Repetitive Endoscopic Sinus Surgery Failure: A Role for Radical Surgery?

Videler, W J M; Wreesmann, Volkert B.; Meulen, Freerk W. van der; Knegt, P.; Fokkens, Wytske J.

doi:10.1016/j.otohns.2005.11.013

Cited by 24 publications

(26 citation statements)

References 20 publications

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“…This was found to be insignificant statistically. In a retrospective study, Wynn and Har found a recurrence rate in patients with nasal polyps of 60% after 40 months of follow up 12. The lower rate in our study may be due to the shorter period of follow-up.…”

Section: Discussioncontrasting

confidence: 57%

Prevalence of allergic fungal sinusitis among patients with nasal polyps

Telmesani

2009

Ann Saudi Med

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BACKGROUND:Nasal polyposis is a common problem in the eastern province of Saudi Arabia. Since allergic fungal sinusitis (AFS) can present with unilateral or bilateral nasal polyps, it is important to be aware of the prevalence of AFS in patients with nasal polyps.PATIENTS AND METHODS:The medical records of 91 patients with nasal polyps admitted for functional endoscopic sinus surgery were reviewed. The diagnosis of AFS was considered if histopathology showed the presence of eosinophillic mucin-containing hyphae. The following data were collected: presence of associated asthma, IgE levels, grading of CT scan findings, and operative details.RESULTS:Histopathological diagnosis was positive for AFS in 11 of 91 patients 12.1%. There was a highly significant statistical difference in IgE levels between patients suffering AFS and chronic hyperplastic rhinosinusitis with nasal polyps (P<.0001). The overall incidence of recurrence of polypi was 50.5% (45 of 89 patients who had follow up for a minimum of one year) and the rate of recurrence in patients with AFS was 54.5% (6 of 11 patients with AFS). There was a significant direct relationship between the CT grading of nasal polyps and recurrence, with a recurrence rate of 60.7% (34 of 56) in patients with grade III nasal polyps.CONCLUSION:This study showed that the prevalence of AFS among patients with nasal polyps is 12.1%, and suggests that CT grading of nasal polyps can be used as a prognostic factor for disease recurrence.

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Section: Discussioncontrasting

confidence: 57%

Prevalence of allergic fungal sinusitis among patients with nasal polyps

Telmesani

2009

Ann Saudi Med

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“…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

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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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“…Endoscopic sinus surgery remains the gold standard for the treatment of chronic sinusitis [7], it appears to be a very effective method for the treatment of an upper eyelid fistula when it combined with excision of the fistular tract. Endoscopic surgery attempts to restore normal ciliary flow within the sinuses using minimal invasive surgery on the osteo-meatal unit [8], and can usually establish intranasal drainage of mucocoeles [9].…”

Section: Discussionmentioning

confidence: 99%

Upper Eyelid Fistula Secondary to a Frontal Sinusitis: A Case Report and Review of the Literature

Rabii¹

2018

OOAJ

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Introduction: Sinus disease may occur in individuals who are not otherwise aware that they have problems (occult sinusitis). An upper eyelid fistula is one of the complications of the frontal sinusitis. It can happen as a result of the obstruction of the frontal sinus ostia. Case report: In this article, we reported a case of a 64 years old female patient admitted to our department with a 2 years' history of an upper eyelid fistula secondary to a frontal sinusitis. A paranasal sinus computed tomography (CT) concluded to a frontal and ethmoidal sinusitis associated to a frontal osteitis. The patient underwent a functional endoscopic sinus surgery to establish drainage of the affected sinuses and direct excision of the fistular tract. Conclusion: The development of a sinocutaneous fistula secondary to a frontal sinusitis is rare, but still occurs in the modern antibiotic era. Definitive management of this disease process requires a frontal drainage of the affected sinus with fistula excision and multilayer closure.

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Repetitive Endoscopic Sinus Surgery Failure: A Role for Radical Surgery?

Abstract: C-4.

Cited by 24 publications

References 20 publications

Prevalence of allergic fungal sinusitis among patients with nasal polyps

Prevalence of allergic fungal sinusitis among patients with nasal polyps

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

Upper Eyelid Fistula Secondary to a Frontal Sinusitis: A Case Report and Review of the Literature

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