Balloon sinuplasty: a new concept in the endoscopic nasal surgery

International Forum of Allergy & Rhinology, 2011

Background: Outcomes for revision endoscopic sinus surgery (RESS) are rarely reported in relation to technique. Our goal was to document the outcome of full-house functional endoscopic sinus surgery (FESS) (FHF) (complete sphenoethmoidectomy with Draf IIA frontal sinusotomy) for treatment of this recalcitrant group. Methods: Twenty-one patients with chronic sinusitis having had at least 1 previous sinus surgery (mean, 2.14) underwent FHF, followed by postoperative nasal douching and oral antibiotics for 12 weeks. A er a minimum 6 months of follow-up, patients were asked to complete a 5-item Patient Response Score (PRS) (graded on a 6-point scale from 1 = completely improved to 6 = much worse). Objective measures collected included computed tomography (CT) Lund MacKay score (L-M score, LMS), and endoscopic findings: mucosal swelling (MS) and mucopus (MP) (graded on a 4-point scale from 0 = none to 3 = severe). Results: Patients were divided into 3 subgroups based on months of follow up from surgery: 6-12, 12-18, and 18-24. There was no statistical difference in any outcome based on length of follow up. Mean symptom outcome was reported as much improved (PRS = 1.9 ± 0.1). Both mucosal swelling and mucopus improved dramatically (2.48 vs 0.29, p < 0.001; 2.52 vs 0.29, p < 0.001, respectively). LMS also improved dramatically (11.52 vs 2.1, p < 0.001). Presence of nasal polyps did not affect any subjective or objective outcome. Conclusion: Marked improvements in symptoms and mucosal findings were consistently obtained with FHF between 6 and 24 months postoperatively. C 2011 ARS-AAOA, LLC.

2011

Nasal polyposis are common presentations in patients of chronic rhinosinusitis and are considered to be associated with more severe forms of disease with poor treatment outcome. The presentation and treatment outcome after endoscopic sinus surgery in patients of chronic rhinosinusitis and nasal polyposis have been analysed in this study. A prospective analysis of 90 patients of chronic rhinosinusitis who were classified into two groups depending on presence and absence of nasal polyps was performed in the study. The two groups were evaluated using subjective (patient complaints) and objective (computed tomography scan and endoscopy scores) criteria. Preoperative data were compared with data obtained 12 months post endoscopic sinus surgery. The study included 38 patients of chronic rhinosinusitis and 52 patients of nasal polyps. The patients of nasal polyp group presented with increased severity of symptoms of nasal blockage, nasal discharge and reduced sense of smell as compared to the chronic rhinosinusitis group who had significantly higher presentation of headache and facial pain. The preoperative CT scan revealed significantly higher bilateral disease with increased involvement of multiple sinuses in nasal polyp group. Post endoscopic sinus surgery both the groups showed significant improvement in their symptoms with the nasal polyp group demonstrating reduction in improvement on 1 year follow up. In our study we have found the patients with chronic rhinosinusitis and nasal polyp have varied severity of symptoms with the nasal polyp group having higher nasal symptoms and increased severity as compared to chronic rhinosinusitis group. Though the universal rationale of management by adequate drainage and ventilation of sinus is similar in both groups, there is a reduction in both objective and subjective scores during 1 year follow up in the nasal polyp group.

IP Journal of Otorhinolaryngology and Allied Science, 2020

2012

Use of endoscopes in the sinonasal cavity dates as far back as the turn of the 20th century with Hirschmann and Reichert performing the first sino-endoscopies and sinus surgeries, respectively. Widespread use was limited until H.H. Hopkins helped address illumination difficulties with the rod optic system in the 1960s and Walter Messerklinger began systematic use of the endoscope to evaluate the lateral nasal wall and mucociliary clearance in the late 1970s (Lee & Kennedy 2006). With the advent of modern endoscopic sinus surgery instruments and techniques in the 1980s, the endoscope has radically altered the surgical approach and management of inflammatory and neoplastic sinonasal disease rendering many of the open approaches nearly obsolete. Successful outcomes in endoscopic sinus surgery have often been largely based on subjective qualifiers by the patient. Significant improvements in patient perceived nasal congestion, obstruction, facial pressure, rhinorrhea, headache, postnasal...

