The International Classification of the radiological Complexity (ICC) of frontal recess and frontal sinus

Wormald, Peter John; Bassiouni, Ahmed; Callejas, Claudio; Kennedy, David W.; Citardi, Martin J.; Smith, Timothy L.; Orlandi, Richard R.; Kaschke, Oliver; Siow, Jin Keat; Szczygielski, Kornel; Lund, Valerie J.; Fokkens, Wytske J.; Psaltis, Alkis J.

doi:10.1002/alr.21893

Cited by 16 publications

(15 citation statements)

References 8 publications

(15 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This prospective cohort study used data from patients with bilateral CRSwNP scheduled to undergo endoscopic sinus surgery in the Rhinology Department of Beijing TongRen Hospital between January 1, 2010 and October 31, 2013. At the screening visit, 112 participants with bilateral CRSwNP were preselected as candidates; of whom 31 patients were excluded because they did not meet the following inclusion criteria: having had at least 1 previous sinus surgery (FESS, full maxillary antrostomy, ethmoidectomy, sphenoidotomy and frontal sinusotomy, but with the middle turbinate [MT] preservation), "good gasification" of the frontal sinus (i.e a developed frontal ostium with anteriorposterior diameter ≥ 10 mm,) and with no complicated frontal sinus mucocele or tumor to warrant a successful Draf 3 (17,18) , with concomitant asthma, with no unilateral disease, allergic fungal rhinosinusitis, antrochoanal polyps, or cysts, and treated with no antibiotics or corticosteroids within a 4-week period before enrollment. The extensiveness of previous FESS surgery was confirmed on the basis of hospital records of the surgery and performance of a CT scan on enrolment to the study.…”

Section: Patients and Study Designmentioning

confidence: 99%

Long-term outcomes of different endoscopic sinus surgery in recurrent chronic rhinosinusitis with nasal polyps and asthma

Zhang¹,

Zhang²,

Gao³

et al. 2020

Rhin

View full text Add to dashboard Cite

Background: Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and asthma have poorer outcomes after functional endoscopic sinus surgery (FESS) and higher recurrence rate. The aim of present study was to investigate the long-term clinical outcomes of extended surgical strategies for patients with recurrent CRSwNP and asthma.Methods: Eighty-one patients with CRSwNP and asthma were enrolled in this 5-year prospective study. They were randomly assigned to undergo FESS, radical endoscopic sinus surgery (RESS), or RESS+Draf 3 surgery. Disease severity and clinical outcomes were evaluated using symptoms scoring, endoscopic scoring system, computed tomography staging system, sinus-specific quality of life scores, tissue and peripheral blood eosinophil percentage, and pulmonary function tests. Baseline, 1-year, 3-year, and 5-year follow-up data were compared among the groups.Results: RESS and RESS+Draf 3 strategies yielded better short-term (1 year) outcomes than did FESS. FESS had a higher short-term recurrence rate, although recurrence rates were similarly high (95.6-96.1%) in all the groups at 5 years postoperatively. RESS and RESS+Draf 3 yielded a lower long-term revision surgery rate and a longer time to recurrence post-surgery than FESS, which was negatively correlated with tissue and peripheral blood eosinophil percentage. Conclusions:CRSwNP with asthma is a systemic disease that inevitably recurs. Radical surgery prolongs recurrence time and improves olfaction, rhinorrhea, and quality of life in the short-term. Combining Draf 3 with RESS did not yield better clinical outcomes than RESS alone; thus, although RESS alone appears to be the best option, these findings need to be confirmed in further studies involving more patients, longer follow-up duration and stricter standardized medication use especially the adequate steroid irrigations.

show abstract

Section: Patients and Study Designmentioning

confidence: 99%

Long-term outcomes of different endoscopic sinus surgery in recurrent chronic rhinosinusitis with nasal polyps and asthma

Zhang¹,

Zhang²,

Gao³

et al. 2020

Rhin

View full text Add to dashboard Cite

show abstract

“…Imaging accurately visualises areas beyond the naked eye and endoscope. It is used to provide an accurate assessment of the anatomy, a corroboration of clinical symptoms and endoscopic findings and facilitates an objective evaluation of pathology both in terms of diagnosis and extent of disease (191,192) . However, how and when the scan is done will influence the results.…”

