Endoscopic Sinus Surgery for the Management of Orbital Diseases

Liang, Kai‐Li; Su, Mu-Chun; Shiao, Jiun-Yi; Hsin, Chung‐Han; Jiang, Rong–San

doi:10.1159/000114538

Cited by 6 publications

(16 citation statements)

References 43 publications

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“…Endoscopic sinus surgery has become an ideal method for treatment of certain orbital diseases and has the advantages of excellent visualization with minimal cosmetic and functional morbidity. 11 The indications for Endoscopic sinus surgery have been rapidly expanding since its introduction in nose and sinus surgery. Endoscopic sinus surgery is indicated any time when we observe acute sinusitis with complications.…”

Section: Introductionmentioning

confidence: 99%

Orbital complications of ENT diseases

Kumar

Chauhan

Bhadouriya

et al. 2017

Int J Otorhinolaryngol Head Neck Surg

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Background: Orbital complications are fairly common in Otorhinolaryngology practice because of close proximity of orbit to adjacent ENT regions. Orbital complications must be suspected whenever ENT patients present with complaints of proptosis, diplopia, vision loss and epiphora. Early diagnosis and treatment is necessary to prevent morbidity and mortality in these patients.Methods: This prospective study was conducted in the ENT department for a period of 1 year from August 2016 to July 2017 and comprised of 38 cases. This study was conducted to see the incidence, etiology, clinical, radiological and histopathological profile in relation to ophthalmic complications in ENT diseases. Results: Male to female ratio was 1.71:1. Patients mean age at presentation in present study was 39.71±19.86 (SD) years and maximum number of cases 10 (26.32%) were between 41-50 years of age. Among 38 patients of our series, most common clinical presentation was proptosis followed by nasal obstruction. Commonest ENT diseases responsible for orbital complications were the different sinonasal tumours comprising 18 cases, in which carcinoma maxilla constituted 6 cases.Conclusions: In conclusion, correct diagnosis, adequate antibiotic therapy, and surgical intervention are important for management of orbital and ophthalmic complications. Cooperation between Ophthalmologist and the Otolaryngologist is clearly desirable for proper management of these cases.

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Section: Introductionmentioning

confidence: 99%

Orbital complications of ENT diseases

Kumar

Chauhan

Bhadouriya

et al. 2017

Int J Otorhinolaryngol Head Neck Surg

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“…Within the review, sixteen of the included studies reported objective outcomes in the form of endoscopic findings. The endoscopic findings were either reported as part of validated scoring scales (1,7,(16)(17)(18)(19)21,22,(25)(26)(27)(28) or nonvalidated systems (15,20,23,24,30) . Seven studies reported endoscopic improvement (15,(17)(18)(19)(22)(23)(24) , whereas the remainder of the studies reported no benefit (endoscopic) from antifungal agents.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies specified within their inclusion criteria for participants to have recently undergone FESS prior to the study (17)(18)(19)(20)25) or as part of the study (15,22,23,26,30) . However, a number of studies specifically excluded participants whom had recent FESS prior (range 3 to 12 weeks) to the medical intervention (16,21,27,29) . The studies that excluded FESS prior to intervention argued that surgery would positively influence outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…However, this study included three trials that actively aimed to exclude AFS (25)(26)(27) . Liang et al (16) and Ponikau et al (17) of AMB at two weeks (p=0.018), however, this difference was not reported at four weeks (16) . Data extracted from these two studies for the purpose of the meta-analysis revealed a SMD that favoured the treatment group.…”

Section: Validated -Patient Reported Outcome Measures (Prom)mentioning

confidence: 91%

“…The remainder of the individual trials reported adverse events inconsistently and failed to show any statistically significant associations with the therapeutic intervention. Four studies which utilised topical antifungal therapy reported nasal irritation / burning with AMB (17,18,26,27) , with one study reported skin itching (16) . The use of systemic antifungals were associated with elevation of hepatic enzymes in five studies (15,22,24,30) .…”

Section: Adverse Effects Of Topical and Oral Antifungalsmentioning

confidence: 99%

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The value of antifungal therapy in allergic fungal rhinosinusitis

Sg¹,

Bn²

2014

Rhin

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Background: Allergic fungal rhinosinusitis (AFS) is considered to part of the disease spectrum of chronic rhinosinusitis, which affects between five to fifteen per cent of the population. Currently, there is uncertainty relating to the pathological process and therefore optimal management of AFS. Studies assessing antifungal use have shown mixed results. The aim of this review is to assess the effect of antifungals on patients with AFS. Methods:A systematic review of the literature to include all published trials searching Pubmed, Medline (Ovid), CINAHL (EBSCO) and the Cochrane central register of controlled trials (CENTRAL) databases. Results:Sixteen studies (two systematic reviews, two meta-analysis, four randomised controlled trials, five prospective cohort studies and three retrospective studies) were included in this review. There was found to be no overall benefit of topical or oral antifungals upon endoscopic findings or patient reported outcome measures in AFS. There were no statistically significant differences in adverse effect profiles between treatment and control groups. Conclusion:There is limited evidence to support the use of topical or oral antifungal agents in patients with AFS. Future research recommendations include large multicentre randomised trials with better matched patient groups and appropriate dosage and timing of antifungals.

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A Systematic Review of the Endoscopic Management of Orbital Floor Fractures

Cheung

Voineskos

Avram

et al. 2013

JAMA Facial Plast Surg

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To determine the safety and efficacy of the endoscopic management of isolated orbital floor fractures.Methods: A systematic review was performed using electronic databases. Studies investigating the reconstruction of isolated orbital floor fractures using an endoscopic approach were considered for inclusion. Two investigators independently reviewed all results. Study quality was assessed using the Methodological Index for Nonrandomized Studies scale. Primary outcomes were the resolution of diplopia and enophthalmos. Secondary outcomes were postoperative complications, including blindness, paresthesias, sinusitis, infection, conversion to external approach, and need for revision surgery.Results: Nine studies capturing 172 patients met the inclusion criteria for systematic review. Two studies were comparative and 7 were case series. Study quality was poor, lacking prospective data and reliable assessment of outcomes. Strong reviewer agreement was observed (intraclass correlation, 84%; 95% CI, 35%-96%). Diplopia resolved in 102 of 118 patients (86%) and enophthalmos resolved in 41 of 43 (95%). No complications of blindness, sinusitis, or conversion to external approach were reported. Thirteen patients (8%) had transient cheek numbness. Two patients (1%) required revision surgery.Conclusions: Reconstruction of isolated orbital floor fractures through an endoscopic approach appears to be safe and effective. High-level evidence prospectively comparing endoscopic and external approaches, however, is lacking.

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Endoscopic Sinus Surgery for the Management of Orbital Diseases

Cited by 6 publications

References 43 publications

Orbital complications of ENT diseases

Orbital complications of ENT diseases

The value of antifungal therapy in allergic fungal rhinosinusitis

A Systematic Review of the Endoscopic Management of Orbital Floor Fractures

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