Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-28T11:59:15.176Z Has data issue: false hasContentIssue false
  • English
  • Français

Minimally invasive surgery under local anaesthesia for chronic rhinosinusitis with nasal polyps: our experience in older adults

Published online by Cambridge University Press:  12 February 2020

M Casale ,
A Costantino ,
L Sabatino ,
A Luchena ,
A Moffa ,
M Cassano ,
V Rinaldi  and
P M Baptista
M Casale
Affiliation:
Department of Otolaryngology, Integrated Therapies in Otolaryngology, Campus Bio-Medico University, Rome, Italy
A Costantino*
Affiliation:
Department of Otolaryngology, Integrated Therapies in Otolaryngology, Campus Bio-Medico University, Rome, Italy
L Sabatino
Affiliation:
Department of Otolaryngology, Integrated Therapies in Otolaryngology, Campus Bio-Medico University, Rome, Italy
A Luchena
Affiliation:
Department of Otolaryngology, Integrated Therapies in Otolaryngology, Campus Bio-Medico University, Rome, Italy
A Moffa
Affiliation:
Department of Otolaryngology, Integrated Therapies in Otolaryngology, Campus Bio-Medico University, Rome, Italy Department of Otolaryngology, University of Foggia, Italy
M Cassano
Affiliation:
Department of Otolaryngology, University of Foggia, Italy
V Rinaldi
Affiliation:
Department of Otolaryngology, Integrated Therapies in Otolaryngology, Campus Bio-Medico University, Rome, Italy
P M Baptista
Affiliation:
Department of Otolaryngology, University Clinic of Navarra, Pamplona, Spain
*
Author for correspondence: Dr Andrea Costantino, Department of Otolaryngology, Integrated Therapies in Otolaryngology, School of Medicine, Campus Bio-Medico University, Via Alvaro del Portillo 21, 00128Rome, Italy E-mail: [email protected] Fax: +39 06 2254 1520
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

This paper aims to report our experience with a minimally invasive surgical procedure for the treatment of chronic rhinosinusitis with nasal polyps, performed in a day-surgery setting under local anaesthesia.

Methods

A retrospective study of 30 patients with chronic rhinosinusitis with nasal polyps was conducted. Sino-Nasal Outcome Test 22 and modified Lund–Kennedy scores were collected. Intra- and post-operative pain was evaluated using a 10-point visual analogue scale.

Results

The mean Sino-Nasal Outcome Test 22 score decreased from 41.8 ± 15.8 pre-operatively to 13.3 ± 9.5 post-operatively (p < 0.001). Accordingly, the mean endoscopic score decreased from 6.8 ± 1.8 to 0.2 ± 0.7 (p < 0.001). The mean intra-operative pain score was 2.9 ± 3.2, and 29 patients (96.7 per cent) reported no pain in the post-operative period (visual analogue scale score = 0).

Conclusion

Our study confirms that minimally invasive surgery represents a safe, repeatable procedure that results in remarkable subjective and objective improvement, without intra- and post-operative pain or discomfort.

Keywords

SurgeryElderlyNasal PolypsSinusitisAnesthesia
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 2 , February 2020 , pp. 145 - 149
Copyright
Copyright © JLO (1984) Limited, 2020

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.)

Footnotes

Dr A Costantino takes responsibility for the integrity of the content of the paper

