scholarly journals Patient-reported olfactory function following endoscopic sinus surgery with modified endoscopic Lothrop procedure / Draf 3

2011 ◽  
Vol 49 (2) ◽  
pp. 217-220
Author(s):  
J.M. Yip ◽  
K.A. Seiberlin ◽  
P.-J. Wormald
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Nasal Polyps ◽  
Medical Information ◽  
Negative Impact ◽  
Middle Turbinate ◽  
Olfactory Function ◽  
Sinus Surgery ◽  
Sense Of Smell ◽  
Surgery Patient ◽  
Patient Reported

OBJECTIVES/HYPOTHESIS: The Modified Endoscopic Lothrop procedure (MELP) or Draf 3 is a complex procedure, performed for chronic frontal sinusitis that is refractory to standard functional endoscopic sinus surgery. The procedure involves drilling of the frontal T (formed by the septum and middle turbinate`s attachment to the skull base) onto the olfactory fossa often with exposure of the first olfactory neuron and may affect olfactory function. This study was performed to assess patients` subjective sense of smell following this procedure. STUDY DESIGN: Prospective study of retrospective data. METHODS: Sixty-eight patients, who underwent modified endoscopic Lothrop by the senior author (PJW) between 2003 and 2008, completed a post-operative questionnaire asking about their perception of olfactory function. All patients had their pre-operative subjective sense of smell documented prior to undergoing surgery. Patient records were reviewed for pertinent medical information such as the presence of asthma, aspirin sensitivity and nasal polyps. RESULTS: This study found that the majority of patients reported improvement in their sense of smell post-operatively, while only a small number reported a negative impact on their smell. Thirty-nine patients reported an improvement in their post-operative smell grade. Twenty patients reported no change in their smell grade, while the remaining 9 patients stated that their sense of smell worsened after surgery. No statistically significant correlation was found between patient outcome and the presence of asthma, nasal polyps, or Samter`s triad. CONCLUSIONS: The Modified endoscopic Lothrop procedure/Draf 3 had a positive effect on subjective sense of smell post-operatively in this cohort of patients.

scholarly journals Effects of Age on Recovery of Olfactory Function After Endoscopic Sinus Surgery and Related Risk Factors

2021 ◽  
pp. 014556132110129
Author(s):  
Weiping Qi ◽  
Liang Feng ◽  
Fengyan Yang ◽  
Weihuan Ma
Keyword(s):  
Risk Factors ◽  
Allergic Rhinitis ◽  
Endoscopic Sinus Surgery ◽  
Nasal Polyps ◽  
Protective Factor ◽  
Olfactory Function ◽  
Sinus Surgery ◽  
The Poor ◽  
Related Risk ◽  
Good Improvement

Objectives: To study the effects of age on the olfactory function recovery of chronic rhinosinusitis patients after endoscopic sinus surgery and related risk factors. Methods: A total of 176 chronic rhinosinusitis (CRS) patients enrolled from February 2017 to October 2019 were divided into child, youth, middle-aged, and elderly groups. Their baseline data, T&T olfactory test score, visual analogue scale (VAS) olfactory score, sinus computed tomography (CT) Lund-Mackay score, and Lund-Kennedy score were compared. Based on postoperative olfactory function, they were divided into good and poor improvement groups. Results: Complication with nasal polyps, allergic rhinitis history, and sinus surgery history had significant differences among patients of different ages ( P < .05). Three months after surgery, T&T olfactory, VAS olfactory, Lund-Mackay, and Lund-Kennedy scores all rose with increasing age, with significant differences between any 2 groups ( P < .05). The improvement of postoperative olfactory function became poorer with aging ( P < .05). T&T and VAS olfactory scores had significant positive correlations with Lund-Mackay and Lund-Kennedy scores ( P < .001). Age, preoperative Lund-Mackay and Lund-Kennedy scores, complication with nasal polyps, allergic rhinitis history, sinus surgery history, and postoperative complications were risk factors for the poor improvement of postoperative olfactory function. Doctor-directed treatment was a protective factor for good improvement. Conclusions: The improvement of olfactory function of CRS patients after endoscopic sinus surgery declines with aging. Age, preoperative Lund-Mackay and Lund-Kennedy scores, complication with nasal polyps, allergic rhinitis history, sinus surgery history, and postoperative complications are risk factors for the poor improvement of postoperative olfactory function. Doctor-directed treatment is a protective factor for good improvement.