Section: Rationalementioning

confidence: 99%

“…Cone beam CT (CBCT), historically used for dental imaging, is also being utilised in sinonasal imaging producing high resolution images, but the longer scan time, subsequent susceptibility to motion artefact and the lack of soft tissue differentiation can be a drawback. our appreciation of the complex anatomy, particularly in the frontal recess, and led to international efforts to agree a classification of the area (3,192) (Figure 12). Three-dimensional (3D) reconstructions are helpful when surgically planning complex facial trauma or craniofacial anomaly cases.…”

Section: Computed Tomography (Ct) and Cone Beam Ct (Cbct)mentioning

confidence: 99%

European position paper on diagnostic tools in rhinology

Rimmer

Hellings

Lund

et al. 2019

Rhin

114

View full text Add to dashboard Cite

is the official Journal of the European and International Rhinologic Societies and appears quarterly in March, June, September and December. Cited in Pubmed, Current Contents, Index Medicus, Exerpta Medica and Embase Founded in 1963 by H.A.E. van Dishoeck, Rhinology is a worldwide non-profit making journal. The journal publishes original papers on basic research as well as clinical studies in the major field of rhinology, including physiology, diagnostics, pathology, immunology, medical therapy and surgery of both the nose and paranasal sinuses. Review articles and short communications are also pulished. All papers are peer-reviewed. Letters-to-the-editor provide a forum for comments on published papers, and are not subject to editorial revision except for correction of English language. In-depth studies that are too long to be included into a regular issue can be published as a supplement. Supple ments are not subject to peer-review.

show abstract

“…The anterior-posterior diameter (A-PD) of the FSO below 5 mm is regarded as a factor increasing the difficulty of the surgery. 4 The scope resting on the limen nasi introduced just below the axilla of the middle turbinate is at an angle of about 55 to the floor of the nasal cavity. 5 Under these conditions, the 30 scope lens is positioned nearly parallel to the floor of the nasal cavity.…”

Section: Introductionmentioning

confidence: 99%

Frontal Angle: A New Predictor of Difficulty in Endoscopic Frontal Sinus Surgery—A Preliminary Computed Tomography Study

2021

View full text Add to dashboard Cite

Objectives: The possibility of visualization of the frontal sinus during endoscopic surgery depends on 3-dimensional configuration of the frontal sinus opening (FSO). We aimed to determine the prevalence of unfavorable angulation of the lower part of the posterior wall of the frontal sinus and its relation to FSO diameter. Methods: One hundred and twenty-eight computed tomography (CT) scans were retrospectively reviewed to measure (1) the angle between the nasal floor and the plane tangent to the posterior table of the frontal sinus above the most posterior aspect of the anterior buttress (frontal angle, FA) and (2) dimensions of the FSO. Results: The FA ranged from below 30° to 90°. Nearly 13% of sinuses (16.4% of patients) showed FA about 90°, which should enable good visualization of the sinus with the 30° scope after opening and clearing the frontal recess, while 4% (6.25% of patients) showed FA ≤ 30°. The anterior–posterior diameter (A-PD) was below 5 mm in 17.6% of sinuses (26.6% of patients). There was a significant correlation between FA and A-PD. Unfavorable combination of FA and A-PD (<45°, <5 mm) was present in 5.2% of sinuses (8.6% of patients), and extremely unfavorable combination (<30°, <5 mm) in 0.8% (0.8% of patients). Conclusions: The FA shows great interindividual variability, which is very likely to reflect the possibility of inspection of the frontal sinus. This implies a need for further prospective clinical studies to validate FA as a predictor of difficulty in frontal sinus surgery.

show abstract

The International Classification of the radiological Complexity (ICC) of frontal recess and frontal sinus

Abstract: We propose a fast, easy classification to anticipate the complexity of surgery in the frontal sinus and recess, for patients undergoing primary surgery.

Cited by 16 publications

References 8 publications

Long-term outcomes of different endoscopic sinus surgery in recurrent chronic rhinosinusitis with nasal polyps and asthma

Long-term outcomes of different endoscopic sinus surgery in recurrent chronic rhinosinusitis with nasal polyps and asthma

European position paper on diagnostic tools in rhinology

Frontal Angle: A New Predictor of Difficulty in Endoscopic Frontal Sinus Surgery—A Preliminary Computed Tomography Study

Contact Info

Product

Resources

About