APPROACH TO UNCINECTOMY BY SWING DOOR TECHNIQUE VS STANDARD TECHNIQUE – A COMPARATIVE STUDY

2021 ◽  
pp. 37-39
Author(s):  
Praveen Singh ◽  
Tarun Ojha ◽  
Shreya Prasad
Keyword(s):  
Complication Rate ◽  
Endoscopic Sinus Surgery ◽  
Maxillary Sinusitis ◽  
Tertiary Care ◽  
Standard Technique ◽  
Symptomatic Improvement ◽  
Sinus Surgery ◽  
Minor Complication ◽  
Tertiary Care Centre ◽  
Group B

Introduction: Uncinectomy is the most important step in endoscopic sinus surgery which can be performed by various methods. The present study aimed to compare the results and complications of performing uncinectomy and middle meatus antrostomy using the standard and swing door techniques during FESS. Methods: In this study, 50 patients of both gender (aged 18–50 years) suffering from chronic maxillary sinusitis underwent functional endoscopic sinus surgery (FESS) from January 2019 to December 2019 at a tertiary care centre. The patients were divided on random basis into two groups of 25. Group Apatients underwent uncinectomy using standard technique while Group B underwent uncinectomy using swing door technique. Results:The mean VAS scores for Group Aand Group B were 78.50 ± 16.63 and 80.58 ± 14.34, respectively, suggesting that Group B patients have better symptomatic improvement. No major complications were observed in both groups. At the end of Week 2, minor complications were observed in 8 (26.7%) of the patients from Group Aand 2 (6.7%) from Group B. By the sixth week, the minor complication rate was 1 (3.3%) and 0 in Group A and Group B, respectively. When compared statistically during the second week using chi-square test, the difference in minor complication rate was found to be statistically signicant (p < 0.05, 2 = 4.81), with lower incidence of complications in Group B. Conclusion: Uncinectomy performed by swing door technique produces better postoperative results, with lesser complications, when compared to the standard technique.

scholarly journals Correlations and Comparison between Repeat Computed Tomography Scores, Endoscopy Scores and Symptomatic Improvement before and after Endoscopic Sinus Surgery: A Pilot Study

2013 ◽  
Vol 6 (1) ◽  
pp. 32-40 ◽  
Author(s):  
NV Deepthi ◽  
Indudharan R Menon
Keyword(s):  
Computed Tomography ◽  
Pilot Study ◽  
Endoscopic Sinus Surgery ◽  
Medical Center ◽  
Tertiary Care ◽  
Objective Evaluation ◽  
Symptomatic Improvement ◽  
Sinus Surgery ◽  
Tertiary Care Medical Center ◽  
Before And After

ABSTRACT Background Chronic rhinosinusitis (CRS) is diagnosed on the basis of symptoms, nasal endoscopic findings and computed tomography of the paranasal sinuses (CT PNS). Where indicated, functional endoscopic sinus surgery (FESS) is the surgical treatment. Objective To determine correlations between subjective symptom severity and objective endoscopic and radiologic findings in CRS and to compare these before and after FESS. Materials and methods Analysis of prospectively collected data of 20 patients undergoing FESS at a tertiary care medical center followed up for a minimum period of 6 months after surgery. RSI questionnaire-based symptom score, Lund-Mackay system-based endoscopic and CT finding scores were recorded preoperatively and at 8 weeks and 6 months postoperatively. Results Significant positive correlation was noted between the three parameters before surgery, especially endoscopic and radiological scores (r = 0.94 in the latter, p < 0.01 in all three). Postoperative improvement was statistically significant for all three parameters, even at the 6 months stage (p < 0.001). Postoperative correlations reduced significantly, especially between endoscopic and radiological scores. Conclusion This study showed the relevance of objective evaluation of routine parameters of CRS, preoperatively. It also confirmed the usefulness of FESS in indicated cases, in terms of statistical improvement of these parameters. However, repeat CT scans and the methods of scoring used by us may not be equally applicable in the long-term postoperative scenario. How to cite this article Deepthi NV, Menon UK, Menon IR. Correlations and Comparison between Repeat Computed Tomography Scores, Endoscopy Scores and Symptomatic Improvement before and after Endoscopic Sinus Surgery: A Pilot Study. Clin Rhinol An Int J 2013;6(1):32-40.

scholarly journals Demographic profile of subjects currently undergoing middle meatus antrostomy for maxillary sinusitis, in a tertiary care centre of Punjab: analysis of 64 subjects