scholarly journals Safety of human olfactory mucosal biopsy for the purpose of olfactory ensheathing cell harvest and nerve repair: a prospective controlled study in patients undergoing endoscopic sinus surgery

2016 ◽  
Vol 54 (2) ◽  
pp. 183-191
Author(s):  
Peter J. Andrews ◽  
Anne-Lise Poirrier ◽  
Valerie J. Lund ◽  
David Choi
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Olfactory Mucosa ◽  
Olfactory Function ◽  
Sinus Surgery ◽  
Controlled Study ◽  
Complication Rates ◽  
Sense Of Smell ◽  
Significant Difference ◽  
Nasal Function ◽  
Prospective Controlled Study

Background: Nasal olfactory mucosa is an accessible source of olfactory ensheathing cells for spinal cord regeneration. However, safety of the biopsy technique and the effects on sense of smell and nasal function have not been robustly assessed in the form of a prospective controlled study. Methodology: National Health Service ethical approval was granted for this study of 131 patients. The primary outcome measure was olfactory function and the secondary outcomes included postoperative complication rates as well as the SNOT 22, NOSE scale scores and surgeon reported (Lund-Kennedy score) nasal function outcomes. Results: 65 patients underwent functional endoscopic sinus surgery (FESS) and superior turbinate biopsy, and 66 patients underwent FESS only as the control group. There was no significant difference in complication rates between the two groups. All Olfactory function outcomes were unaffected following olfactory biopsy. We demonstrated that the patients quality of life and nasal patency as well as surgeon reported outcome measurements remain unaffected following olfactory harvesting. Conclusions: We have uniquely provided level 2a evidence for the safety of endoscopic biopsy of olfactory mucosa, which does not affect nasal function or the sense of smell compared to standard FESS without biopsy.

scholarly journals Effect of Functional Endoscopic Sinus Surgery on Gustatory Function in Patients With Chronic Rhinosinusitis

2021 ◽  
pp. 014556132110157
Author(s):  
Rong-San Jiang ◽  
Kai-Hsiang Shih ◽  
Kai-Li Liang
Keyword(s):  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Nasal Polyps ◽  
Detection Threshold ◽  
Functional Endoscopic Sinus Surgery ◽  
Olfactory Function ◽  
Sinus Surgery ◽  
Testing Procedures ◽  
Gustatory Function ◽  
Snot 22

Objectives: In this study, we investigated the effect of functional endoscopic sinus surgery (FESS) on gustatory function in patients with chronic rhinosinusitis (CRS). Methods: Forty-three patients with CRS who underwent FESS were included in this study. Prior to FESS and 3 months after surgery, the severity of rhinosinusitis was assessed using the Taiwanese version of the 22-item SNOT (SNOT-22), endoscopic examination, and acoustic rhinometry. The olfactory function was evaluated using the phenylethyl alcohol odor detection threshold test and the traditional Chinese version of the University of Pennsylvania Smell Identification Test, and the gustatory function was evaluated using the whole mouth suprathreshold taste test (WMTT) and the taste quad test (TQT). Subgroup analyses were performed based on CRS phenotypes and endotypes. Results: The SNOT-22 significantly improved 3 months after FESS for all patients with CRS. The endoscopic score and olfactory function significantly improved in patients with eosinophilic CRS and in patients with nasal polyps (CRSwNP). The WMTT sweet and bitter scores were significantly lower after FESS in CRSwNP, but the TQT sweet score was significantly higher in patients without nasal polyps. In addition, patients with noneosinophilic CRS had significantly decreased WMTT and salty scores 3 months after FESS. Conclusion: Our results showed that the effect of FESS on gustatory function of patients with CRS was different with the different testing procedures, the association with nasal polyps, and the underlying inflammatory patterns.

