Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-02T18:57:33.320Z Has data issue: false hasContentIssue false

Post-operative course prediction during endoscopic sinus surgery in patients with chronic rhinosinusitis

Published online by Cambridge University Press:  18 April 2018

K Tsuzuki*
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Hyogo College of Medicine, Nishinomiya, Japan
K Hashimoto
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Hyogo College of Medicine, Nishinomiya, Japan
K Okazaki
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Hyogo College of Medicine, Nishinomiya, Japan
M Sakagami
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Hyogo College of Medicine, Nishinomiya, Japan
*
Address for correspondence: Dr Kenzo Tsuzuki, Department of Otorhinolaryngology – Head and Neck Surgery, Hyogo College of Medicine, 1-1 Mukogawa, Nishinomiya, Hyogo 663-8501, Japan Fax: +81 798 41 8976 E-mail: [email protected]

Abstract

Objective:

This study aimed to analyse findings of functional endoscopic sinus surgery to estimate the post-operative course of patients with chronic rhinosinusitis.

Methods:

From 2007 to 2015, 291 adult patients with bilateral chronic rhinosinusitis, divided into eosinophilic chronic rhinosinusitis (n = 210) and non-eosinophilic chronic rhinosinusitis (n = 81) groups, who underwent primary functional endoscopic sinus surgery were enrolled. Functional endoscopic sinus surgery findings, scored as operating score, were analysed in relation to pre-operative olfactory recognition threshold and sinonasal computed tomography imaging score, as well as post-operative endoscopic appearance.

Results:

Operating scores in eosinophilic chronic rhinosinusitis were significantly worse than those in non-eosinophilic chronic rhinosinusitis. The anterior ethmoid sinus and superior meatus were predominantly inflamed. Operating score significantly correlated with pre-operative olfaction recognition threshold, computed tomography score and pre-operative endoscopic appearance score. In eosinophilic chronic rhinosinusitis, higher operating scores were related to post-operative deterioration of endoscopic appearance score.

Conclusion:

The operating score reflects the course following functional endoscopic sinus surgery. Patients with more severe operative findings require longer post-operative treatment.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Fokkens, WJ, Lund, VJ, Mullol, J, Bachert, C, Alobid, I, Baroody, F et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2012. Rhinol Suppl 2012;23:1298.Google Scholar
2Rosenfeld, RM, Andes, D, Bhattacharyya, N, Cheung, D, Eisenberg, S, Ganiats, TG et al. Clinical practice guideline: adult sinusitis. Otolaryngol Head Neck Surg 2007;137(3 suppl):S131.CrossRefGoogle ScholarPubMed
3Hummel, T, Whitcroft, KL, Andrews, P, Altundag, A, Cinghi, C, Costanzo, RM et al. Position paper on olfactory dysfunction. Rhinol Suppl 2017;54(suppl 26):130.Google Scholar
4Tsuzuki, K, Hinohira, Y, Takebayashi, H, Kojima, Y, Yukitatsu, Y, Daimon, T et al. Novel endoscopic scoring system after sinus surgery. Auris Nasus Larynx 2014;41:450–4.CrossRefGoogle ScholarPubMed
5Senior, BA, Kennedy, DW, Tanabodee, J, Kroger, H, Hassab, M, Lanza, D. Long-term results of functional endoscopic sinus surgery. Laryngoscope 1998;108:151–7.Google Scholar
6Rudmik, L, Smith, TL. Evidence-based practice: postoperative care in endoscopic sinus surgery. Otolaryngol Clin North Am 2012;45:1019–32.Google Scholar
7Haruna, S, Otori, N, Yanagi, K, Moriyama, H. Eosinophilic sinusitis [in Japanese]. Oto-Rhino-Laryngol Tokyo 2001;44:195201.Google Scholar
8Ishitoya, J, Sakuma, Y, Tsukuda, M. Eosinophilic chronic rhinosinusitis in Japan. Allergol Int 2010;59:239–45.CrossRefGoogle ScholarPubMed
9Tokunaga, T, Sakashita, M, Haruna, T, Asaka, D, Takeno, S, Ikeda, H et al. Novel scoring system and algorithm for classifying chronic rhinosinusitis: the JESREC Study. Allergy 2015;70:9951003.Google Scholar
10Lund, VJ, Mackay, IS. Staging in rhinosinusitis. Rhinology 1993;31:183–4.Google Scholar
11Takebayashi, H, Tsuzuki, K, Oka, H, Fukazawa, K, Daimon, T, Sakagami, M. Clinical availability of a self-administered odor questionnaire for patients with olfactory disorders. Auris Nasus Larynx 2011;38:6572.Google Scholar
12Oka, H, Tsuzuki, K, Takebayashi, H, Kojima, Y, Daimon, T, Sakagami, M. Olfactory changes after endoscopic sinus surgery in patients with chronic rhinosinusitis. Auris Nasus Larynx 2013;40:452–7.Google Scholar
13Saito, T, Tsuzuki, K, Yukitatsu, Y, Sakagami, M. Correlation between olfactory acuity and sinonasal radiological findings in adult patients with chronic rhinosinusitis. Auris Nasus Larynx 2016;43:422–8.Google Scholar
14Hashimoto, K, Tsuzuki, K, Okazaki, K, Sakagami, M. Influence of opacification in the frontal recess on frontal sinusitis. J Laryngol Otol 2017;131:620–6.CrossRefGoogle ScholarPubMed
15Seiden, AM, Duncan, HJ. The diagnosis of a conductive olfactory loss. Laryngoscope 2001;111:914.Google Scholar
16Kern, RC. Chronic sinusitis and anosmia: pathologic changes in the olfactory mucosa. Laryngoscope 2000;110:1071–7.Google Scholar
17Soler, ZM, Sauer, DA, Mace, J, Smith, TL. Relationship between clinical measures and histopathologic findings in chronic rhinosinusitis. Otolaryngol Head Neck Surg 2009;141:454–61.CrossRefGoogle ScholarPubMed
18Lavin, J, Min, JY, Lidder, AK, Huang, JH, Kato, A, Lam, K et al. Superior turbinate eosinophilia correlates with olfactory deficit in chronic rhinosinusitis patients. Laryngoscope 2017;127:2210–18.Google Scholar
19Lund, VJ, Kennedy, DW. Quantification for staging sinusitis. The Staging and Therapy Group. Ann Otol Rhinol Laryngol Suppl 1995;167:1721.Google Scholar
20Leopold, DA, Hummel, T, Schwob, JE, Hong, SC, Knecht, M, Kobal, G. Anterior distribution of human olfactory epithelium. Laryngoscope 2000;110(3 Pt 1):417–21.Google Scholar
21Soler, ZM, Pallanch, JF, Sansoni, ER, Jones, CS, Lawrence, LA, Schlosser, RJ et al. Volumetric computed tomography analysis of the olfactory cleft in patients with chronic rhinosinusitis. Int Forum Allergy Rhinol 2015;5:846–54.Google Scholar
22Psaltis, AJ, Li, G, Vaezeafshar, R, Cho, KS, Hwang, PH. Modification of the Lund-Kennedy endoscopic scoring system improves its reliability and correlation with patient-reported outcome measures. Laryngoscope 2014;124:2216–23.Google Scholar
23Wright, ED, Agrawal, S. Impact of perioperative systemic steroids on surgical outcomes in patients with chronic rhinosinusitis with polyposis: evaluation with the novel Perioperative Sinus Endoscopy (POSE) scoring system. Laryngoscope 2007;117:128.Google Scholar