2021 ◽  
Vol 8 (3) ◽  
pp. 1196
Author(s):  
Manish Munjal ◽  
Ritu Gupta ◽  
Anurag Chaudhary ◽  
Mahesh Satija ◽  
Shubham Munjal ◽  
...  
Keyword(s):  
Prospective Study ◽  
Eustachian Tube ◽  
Maxillary Sinusitis ◽  
Tertiary Care ◽  
Clinical Findings ◽  
Sinus Surgery ◽  
Middle Meatus ◽  
Tertiary Care Centre ◽  
Demographic Profile ◽  
Male Predominance

Background: The demographic profile of patients with Maxillary sinusitis undergoing surgical intervention in the state of Punjab was analyzed. The emphasis was on the age, gender and clinical presentation in this prospective study.                   Methods: In this prospective study 64 patients with maxillary sinusitis, were randomly selected from the Rhinology clinics of Oto-rhino-laryngology services, Dayanand Medical College and Hospital, Ludhiana in a period of one and a half years (June 2008 to December 2009). All patients were taken up for Functional endoscopic sinus surgery with middle meatus antrostomy.Results: Only 7 (10.94%) patients, with maxillary sinusitis were in the pediatric age group. 40(62.5%) were males and 24 (37.5%) females. Males outnumbered females in the ratio of 1.67:1. Clinical findings were nasal polyp in 33 (51.56%), middle meatus discharge in 10 (15.63%) and septal deviation was seen in 36 (56.25%) patients. Polypoidal mass was seen in the posterior choana in 24 (37.5%) patients followed by discharge inferior to the Eustachian tube orifice in 7 (10.94%). Recurrence of polypoidal change or frank polyposis occurred in 7 patients (10.94%). Post nasal drip persisted in 15/49 cases, while 54 (84.38%) were completely relieved of their symptoms. Recurrence was noticed more commonly in the region of ethmoid air cells.Conclusions: Patients with maxillary sinusitis were seen in the broad age range from 11 to 66 years with a male predominance. Nasal blockage rather than cheek ache was the primary complaint followed by polyp in the middle meatus and post nasal drip inferior to the Eustachian tube.     

Outcome of Endoscopic Sinus Surgery

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P79-P80
Author(s):  
Yahya Nasser Al Badaai ◽  
Mark Samaha
Keyword(s):  
Quality Of Life ◽  
Endoscopic Sinus Surgery ◽  
Chronic Sinusitis ◽  
Tertiary Care ◽  
Sinus Surgery ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Average Improvement ◽  
Co Morbidity

Objective 1) Determine the effect of surgical therapy for Chronic Rhinosinusitis (CRS) on patient quality of life in a tertiary care centre in Quebec. 2) Compare the outcome of endoscopic sinus surgery on patients with different comorbidities. Methods Prospective cohort study. Subjects were consecutive patients with a diagnosis of CRS who failed medical treatment and were undergoing Endoscopic Sinus Surgery (ESS). General health (SF-12 v2) and disease-specific (chronic sinusitis survey (CSS)) outcomes questionnaires were filled out pre-operatively and postoperatively. Results 152 patients were enrolled in a 7-month period. 120 patients completed the postoperative surveys. The most common co-morbidity was asthma (40%). 72% had clinical improvement, 12% worsened, and 15% were unchanged. The average improvement of CSS scores was 17%. Conclusions Significant improvement in quality of life was achieved after ESS for patients with CRS.

Pituitary apoplexy following endoscopic sinus surgery

2009 ◽  
Vol 124 (6) ◽  
pp. 677-679 ◽  
Author(s):  
G Fyrmpas ◽  
J Constantinidis ◽  
N Foroglou ◽  
P Selviaridis
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Pituitary Apoplexy ◽  
Symptomatic Improvement ◽  
Sinus Surgery ◽  
Effective Technique ◽  
Pituitary Fossa ◽  
Middle Meatal Antrostomy ◽  
Risk Patients ◽  
Life Threatening ◽  
Life Threatening Event

AbstractObjective:To highlight the possibility of pituitary apoplexy after functional endoscopic sinus surgery for elimination of sinonasal infection, an important preparatory step for safe trans-sphenoidal access to the pituitary fossa.Case report:A 67-year-old man with a known pituitary macroadenoma developed headache, diplopia and reduced vision after endoscopic middle meatal antrostomy and ethmoidectomy for rhinosinusitis with polyps. Magnetic resonance imaging showed pituitary haemorrhage. The patient underwent emergency endoscopic trans-sphenoidal resection of the tumour, with significant symptomatic improvement. Despite mild right eyelid ptosis and persistent diabetes insipidus, the patient resumed normal activities in a few weeks. To our knowledge, this is the first report of pituitary apoplexy after a nasal operation.Conclusion:Pituitary apoplexy is a rare and potentially life-threatening event in high risk patients with pituitary adenomas; it may occur spontaneously or after surgical procedures. Early, combined surgical intervention by rhinologists and neurosurgeons is recommended. The endoscopic trans-sphenoidal approach is a safe and effective technique for the acute management of pituitary apoplexy.

