Mucosal healing and mucociliary transport change after endoscopic sinus surgery in children with chronic maxillary sinusitis

Huang, Hsiao‐Ping; Cheng, Ja-Jian; Liu, Chia‐Ming; Lin, Kai‐Wei

doi:10.1016/j.ijporl.2006.01.016

Cited by 27 publications

(18 citation statements)

References 12 publications

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“…At the same time, a lower rate of tissue damage was revealed after endoscopic surgery, which is in agreement with the more radical character of Caldwell‐Luc surgery . Particularly, it has been demonstrated that in children with chronic maxillary sinusitis who underwent endoscopic surgery, effective recovery of the mucosa and mucociliary clearance was observed in 2 to 4 months depending on the type of process . It is also important to note a significant decrease in nasal fluid transforming growth factor beta (TGF)‐β1 and TGF‐β2, epidermal growth factor, and platelet‐derived growth factor levels 2 to 3 weeks following endoscopic sinonasal surgery, which is indicative of the repair process .…”

Section: Discussionsupporting

confidence: 63%

Comparison of the efficiency and safety of endonasal and open rhinosurgery in children

Alekseenko

Karpishchenko

2019

The Laryngoscope

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Objectives/Hypothesis The objective of this study was to compare the efficiency and safety of endonasal endoscopic maxillary surgery and the Caldwell‐Luc approach in children. Study Design Case series. Methods A total of 121 children aged 9 to 17 years with chronic rhinosinusitis were included in the study. The patients were operated on using Caldwell‐Luc (n = 36) and endoscopic maxillary surgery (n = 85) procedures. Efficiency and safety of the surgeries were assessed using pre‐ and postoperative endoscopic evaluation of the mucosa of the nasal cavity, 20‐item Sino‐Nasal Outcome Test (SNOT‐20), and subjective (both children's and parents') evaluation of the outcomes. Results Endoscopic investigation of the mucosa of the nasal cavity demonstrated a significant improvement after both Caldwell‐Luc and endoscopic surgery, although the Caldwell‐Luc procedure did not result in significant improvement in mucosal color. However, no significant group difference was observed. Both techniques resulted in a significant improvement of mucosal edema and fluid characteristics. Based on the results of the SNOT‐20, endoscopic maxillary surgery was characterized by a significant improvement in headache frequency, waking up at night, reduced concentration, ear pain, and emotional suppression as compared to Caldwell‐Luc surgery. Although no significant group difference in efficiency between the Caldwell‐Luc approach and endoscopic surgery was observed, the latter was characterized by a lower rate of scar formation, and reduced sensitivity, local painfulness, lacrimation, and psychologic discomfort. Conclusions The obtained data demonstrate the higher efficiency and safety of endoscopic sinus surgery as compared to the Caldwell‐Luc approach in children. Level of Evidence 4 Laryngoscope, 130:1056–1063, 2020

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Section: Discussionsupporting

confidence: 63%

Comparison of the efficiency and safety of endonasal and open rhinosurgery in children

Alekseenko

Karpishchenko

2019

The Laryngoscope

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“…reported reduction in saccharine clearance time after FESS [24]. Several other studies have reported improvement in saccharine clearance time after FESS [8,10,[16][17][18][19][20][21]. Measurement of NMCT by saccharine method can be easily performed, is free from observer variations, has no side-effects, cheap, simple to carryout and requires no elaborate equipments.…”

Section: Discussionmentioning

confidence: 99%

Role of measurement of nasal mucociliary clearance by saccharine test as a yard stick of success of functional endoscopic sinus surgery

Singh

Chandra

Gupta

et al. 2010

Indian J Otolaryngol Head Neck Surg

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“…Hafner et al19 showed that although the measured saccharin test transit times improved significantly in 17 of 22 patients post‐FESS, it remained prolonged in five patients; Asai et al20 discovered that postoperative mucociliary function (as indicated by the saccharin test) did not always correlate with postoperative endoscopy. Some studies noted that, although OMC blockage cleared, mucociliary clearance tended to be significantly prolonged in sinuses containing polyps when compared to sinuses without polyps 20–22. Moreover, many patients reported absence of symptoms, although mucociliary function had still not fully recovered.…”

Section: Introductionmentioning

confidence: 99%

When FESS fails: The inflammatory load hypothesis in refractory chronic rhinosinusitis

2012

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Through recent advances in research, our understanding of chronic rhinosinusitis (CRS) has evolved to consider it as an inflammatory condition of the mucosa brought about by multiple factors. However, surgical management is still ruled by the classical concepts of functional endoscopic sinus surgery (FESS), which emphasizes the importance of ostial obstruction and sinus ventilation. These concepts fail to provide sufficient explanation for the presence of a subset of patients with refractory CRS who fail to respond to conventional FESS. Recent outcome studies have shown that high-grade mucosal inflammation often results in a poor outcome and that this patient group may show improved results with more radical surgery. This review examines the "inflammatory load hypothesis" as a possible explanation. We hypothesize that the grade of the inflammation is the most important predictor of long-term outcomes. Surgery, therefore, has a significant role not only in reestablishing ventilation, but also with removing the inflammatory load in the affected sinuses. We suspect that in these severely diseased patients, a more radical removal of local proinflammatory factors during surgery may improve patient outcomes.

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Mucosal healing and mucociliary transport change after endoscopic sinus surgery in children with chronic maxillary sinusitis

Cited by 27 publications

References 12 publications

Comparison of the efficiency and safety of endonasal and open rhinosurgery in children

Comparison of the efficiency and safety of endonasal and open rhinosurgery in children

Role of measurement of nasal mucociliary clearance by saccharine test as a yard stick of success of functional endoscopic sinus surgery

When FESS fails: The inflammatory load hypothesis in refractory chronic rhinosinusitis

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