Feasibility of balloon sinuplasty in patients with chronic rhinosinusitis: the Graz experience

Background: Balloon sinuplasty (BSP) is a catheter-based technique to dilate sinus ostia and drainage pathways to create ventilation and drainage. The aim of this study was to evaluate the feasibility of BSP in routine treatment of patients suffering from chronic rhinosinusitis (CRS). Methodology: Patients with CRS refractory to medical therapy who had been scheduled for endoscopic sinus surgery between 2009 and 2011 were included in this study. Results: Forty-five consecutive patients were included in this study, in whom 112 sinuses were approached by BSP. Of the 112 sinuses, 68 (60%) were planned as a "Balloon-Only" procedure and 44 (40%) were planned as a "Hybrid" procedure. Of the 68 sinuses in the "Balloon-Only" group, in 44 sinuses BSP failed, equating to a failure rate of 65%. Forty-four sinuses were planned for "Hybrid" procedures. In 29 of these sinuses BSP failed, giving a failure rate of 66%. Conclusion: According to literature, BSP can be a useful adjunct technique to standard FESS. In our experience, however, a failure rate of 65% for "Balloon-Only" and of 66% for "Hybrid" procedures occurred, which was regarded as unacceptable by the study group. Therefore, the study initially scheduled for 200 consecutive patients, was abandoned.

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Functional Endoscopic Sinus Surgery (FESS) Alone vs FESS and Balloon Sinuplasty: A Comparative Outcome Analysis in a Pediatric Population with Chronic Rhinosinusitis

Otolaryngology ◽

10.1177/0194599811416318a260 ◽

2011 ◽

Vol 145 (2_suppl) ◽

pp. P122-P122

Author(s):

Prasad John Thottam ◽

Ranga R. Sirigiri ◽

David N. Madgy ◽

Michael S. Haupert ◽

Sonal Saraiya ◽

...

Keyword(s):

Chronic Rhinosinusitis ◽

Endoscopic Sinus Surgery ◽

Pediatric Population ◽

Functional Endoscopic Sinus Surgery ◽

Sinus Surgery ◽

Outcome Analysis ◽

Balloon Sinuplasty

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Functional Endoscopic Sinus Surgery Versus Balloon Sinuplasty with Ethmoidectomy: A 2-year Analysis in Pediatric Chronic Rhinosinusitis

Indian Journal of Otolaryngology and Head & Neck Surgery ◽

10.1007/s12070-015-0839-2 ◽

2015 ◽

Vol 68 (3) ◽

pp. 300-306 ◽

Cited By ~ 11

Author(s):

Prasad John Thottam ◽

Chistopher M. Metz ◽

Monica C. Kieu ◽

James Dworkin ◽

Janardhan Jagini ◽

...

Keyword(s):

Chronic Rhinosinusitis ◽

Endoscopic Sinus Surgery ◽

Functional Endoscopic Sinus Surgery ◽

Sinus Surgery ◽

Balloon Sinuplasty

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Endoscopic sinus surgery and its effects on pulmonary function test in patients of chronic rhinosinusitis with nasal polyposis

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20203200 ◽

2020 ◽

Vol 6 (8) ◽

pp. 1484

Author(s):

Dameshwa S. Lyngdoh ◽

Subrat Kumar Behera ◽

Smruti Swain ◽

Manoranjan Pattnaik

Keyword(s):

Pulmonary Function ◽

Chronic Rhinosinusitis ◽

Pulmonary Function Test ◽

Endoscopic Sinus Surgery ◽

Airway Disease ◽

Sinus Surgery ◽

Lower Airway ◽

Study Results ◽

Objective Evidence ◽

Function Test

Background: The human upper and lower respiratory tract share a close relationship in respect to existence of diseases. The objectives of this study were to evaluate the outcome of endoscopic sinus surgery with the Lund- Mackay staging system and to find any objective changes between the pre and post-operative pulmonary function test values in patients with chronic rhinosinusitis undergoing endoscopic sinus surgery.Methods: A total of 50 patients of CRSwNP refractory to maximal medical treatment (for 1 month) planned for endoscopic sinus surgery were included in the study. Results were assessed on the basis of pre and post-operative endoscopic and CT scores and PFT (FEV1, FVC and FEV1/FVC) values. Results: Postoperatively, Lund Mackay endoscopic and CT scores improved from the preoperative values, which were statistically significant with p values<0.05. Comparing FEV1/FVC, FVC and FEV1 values in three situations- preoperative versus postoperative 1 month, preoperative versus postoperative 3rd month and post-operative 1st month versus postoperative 3rd month, the difference between the means were found to be statistically significant (p=0.000), except for FVC between postoperative 3rd month and 1st month.Conclusions: This study provides objective evidence that patients with CRSwNP may have non clinical lower airway disease detected by PFT and ESS is effective in improvement of both nasal and lower airway disease as evident from the improvements in PFT values.

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Postoperative Antibiotic Care after Functional Endoscopic Sinus Surgery

American Journal of Rhinology ◽

10.2500/ajr.2008.22.3241 ◽

2008 ◽

Vol 22 (6) ◽

pp. 608-612 ◽

Cited By ~ 27

Author(s):

Rong-San Jiang ◽

Kai-Li Liang ◽

Kung-Yaun Yang ◽

Jiun-Yih Shiao ◽

Mao-Chang Su ◽

...

Keyword(s):

Chronic Rhinosinusitis ◽

Postoperative Care ◽

Endoscopic Sinus Surgery ◽

Functional Endoscopic Sinus Surgery ◽

Sinus Surgery ◽

Control Group ◽

Study Group ◽

Term Outcome ◽

Before And After

Background Antibiotics are used routinely in the postoperative care of functional endoscopic sinus surgery (FESS), but their efficacy has not been well evaluated. Methods Patients with chronic rhinosinusitis who underwent FESS were enrolled in this study. They were randomly divided into two groups: a study group and a control group. In the study group, patients took amoxicillin/clavulante for 3 weeks after FESS. In the control group, no antibiotic was given after FESS. Before FESS, all patients filled out a symptom questionnaire and received nasal endoscopy. Swab specimens were taken from the middle meati for bacterial cultures. These procedures were done again 3 weeks after FESS. Results Seventy-one patients completed the study. Thirty-one patients were in the study group, and 40 patients were in the control group. The symptom scores significantly decreased after surgery in both groups, but bacteria identified before and after FESS were statistically different in both groups. There were no differences in the symptom and endoscopic scores, rates of bacterial culture, and drug sensitivity to amoxicillin/clavulante between the two groups after FESS. Conclusion This study showed that postoperative care with amoxicillin/clavulante did not improve the short-term outcome of FESS on chronic rhinosinusitis or decrease bacterial growth 3weeks after FESS, although the long-term influence was not evaluated in this study.

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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

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