scholarly journals Evaluation of therapeutic effectiveness of vitamin D3 injections in common warts in a tertiary care centre

2019 ◽  
Vol 5 (3) ◽  
pp. 462
Author(s):  
Sushmalatha Banoth
Keyword(s):  
Vitamin D3 ◽  
Normal Saline ◽  
Tertiary Care ◽  
Treatment Session ◽  
Tertiary Care Centre ◽  
Cutaneous Manifestations ◽  
Multiple Modalities ◽  
Common Warts ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> Warts or verrucae are the benign cutaneous manifestations caused by human papilloma virus. The treatment of wart possess a therapeutic challenge, as a result multiple modalities are existing for the treatment of cutaneous warts, which is cumbersome and may result in cosmetic disfigurement, chances of recurrences. The aim of the present study was to determine the resolution of common warts in response to vitamin D3 injections and to compare the resolution of common warts in the group receiving vitamin D3 with placebo group receiving normal saline.</p><p class="abstract"><strong>Methods:</strong> A total of 26 patients were enrolled and divided into Group A- received lesional injection of 0.2 ml vitamin D3 every 3 weeks for 3 months for the improvement in the size of warts. Group B- received 0.2 ml of normal saline injections as a control. The maximum of three sessions were carried in both groups. Clinical assessment was done by photographic evaluation at baseline, before each treatment session, and after completion of treatment.<strong></strong></p><p class="abstract"><strong>Results:</strong> In group A, 76.92% (10) of the patients showed complete clearance of wart with vitamin D3 injection, while in group B 8% (1) of patients with normal saline showed partial response. This therapy was well tolerated except for the minimal side effects like pain, redness and swelling at the site of injection.</p><p class="abstract"><strong>Conclusions:</strong> Intralesional Vit D3 injections may be a treatment option for warts, which has a good cosmetical acceptance and simple, well tolerated easily administrated in outpatient clinic rather than conventional treatment.</p>

The Effects of Endoscopic Sinus Surgery on Voice Characteristics in Chronic Rhinosinusitis Patients

2019 ◽  
Vol 128 (12) ◽  
pp. 1129-1133
Author(s):  
Danny B. Jandali ◽  
Ashwin Ganti ◽  
Inna A. Husain ◽  
Pete S. Batra ◽  
Bobby A. Tajudeen
Keyword(s):  
Quality Of Life ◽  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Tertiary Care ◽  
Voice Quality ◽  
Upper Airway ◽  
Sinus Surgery ◽  
Perceptual Evaluation ◽  
Snot 22

Objectives: Functional endoscopic sinus surgery (FESS) is a standard treatment modality for patients with chronic rhinosinusitis (CRS) who have failed appropriate medical therapy. However, FESS entails modification of the upper airway tract that may alter phonatory resonance and produce voice changes. The effects of FESS on postoperative voice characteristics in patients with CRS have yet to be quantitatively assessed. Methods: Patients with severe CRS who underwent FESS at a tertiary care referral center between May and October 2017 were prospectively enrolled. The Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) and the Voice Handicap Index (VHI) were used to quantitatively evaluate voice characteristics and quality of life, respectively. Preoperative and postoperative CAPE-V and VHI scores were compared with postoperative scores for each patient. Sino-Nasal Outcome Test (SNOT-22) scores were also obtained to assess changes in patient symptoms. Results: 18 CRS patients undergoing FESS were enrolled. The average preoperative Lund-Mackay score was 14, indicating baseline severe CRS. Postoperative assessments demonstrated a statistically significant decrease in CAPE-V (45-27, p = .005) and VHI (10-4.7, p < .001) scores. These correlated with a statistically significant decrease in SNOT-22 scores (42-13, p < .001). Conclusions: Patients with CRS experience a significant improvement in voice characteristics and vocal quality of life following FESS. Furthermore, this appears to correlate with a significant decrease in self-reported disease severity. These findings may augment the discussion of potential benefits of FESS to a new potential domain for voice quality.

