Concha bullosa mucocele - endoscopic surgical solution

Headache is a borderline pathology, faced by physicians of various specialties, which has to be thoroughly investigated to establish the etiology and appropriate treatment. The authors present a case of concha bullosa mucocele managed by endoscopic sinus surgery. The mucocele was responsible for persistent nonsystemized headache and also for the chronic rhinosinusitis of the maxillary, ethmoidal and frontal sinus because of the blockage of the middle meatus. The drainage of the anterior sinuses and the mucocele of the concha bullosa were successfully managed by endoscopic sinus surgery.

Download Full-text

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

American Journal of Rhinology and Allergy ◽

10.1177/1945892418765002 ◽

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.

Download Full-text

Predictors of disease progression after endoscopic sinus surgery in patients with chronic rhinosinusitis

The Journal of Laryngology & Otology ◽

10.1017/s0022215119001245 ◽

2019 ◽

Vol 133 (8) ◽

pp. 678-684 ◽

Cited By ~ 4

Author(s):

K Tsuzuki ◽

K Hashimoto ◽

K Okazaki ◽

H Nishikawa ◽

M Sakagami

Keyword(s):

Disease Progression ◽

Chronic Rhinosinusitis ◽

Endoscopic Sinus Surgery ◽

Frontal Sinus ◽

Early Period ◽

Functional Endoscopic Sinus Surgery ◽

Sinus Surgery ◽

Eosinophilic Chronic Rhinosinusitis ◽

Operative Findings

AbstractObjectiveThis study aimed to determine the predictors of disease progression after functional endoscopic sinus surgery in patients with chronic rhinosinusitis.MethodA total of 281 adult chronic rhinosinusitis patients who underwent primary bilateral functional endoscopic sinus surgery between 2007 and 2017 and had at least 12 months of follow-up endoscopic evaluation were examined. Patients were divided into eosinophilic (n= 205) and non-eosinophilic chronic rhinosinusitis groups (n= 76). In order to determine adverse factors, post-operative endoscopic appearance scores were analysed in relation to the pre- and intra-operative findings using multiple regression analyses.ResultsThe post-operative course of eosinophilic cases deteriorated over time, like the early period for non-eosinophilic cases. Frontal sinus polyps recurred early in eosinophilic chronic rhinosinusitis. Multivariate analyses indicated young adulthood, asthma, high computed tomography score and frontal sinus polyps as significant adverse predictors.ConclusionEarly, appropriate estimation of sinonasal conditions appears to be crucial for successful surgical management of chronic rhinosinusitis.

Download Full-text

A concha bullosa crusher for use in endoscopic sinus surgery

The Journal of Laryngology & Otology ◽

10.1258/0022215001905111 ◽

2000 ◽

Vol 114 (3) ◽

pp. 205-206 ◽

Cited By ~ 17

Author(s):

T. J. Woolford ◽

N. S. Jones

Keyword(s):

Endoscopic Sinus Surgery ◽

Mucosal Damage ◽

Sinus Surgery ◽

Middle Meatus ◽

Concha Bullosa ◽

Surgical Reduction

A concha bullosa may require surgical reduction to facilitate access to the middle meatus during endoscopic sinus surgery. Here we describe an original instrument which enables this procedure to be performed simply with minimal mucosal damage.

Download Full-text

Faculty Opinions recommendation of Sinus preservation management for frontal sinus fractures in the endoscopic sinus surgery era: a systematic review.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718015770.793475860 ◽

2013 ◽

Author(s):

Robert M Kellman

Keyword(s):

Systematic Review ◽

Endoscopic Sinus Surgery ◽

Frontal Sinus ◽

Sinus Surgery

Download Full-text

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

Journal of Otolaryngology - Head and Neck Surgery ◽

10.1186/s40463-021-00519-9 ◽

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

Download Full-text