comparison among the groups, it was found that there was a significant difference between group A (nonsurgically treated) compared with group B (surgery by conventional means) or group C (surgery with microdebrider) in nasal endoscopic grades, Lund-Mackay scores, 20-item Sino-Nasal Outcome Test scores, and mucociliary clearance time. However, in comparison between groups B and C, there was no statistically significant difference. Conclusion Mucociliary clearance time tended to recover after starting treatment for chronic rhinosinusitis both after conservative treatment and after surgical treatment. Surgery provided better improvement in different objective scores in chronic rhinosinusitis. There exists no statistical difference in parameters independent of the instrument used for surgery.

Comparison of Isotonic Seawater Nasal Spray Containing Chamomile Liquid Extract and Other Isotonic Seawater Nasal Washing Solutions for Allergic Rhinitis

2021 ◽  
pp. 000348942110254
Author(s):  
Yavuz Atar ◽  
Semih Karaketir ◽  
Imran Aydogdu ◽  
Hüseyin Sari ◽  
Hasan Sami Bircan ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Mucociliary Clearance ◽  
Clearance Time ◽  
Liquid Extract ◽  
Alternative Treatment Option ◽  
Significant Difference ◽  
Before And After ◽  
Group A ◽  
Group B ◽  
Nasal Mucociliary Clearance

Objective: We aim to demonstrate the effect of an isotonic seawater spray containing chamomile liquid extract on symptoms and nasal mucociliary clearance in patients with allergic rhinitis by comparing it with other isotonic seawater nasal washing solutions. Methods: The study included 123 patients. Based on Allergic Rhinitis and its Impact on Asthma guidelines, mometasone furoate intranasal spray treatment was started for all patients in the group diagnosed with allergic rhinitis. In addition to this treatment, isotonic seawater spray with chamomile liquid extract was added to Group A, isotonic seawater spray to Group B, and isotonic seawater nasal irrigation to Group C. The fourth group (Group D) was given only nasal steroid spray without nasal washing treatment. Before and after treatment in all patients, the Sino-Nasal Outcome Test-22 was performed, and nasal mucociliary clearance times were measured by the saccharin test. Results: The differences in duration of nasal mucociliary clearance and Sino-Nasal Outcome Test-22 values were taken before and after treatment. In Group A, B, C, and D the Sino-Nasal Outcome Test-22 differences were statistically significant ( P ≤.001; P ≤ .001; P ≤ .001, and P = .048, respectively). Only Group A and Group B experienced a significant difference in nasal mucociliary clearance times ( P ≤ .001; P = .010, respectively). When the Sino-nasal Outcome Test-22 score and nasal mucociliary clearance time differences before and after treatment were compared between all groups, the Sino-Nasal Outcome Test-22 score difference was higher in Group A than in Groups B, C, and D, the differences were found as statistically significant ( P = .010; P = .003; P ≤ .001, respectively). The nasal mucociliary clearance time difference was higher in Group A than in Groups C and D, the differences were found as statistically significant ( P = .010; P = .001, respectively). Conclusion: Isotonic seawater spray containing chamomile liquid extract is seen as a good alternative treatment option for allergic rhinitis patients.

scholarly journals Comparison of Endoscopic Sinus Surgery and Continued Medical Treatment Therapy for Refractory Chronic Rhinosinusitis

2021 ◽  
Vol 15 (9) ◽  
pp. 2285-2288
Author(s):  
Sadaf Raffat ◽  
Mustafa . ◽  
Nighat Arif ◽  
Usman Aslam ◽  
M Mubarik Ali ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Medical Treatment ◽  
Chronic Rhinosinusitis ◽  
Medical Therapy ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Group A ◽  
Group B ◽  
Disease Specific

