the Frequency of Intranasal Synechiae Formation between Nasal Septum and Lateral Nasal Wall after Endoscopic Sinus Surgery Among Patients with Sinonasal Polyposis

Objectives: To determine the frequency of intranasal synechiae formation between lateral nasal wall and nasal septum after (ESS) Endoscopic Sinus Surgery among patients with Sino nasal Polyposis Methods: After obtaining approval from the ethical committee of our Hospital, a total number of 150 subjects fulfilling the study criteria were recruited in the research which was conducted in the department of Otorhinolaryngology, Services Hospital, Lahore. Demographic information (name, age, gender, contact details) was also obtained were included in this study. All the patients underwent ESS and were followed up post operatively at the end of 1st, 2nd, 3rd and 4th weeks respectively, to observe the formation of synechiae. Results: Age range in this study was between 21-40 years out of which a small number of patients were < 20 years old. Mean age of the patients was 35.30±10.54 years. Male patients were 80 (53.3%) while female patients were 70 (46.7%). Intranasal Synechiae formation was observed in 28 patients (18.7%). Conclusion: Intranasal Synechiae formation between lateral nasal wall and nasal septum was found in 18.4% of the patients after endoscopic sinus surgery. Keywords: Sino nasal polyposis, ESS, Intranasal Synechiae Formation

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A comparative study of microdebrider assisted versus conventional endoscopic sinus surgery for nasal polyposis

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20192725 ◽

2019 ◽

Vol 5 (4) ◽

pp. 1030

Author(s):

Ranganath Kumar Datta ◽

Ramya Bandadka ◽

Lakshmi Priya Shelly

Keyword(s):

Endoscopic Sinus Surgery ◽

Nasal Polyps ◽

Nasal Polyposis ◽

Operative Time ◽

Sinus Surgery ◽

Nasal Discharge ◽

Recurrence Rates ◽

Conventional Instruments ◽

Number Of Patients ◽

Significant Difference

Background: Nasal polyps are benign, chronic, inflammatory lesions arising from the mucosa of the nasal sinuses or from the mucosa of the nasal cavity. They are a challenge to treat due to their uncertain etiology and tendency to recur. Therapy involves both medical and surgical treatment. Surgical management includes Endoscopic sinus surgery using conventional instruments or by microdebrider.Methods: We conducted a study on 80 patients with nasal polyposis in whom conservative management failed. They were equally randomised into powered and conventional instruments Endoscopic Sinus Surgery (ESS) groups. The groups were compared for surgical outcomes, intra and postoperative complications and recurrence rates. Results: Age of patients suffering from bilateral nasal polyposis ranged from 18 to 55 years with maximum number of patients in the group 31 to 40 years. Nasal polyps were more commonly seen in men (53.75%) than women (46.25%). Most common symptom experienced was nasal obstruction (100%), followed by olfactory disturbance in 88.7% and nasal discharge in 76.25%. There was statistically significant difference in operative time, blood loss and postoperative synechiae, with the microdebrider group showing better outcomes. There was no statistically significant difference in the postoperative VAS (visual analogue score) and recurrence rates between the two groups.Conclusions: Powered endoscopic sinus surgery offers a better therapeutic approach for patients with nasal polyposis than with conventional instruments. It provides bloodless operative field with better visualisation for a more precise, less traumatic procedure with shorter operative time.

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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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Mucocele of a giant inferior turbinate concha bullosa mimics a nasal mass: case report

The Egyptian Journal of Otolaryngology ◽

10.1186/s43163-021-00128-3 ◽

2021 ◽

Vol 37 (1) ◽

Author(s):

Kamal Ebeid ◽

Mohamed H. Askar

Keyword(s):

Nasal Cavity ◽

Endoscopic Sinus Surgery ◽

Nasal Septum ◽

Inferior Turbinate ◽

Sinus Surgery ◽

Lateral Nasal Wall ◽

Complete Disappearance ◽

Concha Bullosa ◽

Left Nasal Cavity ◽

Nasal Tumors

Abstract Background The concha bullosa is a pneumatized nasal turbinate commonly middle turbinate but that of the inferior turbinate is an uncommon entity. A giant inferior conchal pneumatization with mucocele formation is not reported in the literature till now. Case presentation A 17-year-old female patient presented with bilateral severe nasal obstruction. Anterior rhinoscopy and endoscopic examination revealed a giant mass which filled the left nasal cavity completely, pushing the septum to the contralateral side. The paranasal sinus CT showed a mass in the left nasal cavity ballooning the whole nasal cavity with compression of the nasal septum to the right side. MRI was done and the lesion was hyperintense in T2 MRI sequences and hypointense in T1 sequences consistent with a cystic lesion. The patient was consented and prepared for endoscopic resection under general anesthesia. The lesion was completely separated from the nasal septum and the orbit but attached to the lateral nasal wall at the site of origin of the inferior turbinate. Conchoplasty was done and patient follow-up for 9 years is excellent with complete disappearance of all patient symptoms. Conclusions Concha bullosa of the inferior turbinate should be considered in the differential diagnosis of nasal tumors, nasal cystic lesions, and preoperative evaluation of endoscopic sinus surgery. Also, a systematic approach for dealing with nasal lesions with thorough examination and radiological review will be of great value in decision-making. The anatomy of the paranasal should be thoroughly examined prior to endoscopic sinus surgery to develop treatment strategies and to prevent possible complications.

