Can FESS Combined with Submucosal Resection (SMR)/Septoplasty Reduce Revision Rate?

Chang, Chan-Chi; Tai, Chih‐Jaan; Ng, Teik Ying; Tsou, Yung An; Tsai, Ming Hsui

doi:10.1177/0194599814543778

Cited by 20 publications

(41 citation statements)

References 25 publications

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“…More studies exist on revision rate, especially in CRSwNP patients without using survival method. A study showed that male patients and younger adult patients were found to have higher revision rates; however, we were not able to demonstrate this. In addition, Chang et al found that patients with asthma or allergic rhinitis had higher revision rates compared with those patients without these comorbidities .…”

Section: Discussioncontrasting

confidence: 83%

“…A study showed that male patients and younger adult patients were found to have higher revision rates; however, we were not able to demonstrate this. In addition, Chang et al found that patients with asthma or allergic rhinitis had higher revision rates compared with those patients without these comorbidities . This is in part in line with our findings that allergic rhinitis independently predicted recurrent surgery.…”

Section: Discussioncontrasting

confidence: 83%

“…Endoscopic sinus surgery usually has high initial success rate . Published success rates for ESS range from 76% to 98% . Common failure factors associated with ESS include inappropriate surgical technique, poor operative field or visualization, and inadequate postoperative care .…”

Section: Introductionmentioning

confidence: 99%

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Factors affecting revision rate of chronic rhinosinusitis

Koskinen

Salo

Huhtala³

et al. 2016

Laryngoscope Investig Oto

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ObjectiveChronic rhinosinusitis (CRS) is a variable multifactorial disease. It can be divided into forms with nasal polyps (CRSwNP) and without (CRSsNP). Sinus and/or nasal polypectomy surgery are considered if maximal conservative treatment is insufficient. The predictive factors of the need of revision surgery comprise mostly the CRSwNP phenotype and are not fully understood.Study DesignThe aim of this follow‐up study was to evaluate the factors associated with the revision surgery rate in CRS patients with variable extent of disease.MethodsData of CRS patients (N = 178) undergoing sinus surgery and/or nasal polypectomy in 2001 to 2010 were used. Patient characteristics and follow‐up data were collected from patient records and questionnaires. Associations were analyzed by Fisher's exact, Mann Whitney U, and the Kaplan‐Meier method with log‐rank test. Unadjusted Cox's proportional hazard models were used for 12 variables and were fitted for the need for revision sinus surgery and/or nasal polypectomy during follow‐up of in average 9 years.ResultsThe proportion of CRS patients who had undergone revision in 5 years was 9.6%. After adjustment, the following factors associated significantly with the need for recurrent CRS surgery: allergic rhinitis, corticosteroid treatment, previous surgery of CRS, and recurrent NP.ConclusionIncreased risk of progressive CRS phenotypes with the need for revision surgery would putatively be recognized by relatively simple clinical questions. Further studies with increased sample size are needed to evaluate whether these predictive factors would be relevant for developing better detection and management of progressive CRS.Level of Evidence2b.

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Section: Discussioncontrasting

confidence: 83%

Section: Discussioncontrasting

confidence: 83%

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Factors affecting revision rate of chronic rhinosinusitis

Koskinen

Salo

Huhtala³

et al. 2016

Laryngoscope Investig Oto

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“…In a large retrospective case series, Chang et al 1182 compared ESS with septoplasty and ESS without septoplasty and noted a lower revision rate in patients who underwent both procedures. This is the only study that demonstrates a clear benefit of performing septoplasty and ESS concurrently, but this conclusion is limited by the retrospective study design 1182 (Table X- r Benefit : Reduction in nasal obstruction, improved access for ESS.…”

mentioning

confidence: 99%

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Orlandi

Kingdom

Hwang

et al. 2016

Int Forum Allergy Rhinol

554

888

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Background:The body of knowledge regarding rhinosinusitis (RS) continues to expand, with rapid growth in number of publications, yet substantial variability in the quality of those presentations. In an effort to both consolidate and critically appraise this information, rhinologic experts from around the world have produced the International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR:RS). Methods:Evidence-based reviews with recommendations (EBRRs) were developed for scores of topics, using previously reported methodology. Where existing evidence was insufficient for an EBRR, an evidence-based review (EBR) was produced. The sections were then synthesized and the entire manuscript was then reviewed by all authors for consensus. Results:The resulting ICAR:RS document addresses multiple topics in RS, including acute RS (ARS), chronic RS (CRS) with and without nasal polyps (CRSwNP and CRSsNP), recurrent acute RS (RARS), acute exacerbation of CRS (AE-CRS), and pediatric RS. Conclusion:As a critical review of the RS literature, ICAR:RS provides a thorough review of pathophysiology and evidence-based recommendations for medical and surgical treatment. It also demonstrates the significant gaps in our understanding of the pathophysiology and optimal management of RS. Too o en the foundation upon which these recommendations are based is comprised of lowerlevel evidence. It is our hope that this summary of the evidence in RS will point out where additional research efforts may be directed. C 2016 ARS-AAOA, LLC. Key Words:rhinosinusitis; chronic rhinosinusitis; acute rhinosinusitis; recurrent acute rhinosinusitis; evidence-based medicine; systematic review; endoscopic sinus surgery List of Abbreviations Used

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“…The minimum and maximum values obtained from this review were used to inform the sensitivity analyses. For revision surgery rates, we adjusted for both the sample size and the follow-up length of the source studies [22][23][24][25][26][27][28][29][30] . Where the available literature did not yield estimates for the time points of interest (e.g.…”

Section: Clinical Datamentioning

confidence: 99%