Correlation of Complications during Endoscopic Sinus Surgery with Surgeon Skill Level and Extent of Surgery

2005 ◽  
Vol 19 (3) ◽  
pp. 274-281 ◽  
Author(s):  
Michael B. Soyka ◽  
David Holzmann
Keyword(s):  
Complication Rate ◽  
Retrospective Review ◽  
Classification System ◽  
Endoscopic Sinus Surgery ◽  
Skill Level ◽  
Point Of View ◽  
Sinus Surgery ◽  
New Classification ◽  
Great Range ◽  
Extent Of Surgery

Background Endoscopic sinus surgery (ESS) produces a great range of potential complications. Rough segregation into “minor” and “major” complications seems insufficient. This study uses a recently published new classification system that is based more on the patient's point of view, with a greater variety of options. Methods A retrospective review was undertaken of 421 ESS procedures. Both, the surgeon's experience and the extent of surgery were correlated with the complication rate. Results The overall complication rate was 39.7% (grades A–D) and did not correlate significantly with either the experience of the surgeon or with the extent of surgery. Conclusion The new classification is simple, precise, and takes complications into account that used to be neglected. ESS is even safe in the hands of less skilled surgeons as long as the degree of difficulty stays highly adapted to his/her ability. Some complications (grade A) seem to be inherent to the procedure.

Comparison of Endoscopic Sinus Surgery with and without Image Guidance

2002 ◽  
Vol 16 (4) ◽  
pp. 193-197 ◽  
Author(s):  
Marvin P. Fried ◽  
Vik M. Moharir ◽  
Jennifer Shin ◽  
Marta Taylor-Becker ◽  
Paul Morrison ◽  
...  
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Image Guidance ◽  
Operative Time ◽  
Tertiary Care ◽  
Guidance System ◽  
Sinus Surgery ◽  
Control Group ◽  
Repeat Surgery ◽  
Patient Profile ◽  
Estimated Blood Loss

Background Image guidance based on preacquired computed tomography scans of the patient is a technique used to assist the physician during endoscopic sinus surgery (ESS). This study seeks to compare ESS with and without image guidance, analyzing a number of parameters that can impact on efficacy. Methods Retrospective chart review took place at a tertiary care referral center. The study group consisted of 97 consecutive patients confirmed to have undergone ESS using an electromagnetic intraoperative image guidance system (IGS). The control group consisted of 61 consecutive patients who underwent ESS, before the IGS was available at the study hospital. The main outcomes measured were analysis of patient profile, including coexisting conditions such as asthma and polyposis, assessment of which specific sinuses underwent surgical treatment; major and minor complications; estimated blood loss (EBL); operative time; and the need for repeat surgery. Results The IGS group had 74% of patients with polyposis; more sinuses, on average, which underwent surgical revision; one major and three minor complications; an average EBL of 134 cc, an average procedure time of 154 minutes; and one patient who needed repeat surgery in a 3-month follow-up period. The non-IGS group had 40% of patients with polyposis; seven major complications and one minor complication; an average EBL of 94 cc; and three patients who needed repeat surgery within 3 months. Conclusions The use of an IGS for endoscopic sinus surgery may reduce the complications associated with the procedure and allow for a more thorough operation. However, operative time and EBL may be increased.

Office-Based Sinus Surgery for Cystic Fibrosis Chronic Rhinosinusitis

ORL ◽  
2020 ◽  
pp. 1-4
Author(s):  
Daniel B. Spielman ◽  
David A. Gudis
Keyword(s):  
Cystic Fibrosis ◽  
Mechanical Ventilation ◽  
Chronic Rhinosinusitis ◽  
Local Anesthesia ◽  
Endoscopic Sinus Surgery ◽  
Care Center ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Sinus Surgery ◽  
Office Setting

<b><i>Objective:</i></b> Chronic rhinosinusitis (CRS) is nearly ubiquitous in the cystic fibrosis (CF) population, and many patients require multiple endoscopic sinus surgeries throughout their lifetime. Recent studies have demonstrated the profound pulmonary and systemic health benefits of comprehensive CRS treatment. Both endotracheal intubation with mechanical ventilation and inpatient hospital care represent significant risks for CF patients. The goal of this study is to evaluate the safety and feasibility of performing revision endoscopic sinus surgery for CF patients in the outpatient office setting using only local anesthesia to decrease the need for mechanical ventilation and inpatient hospitalization. <b><i>Methods:</i></b> This is a prospective cohort study conducted at a tertiary care academic medical center with a CF Foundation-accredited care center. Patients with CF and refractory CRS despite prior surgery and medical therapy were eligible for inclusion. Comprehensive revision ESS was performed in the office using only local anesthesia. <b><i>Results:</i></b> Five patients were enrolled and underwent revision endoscopic sinus surgery without complication. The average preoperative Sinonasal-Outcome Test-22 score was 52.0 ± 12.1 and the average preoperative Lund-Mackay score was 15.2 ± 3.8. No patients requested aborting the procedure early due to pain, discomfort, or any other reason. No subjects required prolonged observation or postoperative hospital admission. <b><i>Conclusion:</i></b> This prospective pilot study is the first to demonstrate the safety and feasibility of performing comprehensive revision endoscopic sinus surgery for CF patients in the outpatient office setting using only local anesthesia.

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