The Effect Of Functional Endoscopic Sinus Surgery On Lung Function In Patients With Chronic Sinusitis And Nasal Polyps Without Asthma

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.

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Functional Endoscopic Sinus Surgery in Patients with Chronic Sinusitis and Asthma

Otolaryngology ◽

10.1177/019459989411000604 ◽

1994 ◽

Vol 110 (6) ◽

pp. 494-500 ◽

Cited By ~ 38

Author(s):

Gary J. Nishoka ◽

Paul R. Cook ◽

William E. Davis ◽

Joel P. McKinsey

Keyword(s):

Endoscopic Sinus Surgery ◽

Hospital Admissions ◽

Chronic Sinusitis ◽

Functional Endoscopic Sinus Surgery ◽

Sinus Surgery ◽

Office Visits ◽

Sinus Disease ◽

Physician Office ◽

Steroid Dependent ◽

The Impact

Twenty asthma patients who underwent functional endoscopic sinus surgery for chronic sinusitis were studied. Medical records and questionnaire data for these 20 patients were studied regarding the Impact of sinus disease and functional endoscopic sinus surgery on their asthma. We found that 95% reported that their asthma was worsened by their sinus disease (95% confidence interval, 0.74 to 0.99+), and 85% reported that functional endoscopic sinus surgery improved their asthma (0.60 to 0.97). Of the 13 patients who used both inhalers and systemic medication, 53.8% were able to eliminate some of their medication (0.21 to 0.79). Furthermore, 61.5% of these patients had a concomitant reduction in their inhaler use (0.28 to 0.85). All patients (six) who used only inhalers experienced a reduction in their inhaler use (0.54 to 1.00), and two patients were able to eliminate their inhalers completely. One of two patients who were steroid dependent was able to discontinue steroids after surgery. Of patients who used steroids intermittently (13), 53.8% were able to eliminate the use of steroids after surgery (0.21 to 0.79). Patients who required preoperative hospital admissions (4) and emergency room or urgent physician office visits (18) had a 75.0% and 81.3% ( p < 0.001) reduction in visits, respectively, after surgery. Because 43% of the cost of asthma is the result of hospitalizations and emergency department/urgent physician office visits, a significant Impact on health care costs can be realized with functional endoscopic sinus surgery in this patient population.

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Major Secretory Mucin Expression in Chronic Sinusitis

Otolaryngology ◽

10.1016/j.otohns.2005.06.005 ◽

2005 ◽

Vol 133 (3) ◽

pp. 423-428 ◽

Cited By ~ 16

Author(s):

Mahmoud S. Ali ◽

David A. Hutton ◽

Janet A. Wilson ◽

Jeffrey P. Pearson

Keyword(s):

Surgical Treatment ◽

Prospective Studies ◽

Nasal Polyps ◽

Inverse Relationship ◽

Chronic Sinusitis ◽

Functional Endoscopic Sinus Surgery ◽

Sinus Surgery ◽

Prognostic Indicators ◽

Nasal Mucus ◽

Mucin Expression

OBJECTIVE: The aim of this study was to investigate mucin expression in chronic sinusitis compared to that in normal nasal mucus. STUDY DESIGN AND SETTING: Sinus mucus samples were collected during functional endoscopic sinus surgery (FESS). The expression of 3 airway mucins, MUC2, MUC5AC, and MUC5B, was determined by ELISA. RESULTS: The 3 mucins are expressed in chronic sinusitis and in normal nasal mucus. MUC5AC and MUC5B represent a major component in sinus mucins while MUC5B and MUC2 predominated in normal nasal mucin. In sinus mucins, upregulation of MUC5AC was associated with downregulation of MUC2 and vice versa. This inverse relationship was strengthened in the presence of nasal polyps. CONCLUSION: At least 3 mucins are expressed at various levels in chronic sinusitis. An inverse relationship was identified between expression of MUC5AC and MUC2. Large prospective studies are required to unravel the complexities of sinus mucus in chronic sinusitis. SIGNIFICANCE: Mucins may be used as markers for assessment of disease severity and may also help as prognostic indicators following medical or surgical treatment.

