Radical surgery: Effect on quality of life and pain in chronic rhinosinusitis

Wang

et al. 2016

Sci Rep

Few studies have investigated the relationship between chronic rhinosinusitis (CRS) and erectile dysfunction (ED). This case-control study aimed to investigate the association between CRS and the risk of ED in a large national sample. Tapping Taiwan’s National Health Insurance Research Database, we identified people 30 years or older with a new primary diagnosis of CRS between 1996 and 2007. The cases were compared with sex- and age-matched controls. We identified 14 039 cases and recruited 140 387 matched controls. Both groups were followed up in the same database until the end of 2007 for instances of ED. Of those with CRS, 294 (2.1%) developed ED during a mean (SD) follow-up of 3.20 (2.33) years, while 1 661 (1.2%) of the matched controls developed ED, mean follow up 2.97 (2.39) years. Cox regression analyses were performed adjusting for sex, age, insurance premium, residence, hypertension, hyperlipidemia, diabetes, obesity, coronary heart disease, chronic kidney disease, chronic obstructive pulmonary disease, asthma, allergic rhinitis, arrhythmia, ischemic stroke, intracerebral hemorrhage, and medications. CRS was revealed to be an independent predictor of ED in the fully adjusted model (HR = 1.51; 95% CI = 1.33–1.73; P < 0.0001).

Section: Discussionmentioning

confidence: 99%

Chronic Rhinosinusitis Associated with Erectile Dysfunction: A Population-Based Study

Wang

et al. 2016

Sci Rep

Current Opinion in Otolaryngology & Head and Neck Surgery

“…The idea of removing all involved bone, through drilling and the performance of radical procedures (Denker [19], endoscopic modified Lothrop or Draf 3 [20]), is an attractive one. There is some evidence that an endonasal medical maxillectomy (Denker) may improve the outcome in patients with recalcitrant CRS [19].…”

Section: Surgerymentioning

confidence: 99%

“…There is some evidence that an endonasal medical maxillectomy (Denker) may improve the outcome in patients with recalcitrant CRS [19]. However, its role -if any -in patients with osteitis is less well defined.…”

Section: Surgerymentioning

confidence: 99%

Osteitis and paranasal sinus inflammation

Georgalas

2013

“…Kerrebijn et al performed it in 56 patients and reported relief of sinusitis with significant improvement in symptoms 13. Videler et al78, 79 reported significant improvements in symptoms and quality‐of‐life measures from Denker's procedure, and Wreesmann et al80 reported improvement of lower airway symptoms in asthmatic patients. Both suggested that radical surgery should be an option for patients who fail repetitive conservative functional surgery 78, 80…”

Section: Introductionmentioning

confidence: 99%

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

2012

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.