Aim: To compare endoscopic sinus surgery and continued medical treatment in refractory refractory chronic rhinosinusitis (CRS) patients regarding diseases specific quality of life measurement Study design: RCT (Randomized controlled trial) Place and duration of study: Study was conducted at ENT (Ear, nose and throat) department, Railway Hospital Rawalpindi. Study duration was one year (January 2018-Deecember 2018) Methods: A sample size of 22 patients was calculated using WHO calculator. Non probability consecutive sampling was used. A prior ethical approval and consent form was taken. Patients were randomly divided into two groups; Group A was given medical therapy while Group B comprised contain patients in whom medical therapy failed and had undergone endoscopic sinus surgery. Patients were followed for disease specific quality of life scores. Data was analyzed using SPSS version22. Chi-square and t test was applied. P value ≤ 0.05 was considered significant. Results: Total of 22 refractory CRS patients were included in study. There were 10(45.5%) males and 12(54.5%) females. Mean age of refractory CRS patients was 33.4 years±6.2SD. Group A (continued medical therapy) N=11, had significantly high SNOTT -22 scores 60.6±7.1SD as compared to endoscopic sinus surgery 21±3.9SD (p=0.000). Group B (endoscopic sinus surgery) had significantly low endoscopic scores 2.7±0.3SD as compared to group A (continued medical therapy) 7.14±0.53SD (p=0.000). Endoscopic sinus surgery group showed significant reduction in work days lost 17.4±4.9SD as compared to continued medical therapy (Group A) 30.1±2.5SD (p=0.000). Conclusion: Endoscopic sinus surgery is an effective treatment option as compared to continued medical therapy with improved quality of life in refractory CRS patients (with reduced baseline disease specific quality of life). Keywords: Refractory chronic rhinosinusitis, endoscopic sinus surgery, quality of life

Efficacy of Endoscopic Posterior Nasal Neurectomy in Treating Eosinophilic Chronic Rhinosinusitis

ORL ◽  
2021 ◽  
pp. 1-5
Author(s):  
Manman Chen ◽  
Ming Xu ◽  
Xuefeng Lei ◽  
Bin Zhang
Keyword(s):  
Chronic Rhinosinusitis ◽  
Surgical Recurrence ◽  
Eosinophilic Chronic Rhinosinusitis ◽  
Group A ◽  
Sinonasal Outcome Test ◽  
Random Number Table ◽  
Group B

<b><i>Objectives:</i></b> Recent guidelines have revealed that eosinophilic chronic rhinosinusitis (ECRS) exhibits a strong tendency for recurrence after surgery and impairs quality of life. Neuropeptides play an important neuroimmunological role. The aim of this study was to determine the efficacy of posterior nasal neurectomy (PNN) for the treatment of ECRS by inhibiting type 2 cytokine expression. <b><i>Methods:</i></b> Forty-six patients were divided into group A and group B according to a random number table. Group A underwent conventional functional endoscopic sinusitis surgery (FESS) combined with PNN, and group B underwent conventional FESS alone. The subjective and objective symptoms included a 10-cm visual analog scale (VAS), 22-item SinoNasal Outcome Test (SNOT-22) score, nasal speculum Lund-Kennedy score, and paranasal sinus computed tomography (CT) Lund-Mackay score at the 1-year postoperative follow-up. <b><i>Results:</i></b> Postoperative VAS (10.33 ± 2.18 vs. 8.38 ± 2.11, <i>p</i> &#x3c; 0.01) and Lund-Kennedy score (1.95 ± 1.32 vs. 3.14 ± 1.35, <i>p</i> &#x3c; 0.01) were significantly improved. The rhinorrhea score (1.76 ± 0.83 vs. 2.90 ± 1.14, <i>p</i> &#x3c; 0.001) in the VAS and the discharge (0.43 ± 0.51, vs. 0.95 ± 0.67, <i>p</i> &#x3c; 0.01) and edema (0.57 ± 0.60 vs. 0.95 ± 0.59, <i>p</i> &#x3c; 0.05) scores in the Lund-Kennedy score were observed to have improved significantly in group A compared with those in group B. <b><i>Conclusions:</i></b> FESS combined with PNN suppresses edema symptoms, which might significantly decrease the surgical recurrence rate of ECRS in the long term.

scholarly journals COMPARISON BETWEEN THERAPEUTIC ULTRASOUND AND SCAR MOBILIZATION OVER PERSISTENT POSTNATAL DYSPAREUNIA

2017 ◽  
Vol 10 (9) ◽  
pp. 48
Author(s):  
Mariyam Farzana Sf ◽  
Ponmathi P ◽  
Sivakumar Pvr
Keyword(s):  
Quality Of Life ◽  
Analogue Scale ◽  
Therapeutic Ultrasound ◽  
Ultrasound Therapy ◽  
Age Group ◽  
Functional Index ◽  
Significant Difference ◽  
Group A ◽  
Group B

