Comparative outcomes of endoscopic sinus surgery in patients with chronic sinusitis and nasal polyps

Abstract

This study was carried out to compare the outcomes of endoscopic sinus surgery in patients with chronic sinusitis without nasal polyps (CRS) and those with nasal polyps (NP). We also sought to determine the correlation between preoperative computed tomography (CT) findings and postoperative endoscopy and symptom score improvement. Data were collected from two groups of patients diagnosed as CRS with and without nasal polyps that underwent functional endoscopic sinus surgery with a 1-year postoperative follow up. Preoperative symptoms, CT scores, and endoscopic scores were recorded. Postoperative symptom and endoscopic scores were recorded at 1, 6, and 12 months. Assessment of symptoms was performed subjectively using visual analogue scoring (VAS). CT scan findings were scored using the Lund-Mackay system. Endoscopic examination findings were scored according to the staging system proposed by Lanza and Kennedy. The correlations between the CT score, endoscopic scores and VAS scores were calculated. There was a statistically significant correlation between the preoperative CT, symptom, and endoscopic scores. Postoperative symptom and endoscopic scores also showed a significant correlation. Total CT scores of the CRS group were significantly lower than the scores of the NP group. Also preoperative endoscopy and symptom scores were statistically lower in CRS group compared to NP group. Endoscopy total scores and symptom total scores of both groups were significantly decreased at postoperative 12th month. Statistically significant difference was observed between the preoperative and postoperative symptom and endoscopy scores. The patients with polyps had higher symptom scores and worse objective findings compared to the patients with CRS. In all patients groups, objective and subjective scores seemed to correlate well preoperatively and postoperatively. These data suggest that endoscopic sinus surgery provides significant symptomatic relief and endoscopic healing in patients with CRS and NP.

Eicosanoid imbalance correlates in vitro with the pattern of clinical symptoms of Samter ́s triad

“…We have also demonstrated that the endoscopy score has correlated with the CT score, con rming the observation of Ryan et al or Toros et al (49,50) . In addition, we have observed that the endoscopy score correlates with nasal obstruction (Table 4).…”

Endoscopic Sinus Surgery in Chronic Rhinosinusitis and Nasal Polyposis: A Comparative Study

“…Deal et al has demonstrated worse results of QOL in patients of NP and hypothesized it due to mass effect of polyps causing blockage, reduced mucociliary clearance, retained secretions, increased mucosal oedema and inflammation and reduced sense of smell [19]. Toros et al in their study of symptoms have observed higher symptom scores and worse objective findings in patients of NP [20]. Contrary to the above studies Smith et al in a study of preoperative factors that predict surgical outcome and Poetker et al on the outcomes of ESS on chronic rhinosinusitis with NP have found better preoperative CSS scores in patients with NP resulting in a positive impact on the QOL [21,22].…”

“…Various authors have observed significantly higher scores in patients of NP as compared to CRS [20]. The endoscopic scoring of Lund Kennedy is based on presence of oedema and polyps and CT scan scores of Lund Mackay on presence of mucosal oedema and opacification of sinus.…”

Correlations and Comparison between Repeat Computed Tomography Scores, Endoscopy Scores and Symptomatic Improvement before and after Endoscopic Sinus Surgery: A Pilot Study

“…Toros et al in one study proved that endoscopic sinus surgery provides significant symptomatic relief and endoscopically evident healing in patients with CRS and nasal polyps. 22 They recorded the preoperative symptom and endoscopic scores, and postoperative symptom and endoscopic scores using VAS. Our study has focussed on the correlations between all the three parameters.…”