A Descriptive Study of Diagnostic and Management Protocols in Chronic Rhinosinusitis

Abstract

BACKGROUNDRhinosinusitis is an inflammatory process involving the mucous membrane of the nose and one or more sinuses. The last decade has seen the development of a number of guidelines as well as publications on the epidemiology, diagnosis and treatment of rhinosinusitis and nasal polyposis in U.S.A. and Europe. In our country, proper population surveys are required to know the exact prevalence of chronic rhinosinusitis. However, even from the limited data available, it is very apparent that chronic rhinosinusitis is a significant health problem resulting in considerable medical costs and severe impact on the health related quality of life.This descriptive study was conducted to-1. To study the efficacy of clinical examination, diagnostic nasal endoscopy and CT scan in diagnosing chronic rhinosinusitis with and without polyps; 2. To study the surgical techniques and surgical findings of all the patients of chronic rhinosinusitis undergoing endoscopic sinus surgery; 3. Patient's satisfaction will be assessed by comparing preoperative and post-operative Rhinosinusitis Disability Index. MATERIALS AND METHODSOur study was a descriptive study conducted at our hospital for a time period of 1 year. The study consisted of 52 cases having clinically diagnosed as chronic rhinosinusitis according to symptoms defined by rhinosinusitis task force. RESULTSThere is a definitive male preponderance in our study with most of the patients coming from age groups between 20 -60 years. This is comparable to most of the studies. Chronic rhinosinusitis with polyps (42.4%), chronic rhinosinusitis without polyps (57.6%), ENT examination could identify 34.6% of patients with polyps, which includes three categories. Sinonasal polyposis (27.7%), Antrochoanal polyps (55.5%), Allergic fungal polyposis (15.6%). Postoperatively, patient's satisfaction is better in chronic rhinosinusitis without polyps. CONCLUSIONPatient's satisfaction was assessed by comparing pre-and post-operative Rhinosinusitis Disability Index. Highly significant difference was noted when pre-and post-operative Rhinosinusitis Disability Index (p= 0.003) were compared. For patients with polyps, P value= 0.00 and patients without polyps, P value= 0.00. KEYWORDSChronic Rhinosinusitis, Endoscopic Sinus Surgery, FESS, Allergic Rhinosinusitis. HOW TO CITE THIS ARTICLE: Varma BRV, Kumar GV. A descriptive study of diagnostic and management protocols in chronic rhinosinusitis. J. Evolution Med. Dent. Sci. 2017;6(61):4463-4469, DOI: 10.14260/Jemds/2017/965 BACKGROUND Chronic rhinosinusitis is quite a common disease of the nose and sinuses seen globally and in India. The incidence of rhinosinusitis is increasing in our country due to increasing air pollution, industrial fumes and allergic factors especially in the urban areas. In the rural areas also, rhinosinusitis is quite prevalent due to lack of proper hygiene and malnutrition resulting in low immunity.The last decade has seen the development of a number of guidelines, consensus documents as well as publications on the e...