  Objective: Dyspareunia is known as the painful sexual intercourse. This study was conducted to compare the effectiveness between therapeutic ultrasound and scar mobilization in persistent postnatal dyspareunia.Methods: This is an experimental study. 30 subjects with superficial dyspareunia, age group between 25 and 35 years are taken in this study and 15 subjects in Group A were treated with ultrasound therapy, 15 subjects in Group B were treated with scar mobilization. Female sexual functional index questionnaire (FSFI) and visual analogue scale (VAS) were used as the outcome measure.Results: Results showed a significant difference in FSFI and VAS measurements in both the groups, but clinically Group A showed better improvement in pain and quality of life than Group B.Conclusion: There is no significant difference between ultrasound therapy and scar mobilization over the pain and quality of life in patients with persistent postnatal dyspareunia.

scholarly journals The Effect on Performance Time and Quality of the Knots after Mono or Bimanual Training of Laparoscopic Intracorporeal Knot Tying according to the Gladiator Rule Technique

2018 ◽  
Vol 40 (05) ◽  
pp. 266-274
Author(s):  
Fernanda Asencio ◽  
Helizabet Ribeiro ◽  
Armando Romeo ◽  
Arnauld Wattiez ◽  
Paulo Ribeiro
Keyword(s):  
Dominant Hand ◽  
Resident Students ◽  
Performance Time ◽  
Laparoscopic Suture ◽  
Significant Difference ◽  
Bimanual Training ◽  
Group A ◽  
Group B ◽  
Intracorporeal Knot Tying

Objective To assess whether the monomanual or bimanual training of laparoscopic suture following the same technique may interfere with the knots' performance time and/or quality. Methods A prospective observational study involving 41 resident students of gynecology/obstetrics and general surgery who attended a laparoscopic suture training for 2 days. The participants were divided into two groups. Group A performed the training using exclusively their dominant hand, and group B performed the training using both hands to tie the intracorporeal knot. All participants followed the same technique, called Romeo Gladiator Rule. At the end of the course, the participants were asked to perform three exercises to assess the time it took them to tie the knots, as well as the quality of the knots. Results A comparative analysis of the groups showed that there was no statistically significant difference (p = 0.334) between them regarding the length of time to tie one knot. However, when the time to tie 10 consecutive knots was compared, group A was faster than group B (p = 0.020). A comparison of the knot loosening average, in millimeters, revealed that the knots made by group B loosened less than those made by group A, but there was no statistically significant difference regarding the number of knots that became untied. Conclusion This study demonstrated that the knots from group B showed better quality than those from group A, with lower loosening measures and more strength necessary to untie the knots. The study also demonstrated that group A was faster than B when the time to tie ten consecutive knots was compared.

scholarly journals Evaluating the Efficacy and Trend of Sinus Surgery

2020 ◽  
Vol 24 (04) ◽  
pp. e407-e412
Author(s):  
Masa Petrovic ◽  
Arash Shamsian ◽  
Martin L. Hopp ◽  
Narine Vardanyan
Keyword(s):  
Medical Center ◽  
Preoperative Evaluation ◽  
Sinus Surgery ◽  
Surgical Results ◽  
Evaluation Time ◽  
Group A ◽  
Group B ◽  
Optimal Evaluation

