TO EVALUATE THE RESULTS OF FUNCTIONAL ENDOSCOPIC SINUS SURGERY TO PATIENTS SUFFERING FROM CHRONIC SINUSITIS WITH SPHENOID SINUSITIS

2017 ◽  
pp. 114-121
Author(s):  
Xuan Trung Ho ◽  
Van Dung Phan ◽  
Tu The Nguyen ◽  
Thanh Thai Le
Keyword(s):  
Ct Scan ◽  
Nasal Obstruction ◽  
Endoscopic Sinus Surgery ◽  
Chronic Sinusitis ◽  
Functional Endoscopic Sinus Surgery ◽  
University Hospital ◽  
Sinus Surgery ◽  
Nasal Discharge ◽  
Sphenoid Sinusitis ◽  
Grade Iii

Objective: To evaluate the features and CT scan of chronic sinusitis with sphenoid sinusitis. To evaluate the results in patients undergoing Functional Endoscopic Sinus Surgery. Subjects and Method: a prospective descriptive study with intervention was designed for 34 patients at Hue Pharmacy and Medicine University hospital and Da nang hospital. Results: almost all patients presented nasal discharge, headache and nasal obstruction. Endoscopic assessment: grade III-IV 82,3%, grade I-II 17,7%. CT scan assessment: grade III-IV 85,2%, grade I-II 14,8%. 34 patients were followed up after 6 months. Conclusions: almost common presenting complaints were nasal discharge, headache and nasal obstruction. Majority of patients were better in symptoms, endoscopic and CT scan features. Key words: sphenoid sinusitis, chronic sinusitis, endoscopic sinus surgery

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

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

<p class="abstract"><strong>Background:</strong> 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.</p><p class="abstract"><strong>Methods:</strong> 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.  </p><p class="abstract"><strong>Results:</strong> 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.</p><p class="abstract"><strong>Conclusions:</strong> 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.</p>

scholarly journals Functional Endoscopic Sinus Surgery and Conventional Surgery in the Management of Chronic Sinusitis

2015 ◽  
Vol 4 (1) ◽  
pp. 16-21
Author(s):  
Mohammod Jamal Hossain ◽  
Md Morshed Alam ◽  
Masroor Rahman ◽  
Mohammad Idris Ali ◽  
SM Sarwar
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Chronic Sinusitis ◽  
Maxillary Antrum ◽  
Functional Endoscopic Sinus Surgery ◽  
Nasal Fossa ◽  
Conventional Group ◽  
Sinus Surgery ◽  
Nasal Discharge ◽  
Conventional Surgery ◽  
Mucosal Thickening

Background & objective: The interest in functional endoscopic sinus surgery (FESS) in the management of chronic sinusitis is increasing day by day. The proponents of FESS for the treatment of chronic sinusitis claim that it is superior to conventional sinus surgery in the management of the disease, but there are limited studies addressing the issue. The present study was undertaken to make a comparative evaluation between FESS and conventional surgery in the treatment of chronic sinusitis. Materials & Methods: This prospective study was conducted between October 2005 to March 2006 in the Department of ENT and Head-Neck Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), and Dhaka Medical College Hospital (DMCH), Dhaka. A total of 60 patients of chronic sinusitis with failed conservative treatment or chronic sinusitis with polyps admitted for surgical treatment were included. Selected patients irrespective of age and sex were randomly assigned to either FESS (n=30) or conventional surgery (n=30) followed by respective interventions. Baseline clinical characteristics, image findings and outcome variables were studied. Result: Majority of the patients (around 70%) in either group was in their second and third decades of life. Males were a bit higher in the FESS group. Nasal obstruction was the predominant complaints (75%) followed by nasal discharge (68.3%) and headache (66.7%). X-ray of paranasal sinuses showed opacity in maxillary antrum and nasal fossa in 90% and mucosal thickening in maxillary antrum in 58.3% cases. CT scan showed isodense shadow in ethmoid region and nasal fossa (86.7%) with blocked osteomeatal complex (OMC) on both sides (73.3%) and mucosal thickening in maxillary antrum (46.7%). The indications for FESS were chronic sinusitis with ethmoidal polyp (73.3%), while that for conventional surgery was chronic sinusitis alone (56.7%). Majority (83.3%) of the FESS group and two-thirds (66.7%) of the conventional group had unilateral operation. Most (90%) of the FESS group required nasal or antral packing during procedure than that of the conventional group (43.3%) (p<0.001). Complete recovery was significantly higher in the former group (70%) than that in the latter group (40%) (p = 0.047). Shorter hospital stay (up to 2 days) was observed in majority of the former group patients (0.001). In terms of complications, periorbital oedema was appreciably lower and numbness of the cheek was completely absent in FESS group than those in the Conventional group (p < 0.001 and p = 0.005 respectively). Conclusion: Functional endoscopic sinus surgery offers higher success and lower morbidity than conventional surgery in the management of chronic sinusitis with or without polyp. However, proper training is mandatory to acquire proficiency in FESS. Ibrahim Cardiac Med J 2014; 4(1): 16-21

scholarly journals Evaluation of ostiomeatal complex pathology related to endoscopic sinus surgery – a retrospective analysis

2015 ◽  
Vol 5 (18) ◽  
pp. 95-100
Author(s):  
Vlad Budu ◽  
Alexandra Schnaider ◽  
Maria Sabina Tache ◽  
Ioan Bulescu
Keyword(s):  
Nasal Obstruction ◽  
Endoscopic Sinus Surgery ◽  
Uncinate Process ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Common Finding ◽  
Nasal Discharge ◽  
Lateral Nasal Wall ◽  
Concha Bullosa ◽  
Ostiomeatal Complex

