Endoscopic Paranasal Sinus Surgery: Results

Vleming, Marleen; Vries, Nico de

doi:10.2500/105065890782021033

Cited by 48 publications

(40 citation statements)

References 12 publications

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“…The highest report of perfect cavities was 63%. However, this series used non-validated endoscopy, the patient population included only 22% CRSwNP patients and surgical indications included headache and nasal obstruction 15 . It is also important to note that CRSwNP patients in our series had a number of significant differences from CRSsNP patients, including number of prior surgeries, asthma prevalence and aspirin tolerance (Table 1).…”

Section: Discussionmentioning

confidence: 99%

Impact of postoperative endoscopy upon clinical outcomes after endoscopic sinus surgery

Schlosser

Storck

Smith

et al. 2015

Int Forum Allergy Rhinol

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Background After endoscopic sinus surgery (ESS), endoscopy is used to gauge surgical success and clinical outcomes. Prior studies have not examined this topic prospectively using validated outcome metrics across multiple institutions. Methods A multi-institutional, prospective study of patients with chronic rhinosinusitis (CRS) who underwent ESS completed the SinoNasal Outcome Test (SNOT-22), missed productivity and medication usage questionnaires 6 months postoperatively. Lund-Kennedy endoscopy scoring (LKES) was performed with reviewers blinded to patient-reported data. A control cohort of non-CRS patients was recruited for comparison. Results Complete data was available on 183 CRS patients and 48 non-CRS control patients. Approximately 50% of patients achieve perfect or near perfect endoscopy (LKES 0-2) after ESS. Postoperative endoscopy correlated with total SNOT-22 scores (r=0.278, p<0.001), with the strongest correlations to rhinologic and extra-nasal subdomains in the nasal polyp cohort. Improved postoperative endoscopy was associated with decreased antibiotic and oral steroid usage, but had little association with missed productivity. Among patients who achieved near perfect postoperative endoscopy, those with nasal polyps had SNOT-22 scores that were similar to non-CRS control patients (mean SNOT-22 17.7 and 16.3, respectively). However, CRS patients without nasal polyps remained more symptomatic than non-CRS controls and CRS with nasal polyp patients despite nearly perfect endoscopy (mean SNOT-22 21.6). Conclusions Postoperative endoscopy correlates with SNOT-22 and medication usage in CRS patients. Polyp patients who achieve near perfect endoscopy have similar symptoms to healthy controls, however, non-polyp patients with near perfect endoscopy still have rhinologic and extra-nasal symptoms that are worse than healthy controls.

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Section: Discussionmentioning

confidence: 99%

Impact of postoperative endoscopy upon clinical outcomes after endoscopic sinus surgery

Schlosser

Storck

Smith

et al. 2015

Int Forum Allergy Rhinol

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“…Another study also showed that nasal obstruction was more likely to be associated with CT scan findings 7. Symptoms have been shown to not correlate well with nasal endoscopy in preoperative CRS patients 15, 16…”

Section: Discussionmentioning

confidence: 99%

Correlations between symptoms, nasal endoscopy, and in‐office computed tomography in post‐surgical chronic rhinosinusitis patients

2011

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In post-ESS CRS patients, most symptoms do not correlate well with either endoscopy or CT findings. Endoscopy and CT scores correlate well. Abnormal endoscopy findings have the ability to confidently rule in the presence of CT opacification, thus validating the importance of endoscopy in clinical decision making. However, a normal endoscopy cannot assure a normal CT. Thus, symptoms, endoscopy, and CT are complementary in the evaluation of the post-ESS CRS patient.

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“…Most of the patients in Kennedy's study continued to use topical steroids postoperatively. Vleming et al showed a 52% persistence of endoscopic disease in spite of subjective good results 31 . Based on this, we believe that chronic sinusitis is basically a mucociliary clearance abnormality and that the obstructive element is either the only or one of the aggravating factors.…”

Section: Discussionmentioning

confidence: 56%