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Immunotherapy in Patients Undergoing Functional Endoscopic Sinus Surgery

Otolaryngology ◽

10.1177/019459989411000410 ◽

1994 ◽

Vol 110 (4) ◽

pp. 406-412 ◽

Cited By ~ 71

Author(s):

Gary J. Nishioka ◽

Paul R. Cook ◽

William E. Davis ◽

Joel P. McKinsey

Keyword(s):

Endoscopic Sinus Surgery ◽

Chronic Sinusitis ◽

Functional Endoscopic Sinus Surgery ◽

Sinus Surgery ◽

Outcome Parameters ◽

Allergic Symptoms ◽

Polyp Recurrence ◽

Better Than

A total of 283 consecutive patients with chronic sinusitis underwent functional endoscopic sinus surgery. There were 72 allergic patients and 211 nonallergic patients. Data were collected on the effect of immunotherapy on middle meatotomy patency, synechiae formation, and recurrent polyps in allergic patients. Data supported the following conclusions: (1) Immunotherapy given either before or after surgery does not statistically influence middle meatotomy patency, synechiae formation, or recurrence of polyps after functional endoscopic sinus surgery. However, the data do suggest, for all three outcome parameters, that allergic patients who undergo immunotherapy do better than those who do not undergo immunotherapy and, with the exception of recurrent polyps, do as well as nonallergic patients. (2) The prevalence of preoperative polyps is the same for allergic and nonallergic patients in this study, but polyp recurrence is higher in allergic patients. (3) Approximately 40% of allergic patients who began preoperative immunotherapy stopped immunotherapy after surgery because their allergic symptoms resolved or were minimal. A comment regarding this observation is provided.

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Clinical Evaluation of Maxillary Diffuse Polypoid Sinusitis after Functional Endoscopic Sinus Surgery

American Journal of Rhinology ◽

10.2500/105065894781882666 ◽

1994 ◽

Vol 8 (1) ◽

pp. 7-12 ◽

Cited By ~ 7

Author(s):

Chia-Ming Liu ◽

Te-Huei Yeh ◽

Mow-Ming Hsu

Keyword(s):

Clinical Evaluation ◽

Endoscopic Sinus Surgery ◽

Chronic Sinusitis ◽

Functional Endoscopic Sinus Surgery ◽

Sinus Surgery ◽

Maxillary Sinuses

Functional endoscopic sinus surgery (FESS) for chronic sinusitis has become popular as a substitution for radical operations. We selected 24 patients with diffuse polypoid rhinosinopathy who had been admitted for FESS and followed up for at least 6 months. The recovery of 39 maxillary sinuses was inspected with endoscopy through the enlarged middle meatal antrostomies. We found that of 8 sinuses recovered, 19 still had diffuse polypoid change, and another 12 had focal polypoid sinuses. We conclude that for diffuse polypoid rhinosinopathy, management of maxillary polypoid mucosa is complicated, and recovery of polypoid mucosa is dependent not only on the patency of the sinus ostia, but also on other factors such as alterations of mucosal, glandular, and epithelial changes by chronic stimuli.

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RECURRENCE OF NASAL POLYPS AFTER FUNCTIONAL ENDOSCOPIC SINUS SURGERY

Medical Connections ◽

10.33311/medcon.2009.12.4.5 ◽

2009 ◽

Vol 12 (4/2009) ◽

Keyword(s):

Endoscopic Sinus Surgery ◽

Nasal Polyps ◽

Functional Endoscopic Sinus Surgery ◽

Sinus Surgery

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NASAL POLYPS;

The Professional Medical Journal ◽

10.29309/tpmj/2018.25.08.48 ◽

2018 ◽

Vol 25 (08) ◽

pp. 1213-1217

Author(s):

Farhan Salam ◽

Damish Arslan ◽

Muhammad Salman Haider Qureshi ◽

Ejaz Ahmad

Keyword(s):

Endoscopic Sinus Surgery ◽

Nasal Polyps ◽

Nasal Polyposis ◽

Postoperative Bleeding ◽

Case Series ◽

Operational Definition ◽

Functional Endoscopic Sinus Surgery ◽

Sinus Surgery ◽

Male Patients ◽

Age Of Majority

Introduction: Functional Endoscopic Sinus Surgery (FESS) is now undoubtedlythe procedure of choice for surgical treatment of chronic sinusitis and nasal polyposis afterfailure of medical treatment. In order to present the formation of synechie nasal packing isperformed. Moreover, it also helps in supporting the process of wound healing and preventionof postoperative bleeding. Objectives: To determine the frequency of synechiae formation afterfunctional endoscopic sinus surgery (FESS) in patients presenting with nasal polyps. StudyDesign: Descriptive case series. Setting: Department of Otorhinolaryngology at ServicesHospital Lahore. Period: Six months from 03-10-2013 to 02-04-2014. Methodology: A total of150 cases were included in this study. Patients were treated by functional endoscopic sinussurgery (FESS) and were followed at the end of 1st, 2nd, 3rd and 4th week postoperatively forthe development of synechiae (as per operational definition). Results: The age of majority ofpatients was from 20 to 40 years and minimum patients were < 20 years old. Mean age of thepatients was 35.30±10.54 years. Male patients were 80 (53.3%) while female patients were 70(46.7%). Synechiae formation was observed in 28 patients (18.7%). Conclusion: Synechiaeformation was developed in 18.4% of the patients after functional endoscopic sinus surgery.

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