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A randomized control study to compare the efficacy of intranasal fluticasone propionate and intranasal budesonide in controlling postoperative symptoms in patients with nasal polyposis after endoscopic sinus surgery

Romanian Journal of Rhinology ◽

10.2478/rjr-2019-0024 ◽

2019 ◽

Vol 9 (36) ◽

pp. 182-186

Author(s):

Kiruba Shankar ◽

Satvinder Singh Bakshi ◽

Sunil Kumar Saxena ◽

Suriyanarayanan Gopalakrishnan

Keyword(s):

Fluticasone Propionate ◽

Nasal Spray ◽

Endoscopic Sinus Surgery ◽

Nasal Polyposis ◽

Sinus Surgery ◽

Endoscopic Polypectomy ◽

Chronic Inflammatory Condition ◽

Intranasal Steroids ◽

Postoperative Symptoms ◽

Sinonasal Polyposis

Abstract BACKGROUND. Sinonasal polyposis represents a chronic inflammatory condition characterized by nasal obstruction, reduction in the sense of smell and impaired quality of life. Intranasal steroids play an important role in preventing the postoperative recurrences in these cases. We carried out a study to evaluate and compare intra nasal budesonide and intranasal fluticasone propionate in the postoperative management of ethmoidal nasal polyposis. MATERIAL AND METHODS. 106 patients with ethmoidal polyposis were treated with endoscopic polypectomy and were postoperatively started and maintained on intranasal steroids. 54 patients were managed with budesonide and 52 patients maintained on fluticasone propionate nasal spray. The patients were followed-up for 6 months and recurrences and control of symptoms evaluated. RESULTS. There was a statistical difference in the SNOT-22 (p<0.0001) and Lund-Kennedy scores (p=0.015) between patients using fluticasone propionate as compared to those using budesonide intra nasal spray by the end of the 6th month. CONCLUSION. Both intranasal budesonide and fluticasone propionate are effective in controlling symptoms after endoscopic sinus surgery in patients with sinonasal polyposis; however, intranasal fluticasone propionate was more efficacious than budesonide in the control of postoperative symptoms.

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Grafting to denuded nasal cavity for prevention of recurrent nasal polyposis by endoscopic sinus surgery

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20183689 ◽

2018 ◽

Vol 4 (5) ◽

pp. 1135

Author(s):

Hany Amin ◽

Yasser Mohammed Hassan Mandour ◽

Ahmed Elrefai

Keyword(s):

Nasal Cavity ◽

Nasal Obstruction ◽

Nasal Mucosa ◽

Endoscopic Sinus Surgery ◽

Nasal Septum ◽

Nasal Polyposis ◽

Inferior Turbinate ◽

Sinus Surgery ◽

Nasal Polypi ◽

Recurrent Nasal Polyposis

Background: The objective of the study was to avoid nasal polyposis occurrence after recurrent FEES.Methods: 87 patients undergoing recurrent FESS due to recurrent nasal polyposis, after completing all steps of FESS the placement of normal nasal mucosa from inferior turbinate or nasal septum instead of the mucosa of the fovea ethmoidalis and lamina papyracea was done. Results: There were nasal obstruction improvement in 79 patients (90.8%), but there were 8 patients (9.2%) had recurrent nasal polypi causing nasal obstruction. There was smell improvement in 38 patients (71.7%) out of 15 patients (28.3%).Conclusions: The nasal cavity grafting in FESS of recurrent nasal polyposis with nasal septal or inferior turbinate mucosa had promising results in prevention of nasal polyposis recurrence. These results made a recommendation of nasal cavity grafting during primary FESS of nasal polyposis.

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Effect of topical furosemide on sinonasal polyposis relapse after endoscopic sinus surgery

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20205628 ◽

2020 ◽

Vol 7 (1) ◽

pp. 101

Author(s):

Souvagini Acharya ◽

Alka Kapil ◽

Kamalini Bepari ◽

Sandrendu Rajan ◽

Prachi Mohapatra ◽

...

Keyword(s):

Normal Saline ◽

Endoscopic Sinus Surgery ◽

Nasal Polyposis ◽

Statistical Significance ◽

Saline Group ◽

Sinus Surgery ◽

Randomised Control Trial ◽

Normal Saline Group ◽

Sinonasal Polyposis

Background: Chronic rhinosinusitis with nasal polyposis (CRSwNP) relapse is commonly seen during follow up period after endoscopic sinus surgery. Some studies claim the credibility of topical furosemide in preventing the polyposis recurrence after surgery. This randomised control trial was done to check the effectiveness of topical furosemide on sinonasal polyposis relapse after the endoscopic sinus surgery.Methods: In the current study, 44 patients, attending ENT department, VSSIMSAR, for follow up after endoscopic sinus surgery, were evaluated clinically and endoscopically to demonstrate the prevalence and severity of polyposis relapse using Visual analogue scale (VAS) and meltzer endoscopic grading, before initiating the intervention. Patients were then randomised in two groups- one receiving topical furosemide nebulization and other intranasal normal saline spray, respectively. All patients were evaluated again at 1st, 2nd, 4th and 6th month follow-ups by VAS and MEG, setting statistical significance at p<0.05.Results: The MEG was grade 0 in 77% (17) patients of furosemide group and 32% (7) of normal saline group (p=0.0147). Statistically significant improvement was also observed in VAS for nasal symptoms in former group (p=0.028) than latter. The rate of relapse was less (23.81%) in furosemide group as compared to normal saline group (65%) but result not statistically significant at p<0.05.Conclusions: Topical furosemide can be used as a valid therapeutic approach for reducing the severity of sinonasal polyposis relapse after endoscopic sinus surgery with no known side effects of furosemide when administered topically.

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