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

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

scholarly journals Rectal Staphylococcus aureus Carriage and Recurrence After Endoscopic Sinus Surgery for Chronic Rhinosinusitis With Nasal Polyps: A Prospective Cohort Study

2021 ◽  
pp. 014556132110197
Author(s):  
Yue Peng ◽  
Zhao Liu ◽  
Zhijian Yu ◽  
Aiwu Lu ◽  
Tao Zhang
Keyword(s):  
Staphylococcus Aureus ◽  
Cohort Study ◽  
Regression Model ◽  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Prospective Cohort ◽  
Multivariate Regression ◽  
Nasal Polyps ◽  
Sinus Surgery ◽  
Multivariate Regression Model

Objective: Chronic rhinosinusitis with nasal polyps (CRSwNPs) remains a major challenge due to its high recurrence rate after endoscopic sinus surgery (ESS). We aimed to investigate the risk factors of recurrence among patients who underwent ESS for Chronic rhinosinusitis (CRS). Methods: Prospective cohort study including 391 cases in a single institution receiving ESS were included for analysis from 2014 and 2017. Baseline characteristics including rectal Staphylococcus aureus ( S aureus) carriage in patients receiving ESS for CRSwNPs. The primary outcome was the recurrence of CRSwNPs. Multivariate regression model was established to identify independently predictive factors for recurrence. Results: Overall, 142 (36.3%) cases with recurrence within 2 years after ESS were observed in this study. After variable selection, multivariate regression model consisted of 4 variables including asthma (odds ratio [OR] = 3.41; P < .001), nonsteroidal anti-inflammatory drug allergy (OR = 2.27; P = .005), previous ESS (OR = 3.64; P < .001), and preoperative carriage of S aureus in rectum (OR = 2.34; P = .001). Conclusions: Based on our results, surgeons could predict certain groups of patients who are at high risk for recurrence after ESS. Rectal carriage of S aureus is more statistically related to the recurrence of CRSwNP after ESS compared with skin and nasal carriage.

scholarly journals Chronic rhinosinusitis in adult patients with cystic fibrosis: clinical manifestation and therapeutic approaches

2019 ◽  
Vol 29 (3) ◽  
pp. 311-320
Author(s):  
G. L. Shumkova ◽  
E. L. Amelina ◽  
V. M. Svistushkin ◽  
E. V. Sin’kov ◽  
S. A. Krasovskiy ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Surgical Treatment ◽  
Treatment Group ◽  
Chronic Rhinosinusitis ◽  
Paranasal Sinuses ◽  
Endoscopic Sinus Surgery ◽  
Nasal Polyps ◽  
Adult Patients ◽  
Sinus Surgery ◽  
Markers Of Inflammation

The aim of this study was to evaluate prevalence of chronic rhinosinusitis (CRS) and nasal polyps in adult patients with cystic fibrosis (CF) in Russian Federation. Additionally, we investigated the clinical course of CRS and developed the optimal therapeutic strategy.Methods. Three hundred and forty eight CF patients were involved in the study. Physical examination, computed tomography (CT) of paranasal sinuses and audiometry, if needed, were used. CRS and bilateral nasal polyps were diagnosed in 28 patients. Nasal endoscopy, SNOT-20 questionnaire, rhinomanometry, micro - biological examination of sputum and mucus from paranasal sinuses (obtained during puncture or surgery), spirometry, and measurement of serum markers of inflammation were used. Endoscopic sinus surgery was used in 14 patients (the group 1) and others were treated non-surgically (the group 2). Both group were treated during 6 months using intranasal mometasone, mucolytics and antibiotics via PARI SINUSTM nebulizer.Results. An improvement in symptoms, CT signs, rhinomanometry parameters and endoscopic signs was seen in both groups after treatment and was more prominent in the surgical treatment group compared to the non-surgical treatment group. Bacterial load reduction in nasal sinuses, decrease in the rate of pulmonary disease exacerbations, and an improvement in oxygen blood saturation were found in the surgical treatment group only. Treatment of CRS did not affect lung function, sputum microbiology and serum inflammatory markers.Conclusion. Endoscopic sinus surgery followed by intranasal mucolytics and antibacterials is an effective and well-tolerated treatment in adult CF patients with CRS. 

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