Abstract Introduction From April 2009 to December 2016, 661 consecutive patients undergoing sinus surgery completed a quality of life (QOL) questionnaire (SNOT-22) preoperatively and at 3, 6, and 12 months postoperatively. Objective (1) To evaluate the long-term efficacy of sinus surgery using QOL instruments. (2) To determine the optimal evaluation time for surgical efficacy. (3) To determine if surgical results improve with yearly experience. Methods The prospective study patients were split into two groups: Group A, those who completed the initial preoperative evaluation and all postoperative evaluations, and Group B, who completed the preoperative questionnaire and at least one but not all of the postoperative questionnaires. Group A included 93 patients. Group B included 240 patients at 3 months, 180 at 6 months, and 121 at 12 months postoperatively. Results Group A efficacy reported at 3 months was 82.8%, 80.6% at 6 months, and 84.9% at 12 months postoperatively. Group B efficacy reported at 3 months was 71.3%, 78.3% at 6 months, and 84.3% at 12 months postoperatively. An 8-year trend analysis of year-to-year 12 months postoperative data illustrates a significant improvement with an analysis of variance (ANOVA) linear rate of 1.594 (p ≤0.12). Conclusion The 8-year trend at 12 months postoperatively shows a positive improvement in surgical results. Patients undergoing sinus surgery at tertiary medical center showed 84.9% improvement in sinus disease symptoms by 12 months postoperatively. Long-term improvement analysis showed no difference between 6 months postoperatively and 12 months, signifying 6 months as an effective evaluation for surgical efficacy.

Therapeutic indications for sinonasal topical steroid treatment and its effects on eosinophilic chronic rhinosinusitis after endoscopic sinus surgery

2021 ◽  
pp. 1-6
Author(s):  
T Saito ◽  
K Okazaki ◽  
Y Hamada ◽  
K Hashimoto ◽  
K Tsuzuki
Keyword(s):  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Topical Steroid ◽  
Steroid Treatment ◽  
Sinus Surgery ◽  
Olfactory Loss ◽  
Eosinophilic Chronic Rhinosinusitis ◽  
Group A ◽  
Operative Indications ◽  
Group B

Abstract Objective This study evaluated the post-operative indications for sinonasal topical steroid treatment using a corticosteroid (steroid)-eluting, sinus-bioabsorbable device and its effects in patients with eosinophilic chronic rhinosinusitis. Method Post-operative courses were investigated in two groups: group A with patients who underwent sinonasal topical steroid treatment, and group B with control patients who did not. Results Group A was significantly younger than group B (p < 0.01), and the pre-operative computed tomography score was significantly higher in group A than in group B (p < 0.05). In the post-operative stage, the nasal symptoms questionnaire component of olfactory loss and the post-operative endoscopic appearance score were significantly worse in group A than in group B (p < 0.01). Conclusion These data suggest that younger age, more severe rhinosinusitis and post-operative olfactory loss led to the need for sinonasal topical steroid treatment to prevent relapsing inflammation after functional endoscopic sinus surgery in patients with eosinophilic chronic rhinosinusitis.

Septoplasty Improves Life Quality Related to Allergy in Patients with Septal Deviation and Allergic Rhinitis

2011 ◽  
Vol 145 (6) ◽  
pp. 910-914 ◽  
Author(s):  
Young Hyo Kim ◽  
Beom Joon Kim ◽  
Kang Hyun Bang ◽  
Yoonseok Hwang ◽  
Tae Young Jang
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Clinical Course ◽  
Septal Deviation ◽  
Vas Score ◽  
Medication Score ◽  
Significant Difference ◽  
Group A ◽  
Group B

Objective. Evaluate the effect of septoplasty on the clinical course of allergic rhinitis by comparing (1) symptom change using the Visual Analogue Scale (VAS), (2) change of the medication score, and (3) improvement of the quality of life using a questionnaire. Study Design. Prospective pilot. Setting. Academic tertiary rhinological practice. Subjects and Methods. Sixty-two patients who had undergone septoplasty and turbinoplasty for septal deviation and allergic rhinitis were enrolled in group A. Twenty-six patients who had undergone only turbinoplasty for allergic rhinitis were enrolled in group B. The VAS score, the Average Rescue Medication Score (ARMS), and the Rhinasthma Questionnaire for the quality of life were all obtained from each patient. These parameters were compared before and after the surgery and between the groups. Results. Both groups showed significant improvement of the VAS score ( P < .001). When the change of VAS was compared between groups, there was a significant difference in group A only for nasal obstruction ( P = .047). Comparison of the ARMS between groups showed significant improvement in both groups after the surgery ( P < .01). However, there were no differences between the groups. The Rhinasthma score of group A was significantly lowered after the surgery (56.4 ± 13.2 to 34.1 ± 12.3, P < .001). The Rhinasthma score of group A was significantly lower than that of group B after the surgery ( P = .004). Conclusions. This is the first research about the potential effect of septoplasty on the clinical course of allergic rhinitis. Further studies are needed to elucidate the mechanisms underlying these effects.

