Eficácia da cirurgia endoscópica nasal nos sintomas da rinossinusite crônica associada ou não à polipose

Abstract

Funct ional endoscopic sinus surgery is the preferred treatment for chronic rhinosinusitis currently. Success on symptoms relief and quality of life improvement are the study leading objectives. Study design: retrospective clinical trial. Methods: Questionnaires were given to the patients referred to Hospital das Clinicas-UFPE to chronic rhinosinusitis (CRS) functional endoscopic sinus intervention during [2003][2004]. Symptoms outcome before and after surgery were compared and analyzed using a five-pointranking scale. Results: Twenty-four pacients answered the questions. Eleven pacientes had CRS and 13 had CRS associated with nasal polypos. Quality of life was restricted by CRS in everyone, with a good improvement in 54,2% cases. All patients could recommend functional endoscopic sinus surgery to someone with same nasal problems and only 3 would not get surgery again. The best symptoms relif results were: nasal obstruction (83,3%), cacosmia/halitosis (80%), hyposmia/anosmia (63,15%), headache (62%). Patients with polyps achieved better symptomatic response than patients with only CRS. Conclusions: The leading simptoms were improved by functional endoscopic sinus surgery but not so much we expect. Allergic rhinits presenting, not using nasal spray, poor ambient control influenced this result. Polyps patient achivied better symptoms outcome and quality of life responses on the most of symptoms than CRS pacients.

Setting of an endoscopic nasal reference point for surgical access to the anterior base through an anatomical study on cadavers

“…Skull base surgery and revision procedures with distorted anatomy are the procedures most in need of precise anatomical references. 4 , 5 , 6 …”

Eficácia da cirurgia endoscópica nasal no tratamento da Rinossinusite crônica

“…Its effects were respectively: 95.45% 86.3% 81.8% 81.2% 72.7% in patients with CRS and polyposis in the group we find: 100%, 83%, 58.3% , 100% and 91.6%. Compared with the national study conducted in 2006 at the Hospital de Clinicas, Federal University of Pernambuco (8) gives 100% nasal obstruction, headache in 87.5%, 91.6% in rhinorrhea and hyposmia in 83.3%, the which shows correlation between the incidence of symptoms. In the same study, the improvement of nasal obstruction was 92.3% in patients with nasal polyps, 76.6% in our study.…”

“…In the study by Damm (10) the overall improvement after surgery was 85%, while Bhattcharyya (7) described improvement in 100% of patients, especially in the following symptoms: facial pain, congestion, nasal obstruction, rhinorrhea, and headache. In a similar study conducted at University Hospital of Pernambuco (8) found an overall improvement in 50% of patients, 54.2% of cases reported considerable gain in quality of life. In the study by Dursun (11) and colleagues, which examined the predictors of success in CRS FEES, was hit success of FESS in 83% of cases, 54.4% had associated nasal polyposis.…”

“…When considering the overall success rates in the postoperative period, the results of FESS are very satisfactory. An improvement rate of 80% to 98% in this sense is found for FESS in the literature (3)(4)(5)(6)(7)(8)(9)(10). The authors attribute this small percentage of failure to different factors in the pathophysiology of the disease, including environmental factors like pollution, dust and cigarette smoke (9).…”

“…The surgical technique was standardized and popularized by KENNEDY (2) in the early 80s, and since then, the indications for this procedure has increased due to its good results. A total success rate of 80% to 98% is reported in the literature, most often without an accompanying long-term (3)(4)(5)(6)(7)(8)(9)(10). But even with good technique, the clinical course of disease can be challenging due to various factors involved in the pathophysiology of CRS.…”