Otolaryngology-Head and Neck Surgery, 1989

Endoscopic .Inu••urgery I. a relatively new technique for the management of .Inu.ltl. refractory to nonlnva.lve therapy. Success depends on the use of newly developed In.tNments, Including the endoscopes, that allow one to enlarge the natural drainage o.tla of the Involved .Inu.... Furthermore, Its use assumes that the mucosal disease I. reverstble and that de.tNctlve procedures, such as the Caldwell•Luc. are unnecessary. To date there have been no reports In the English literature of patient. followed for more than a few month•. Herein we report 100 consecutive patient. followed for at lea.t 2 vears. (OTOI..ARVNGOL HEAD NECK SURG 1989;101:476.

Acta Otorrinolaringologica (English Edition), 2008

Introduction: Functional endoscopic sinus surgery (FESS) is a useful and widespread technique that allows the treatment of a large number of nasal pathologies. Nevertheless, although many ENT operations are carried out on an outpatient basis, FESS procedures commonly require at least 1 day of hospital admission in many centres. Objectives: To evaluate our experience in FESS as day-case, to study causes of unexpected overnight admission, and to identify any risk factors for failing to comply with early discharge. Material and method: We studied 145 patients consecutively subjected to outpatient FESS procedures for chronic rhinosinusitis, antrochoanal polyps, and dacryocystorhinostomy from August 2004 to June 2007. We analyzed sex, age, medical history (arterial hypertension, asthma, Widal syndrome), pathology, associated septoplasty, extent of the surgery, and revision surgery. Results: The re-admission rate was 13.1% with the following as the most frequent causes: bleeding (31.6%), requiring only observation in over half the cases (ie, without changing the nasal packing), and dizziness/weakness (36.8%). Only revision surgery was associated with an increase in the readmission rate (odds ratio, 3.5; 95% CI, 1.2-10.1). Conclusions: Our experience in FESS for outpatient surgery shows a readmission rate of 13.1%, although most cases were related to minor complications. Revision surgery was the only variable that could be associated with an increase in re-admission rate.

2007

Objective: The technique of functional endoscopic sinus surgery (FESS) has been widely accepted and applied to inflammatory diseases of the paranasal sinuses with internationally reported results of this technique having been very good. Our objective was to find out outcome after FESS at our centre. Methodology: Two hundred patients who had undergone FESS during a two year period with an average follow-up period of eleven months were evaluated subjectively regarding the outcome of their endoscopic sinus surgery. Results: An overall subjective improvement of about 94% was documented, with improvement in specific symptoms such as headache, nasal congestion, change in sense of smell, nasal discharge and recurrent infections ranging from 52% to 97%. Conclusion: Our center reports a subjective improvement of symptoms following FESS compatible with results attained internationally.

Clinical Otolaryngology, 2012

Current allergy and asthma reports, 2011

Current research has only reinforced the belief that chronic rhinosinusitis is a multifactorial and idiosyncratic disease process. Most basic science research on the topic focuses on delineating the many proposed contributing factors and attempting to establish therapeutic targets. In patients whose symptoms do not respond to medical therapy, endoscopic sinus surgery may be offered. Several surgical techniques have been proposed, and it would appear that certain techniques are ideal for certain situations. Recent clinical research has focused on the introduction of new technology and new techniques. Additionally, investigators have looked for ways to optimize current techniques and to determine which patient populations may expect to benefit from which types of interventions.

Philippine Journal of Otolaryngology Head and Neck Surgery, 2020

Objective: To compare subjective nasal airflow and overall pain score (as well as safety and added cost of) using an improvised nasal airway tube (nasogastric tube) versus nasal packing after endoscopic sinus surgery (ESS) for chronic rhinosinusitis with nasal polyposis (CRSwNP). Methods:Design: Quasi - Experimental Prospective Cohort StudySetting: Tertiary Government Training HospitalParticipants: Twenty-six (26) consecutive patients aged 18 to 77 years old diagnosed with CRSwNP who underwent ESS were alternately assigned to an experimental group (A) of 13, where an improvised nasal airway (nasogastric) tube was placed in addition to the nasal pack or a control group (B) of 13 with nasal packing alone. Results: There was a significant difference in subjective nasal airflow between experimental (A) and control (B) groups during the immediate postoperative period where the mean subjective airflow was 8.07 and 0.00 over 10.00, respectively. No significant difference was noted between ...