Does the Sweating Severity of Primary Hyperhidrosis Sites Affect Post-Sympathotomy Results?

2020 ◽  
Author(s):  
Hüseyín Ulaş Çınar ◽  
Burçin Çelik
Keyword(s):  
Patient Satisfaction ◽  
Clinical Improvement ◽  
Severity Score ◽  
Postoperative Results ◽  
Satisfaction Rate ◽  
Significant Difference ◽  
Group A ◽  
Primary Hyperhidrosis ◽  
Group B

Abstract Background Improvement in quality of life (QOL) and patient satisfaction after endoscopic thoracic sympathotomy (ETS) in patients with primary hyperhidrosis may be affected by various factors. We examined whether the preoperative sweating severity of primary hyperhidrosis sites affects postoperative results. Methods The records of 112 patients who underwent bilateral ETS were reviewed retrospectively. The patients were divided into three groups according to the sweating severity score obtained from all primary hyperhidrosis sites (primary hyperhidrosis severity score [PHSS]) and analyzed comparatively. Group A (PHSS = 1–4) included 22 patients, Group B (PHSS = 5–8) 36 patients, and Group C (PHSS ≥ 9) 54 patients. Outcome measures included QOL prior to surgery, improvement in QOL after surgery, degree of clinical improvement, presence, severity, localization, and site number of reflex sweating (RS) and general patient satisfaction after 6 months of surgery. Results The preoperative QOL of patients with higher PHSS (groups B, C) was worse than other patients (group A). More than 91% of all patients had any level improvement in QOL, and over 96% had slight or great clinical improvement. RS developed in 80% of the patients, mostly in the back, very severe in 8%, and in median two different body areas. The overall patient satisfaction rate was more than 95%. There was no significant difference between the three groups in terms of all postoperative results. Conclusion Preoperative sweating severity of primary hyperhidrosis sites does not affect post-sympathotomy results. Surgeons should not be worried when deciding upon surgery, even in patients with high sweating severity.

scholarly journals Impact of septoplasty alone or with endoscopic sinus surgery for treatment of chronic rhinosinusitis with deviated septum

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Soad Yehia Mostafa ◽  
Fatma Mohamed Abd-Elgaber ◽  
Bothina Ahmed Mohamed ◽  
Al-Shimaa Said Hammad
Keyword(s):  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Septal Deviation ◽  
Sinus Surgery ◽  
Osteomeatal Complex ◽  
Group A ◽  
Group B ◽  
Mucosal Thickening

Abstract Background Chronic rhinosinusitis represents an important health care problem in the world. Deviated nasal septum leads to increased chance of impaired mucociliary clearance, osteomeatal complex obstruction, and development of rhinosinusitis. Studies have revealed the role of septoplasty in curing chronic rhinosinusitis in patients with significant septal deviation. The purpose of this study is to reveal the role of septoplasty alone or combined with functional endoscopic sinus surgery in improving the outcome of chronic rhinosinusitis in patients with significant septal deviation. Results Postoperative computed tomography findings in group A (underwent septoplasty only) were mild opacity of ethmoid (25%), sinus mucosal thickening (15%), and occluded osteomeatal complex with discharge (25%). Postoperative computed tomography findings in group B mild opacity of ethmoid (30%), sinus mucosal thickening (20%), and occluded osteomeatal complex with discharge (30%). The Sino-Nasal Outcome Test score in group A decreased significantly from 85.75 to 28.85 (P < 0.05). In group B (underwent combination of septoplasty and functional endoscopic sinus surgery), the Sino-Nasal Outcome Test score also decreased significantly from 87.75 to 32.55 (P < 0.05). The improvement was 85% in group A and 80% in group B. Conclusion The post-operative improvement has no significant difference between the two groups. Hence, we suggest that septoplasty alone can be adequate for the treatment of chronic rhinosinusitis with septal deviation.

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