Abstract BACKGROUND. The ostiomeatal complex (OMC) is the anatomical region situated between the middle turbinate and the lateral nasal wall, at the level of the middle meatus. Common anatomical variations of OMC are concha bullosa, hypertrophy of the uncinate process and of the bulla ethmoidalis and Haller’s cell. Our study was aimed to investigate the prevalence of these conditions and their relations to different symptoms. MATERIAL AND METHODS. The study is a retrospective descriptive study based on 256 files of patients who were hospitalized and treated for OMC pathology in our clinic between January 2009 and January 2014. The data acquired were included into Excel Worksheets and statistically analyzed using GraphPad Software. RESULTS. The most common finding was concha bullosa (63.67%), followed by hypertrophy of the bulla ethmoidalis (10.93%) and of the uncinate process (10.15%). Haller’s cell was found in only 3% of cases. The most common symptom for all patients was nasal obstruction, followed by nasal discharge. The majority of symptoms improved after functional endoscopic sinus surgery for OMC drainage. CONCLUSION. OMC pathology is a frequent indication for functional endoscopic sinus surgery. The most common condition that determines blockage of OMC and need for surgical treatment is concha bullosa. The most common complaint of patients with OMC pathology is nasal obstruction.

scholarly journals Allergic fungal rhinosinusitis: an overview on pathogenesis, early diagnosis and management

2018 ◽  
Vol 4 (3) ◽  
pp. 694 ◽  
Author(s):  
Neeraj Suri ◽  
Bhavya B. M.
Keyword(s):  
Nasal Obstruction ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Histological Evaluation ◽  
Nasal Discharge ◽  
Fungal Sinusitis ◽  
Surgical Specimen ◽  
Specimen Handling ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis

<p class="abstract"><strong>Background: </strong>The objective of the study was<strong> </strong>to evaluate the criteria for diagnosing allergic fungal rhinosinusitis and to maintain permanent drainage and ventilation, while preserving the integrity of the mucosa.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study of 50 patients with allergic fungal sinusitis with or without polyposis all of whom were treated with endoscopic debridement. Mucous sample collection, nasal secretion culture, surgical specimen handling, and histological evaluation of surgical specimens are described. All patients treated with endoscopic sinus surgery, debridement, post-operative use of steroids and antifungal therapy.  </p><p class="abstract"><strong>Results:</strong> Fungal mucin was found in all 50 cases, histology and fungal cultures confirmed the diagnosis. Out of 50 patients, 29 were females and 21 were males, with a mean age of 32 years. The most common symptom was nasal discharge 41 (82%) cases, nasal obstruction in 38 (76%) cases, headache and facial pain in 32 (72%) cases, 7 (14%) patients had bronchial asthma. Symptoms of nasal obstruction and nasal discharge were improved in 46 (92%) cases. All preoperative versus postoperative changes in AFRS associated complaints reached statistical significance of p value &lt;0.001 except in patients with asthma.</p><p class="abstract"><strong>Conclusions:</strong> Comprehensive management with endoscopic sinus surgery, oral steroids and antifungals reduces the recurrence or need for revision surgery. Long term follow up is very important.</p>

Pre- and Postoperative Mucociliary Clearance in Functional Endoscopic Sinus Surgery

1997 ◽  
Vol 76 (12) ◽  
pp. 884-886 ◽  
Author(s):  
Shashikant K. Kaluskar
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Chronic Sinusitis ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Controlled Study ◽  
Symptom Profile ◽  
Before And After ◽  
Prospective Controlled Study ◽  
Results Of Surgery ◽  
Nose And Sinuses

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.

Functional Endoscopic Sinus Surgery in Patients with Chronic Sinusitis and Asthma

1994 ◽  
Vol 110 (6) ◽  
pp. 494-500 ◽  
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.

Ultrastructural ciliary changes of maxillary sinus mucosa following functional endoscopic sinus surgery: an image analysis quantitative study

2003 ◽  
Vol 117 (4) ◽  
pp. 273-279 ◽  
Author(s):  
Ahmed Bassiouny ◽  
Ahmed M. Atef ◽  
Mahmoud Abdel Raouf ◽  
Safaa Mohamed Nasr ◽  
Magdy Nasr ◽  
...  
Keyword(s):  
Image Analysis ◽  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Quantitative Methods ◽  
Maxillary Sinusitis ◽  
Functional Endoscopic Sinus Surgery ◽  
University Hospital ◽  
Sinus Surgery ◽  
Chronic Maxillary Sinusitis ◽  
Sinus Mucosa

This was a study of the effect of functional endoscopic sinus surgery (FESS) on the ciliary regeneration of maxillary sinus mucosa in patients with chronic maxillary sinusitis, using objective quantitative methods. Twenty specimens from the mucosa of both the superolateral wall and the ostium of the maxillary sinus were sampled during FESS and then six to 12 months later. They were light examined first by light microscopy and then by scanning electron microscopy in combination with image analysis software in order to study the cilia under higher magnification and to calculate proportion of the field that was ciliated. Samples were taken and studied at Cairo University hospital. This study showed that the maxillary sinus mucosa in chronic sinusitis is capable of regeneration and could return towards normal with the improvement of ventilation and drainage of the maxillary sinus following FESS. There were no significant changes in the degree of glandular hyperplasia, goblet cells or pathological glands after surgery.

Immunotherapy in Patients Undergoing Functional Endoscopic Sinus Surgery

1994 ◽  
Vol 110 (4) ◽  
pp. 406-412 ◽  
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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