References

Fokkens, 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;23:1–298Google ScholarPubMed
Settipane, RA, Peters, AT, Chiu, AG. Nasal polyps. Am J Rhinol Allergy 2013;27:S20–5CrossRefGoogle ScholarPubMed
Renteria, AE, Mfuna Endam, L, Desrosiers, M. Do aging factors influence the clinical presentation and management of chronic rhinosinusitis? Otolaryngol Head Neck Surg 2017;156:598–605CrossRefGoogle ScholarPubMed
Tsikoudas, A, Barnes, ML, White, PS. The effect of functional endoscopic sinus surgery on nasal spray distribution to the middle meatus in patients with rhinosinusitis. Am J Rhinol Allergy 2009;23:546–8CrossRefGoogle ScholarPubMed
DeConde, AS, Mace, JC, Levy, JM, Rudmik, L, Alt, JA, Smith, TL. Prevalence of polyp recurrence after endoscopic sinus surgery for chronic rhinosinusitis with nasal polyposis. Laryngoscope 2017;127:550–5CrossRefGoogle ScholarPubMed
Hopkins, C, Slack, R, Lund, V, Brown, P, Copley, L, Browne, J. Long-term outcomes from the English national comparative audit of surgery for nasal polyposis and chronic rhinosinusitis. Laryngoscope 2009;119:2459–65CrossRefGoogle ScholarPubMed
Bajaj, Y, Sethi, N, Carr, S, Knight, LC. Endoscopic sinus surgery as day-case procedure. J Laryngol Otol 2009;123:619–22CrossRefGoogle ScholarPubMed
Albritton, FD, Casiano, RR, Sillers, MJ. Feasibility of in-office endoscopic sinus surgery with balloon sinus dilation. Am J Rhinol Allergy 2012;26:243–8CrossRefGoogle ScholarPubMed
Caulley, L, Lasso, A, Rudmik, L, Kilty, SJ. Pre-treatment SNOT-22 score predicts response to Endoscopic Polypectomy in Clinic (EPIC): our experience in 30 adults. Clin Otolaryngol 2017;42:732–4CrossRefGoogle ScholarPubMed
Gan, EC, Habib, AR, Hathorn, I, Javer, AR. The efficacy and safety of an office-based polypectomy with a vacuum-powered microdebrider. Int Forum Allergy Rhinol 2013;3:890–5CrossRefGoogle ScholarPubMed
Scott, JR, Sowerby, LJ, Rotenberg, BW. Office-based rhinologic surgery: a modern experience with operative techniques under local anesthetic. Am J Rhinol Allergy 2017;31:135–8CrossRefGoogle ScholarPubMed
Kennedy, JL, Hubbard, MA, Huyett, P, Patrie, JT, Borish, L, Payne, SC. Sino-nasal outcome test (SNOT-22): a predictor of postsurgical improvement in patients with chronic sinusitis. Ann Allergy Asthma Immunol 2013;111:246–51.e2CrossRefGoogle ScholarPubMed
Psaltis, AJ, Li, G, Vaezeafshar, R, Cho, K-S, Hwang, PH. Modification of the Lund-Kennedy endoscopic scoring system improves its reliability and correlation with patient-reported outcome measures. Laryngoscope 2014;124:2216–23CrossRefGoogle ScholarPubMed
Tang, D, Lobo, BC, D'Anza, B, Woodard, TD, Sindwani, R. Advances in microdebrider technology: improving functionality and expanding utility. Otolaryngol Clin North Am 2017;50:589–98CrossRefGoogle ScholarPubMed
Coates, ML, Carrie, S. A local safety standard for invasive procedures for out-patient endonasal procedures performed under local anaesthetic: a template from Newcastle upon Tyne hospitals. J Laryngol Otol 2019;133:441–4CrossRefGoogle ScholarPubMed
Kilty, SJ, Lasso, A, Mfuna-Endam, L, Desrosiers, MY. Case-control study of endoscopic polypectomy in clinic (EPIC) versus endoscopic sinus surgery for chronic rhinosinusitis with polyps. Rhinology 2018;56:155–7CrossRefGoogle ScholarPubMed
Rudmik, L, Smith, KA, Kilty, S. Endoscopic polypectomy in the clinic: a pilot cost-effectiveness analysis. Clin Otolaryngol 2016;41:110–17CrossRefGoogle ScholarPubMed
Larsen, K, Tos, M. A long-term follow-up study of nasal polyp patients after simple polypectomies. Eur Arch Otorhinolaryngol Suppl 1997;254:S85–8CrossRefGoogle ScholarPubMed
Wynn, R, Har-El, G. Recurrence rates after endoscopic sinus surgery for massive sinus polyposis. Laryngoscope 2004;114:811–13CrossRefGoogle ScholarPubMed
Deal, RT, Kountakis, SE. Significance of nasal polyps in chronic rhinosinusitis: symptoms and surgical outcomes. Laryngoscope 2004;114:1932–5CrossRefGoogle ScholarPubMed
Brescia, G, Barion, U, Pedruzzi, B, Cinetto, F, Giacomelli, L, Pendolino, AL et al. Sinonasal polyposis in the elderly. Am J Rhinol Allergy 2016;30:153–6CrossRefGoogle ScholarPubMed
Lou, H, Meng, Y, Piao, Y, Wang, C, Zhang, L, Bachert, C. Predictive significance of tissue eosinophilia for nasal polyp recurrence in the Chinese population. Am J Rhinol Allergy 2015;29:350–6CrossRefGoogle ScholarPubMed
Vlaminck, S, Vauterin, T, Hellings, PW, Jorissen, M, Acke, F, Van Cauwenberge, P et al. The importance of local eosinophilia in the surgical outcome of chronic rhinosinusitis: a 3-year prospective observational study. Am J Rhinol Allergy 2014;28:260–4CrossRefGoogle ScholarPubMed
Honma, A, Takagi, D, Nakamaru, Y, Homma, A, Suzuki, M, Fukuda, S. Reduction of blood eosinophil counts in eosinophilic chronic rhinosinusitis after surgery. J Laryngol Otol 2016;130:1147–52CrossRefGoogle ScholarPubMed
Tsuzuki, K, Hashimoto, K, Okazaki, K, Nishikawa, H, Sakagami, M. Predictors of disease progression after endoscopic sinus surgery in patients with chronic rhinosinusitis. J Laryngol Otol 2019;133:678–84CrossRefGoogle ScholarPubMed
Li, QC, Cheng, KJ, Wang, F, Zhou, SH. Role of atopy in chronic rhinosinusitis with nasal polyps: does an atopic condition affect the severity and recurrence of disease? J Laryngol Otol 2016;130:640–4CrossRefGoogle ScholarPubMed
Finkensieper, M, Poller, K, Wittekindt, C, Meissner, W, Guntinas-Lichius, O. Postoperative pain assessment after functional endoscopic sinus surgery (FESS) for chronic pansinusitis. Eur Arch Otorhinolaryngol 2013;270:157–66CrossRefGoogle ScholarPubMed
Rezaeian, A. Administering of pregabalin and acetaminophen on management of postoperative pain in patients with nasal polyposis undergoing functional endoscopic sinus surgery. Acta Otolaryngol 2017;137:1249–52CrossRefGoogle ScholarPubMed
Yu, MS, Kang, S-H, Kim, B-H, Lim, DJ. Effect of aerosolized fibrin sealant on hemostasis and wound healing after endoscopic sinus surgery: a prospective randomized study. Am J Rhinol Allergy 2014;28:335–40CrossRefGoogle ScholarPubMed
Dadgarnia, M, Meybodian, M, Karbasi, A, Baradaranfar, M, Atighechi, S, Zand, V et al. Comparing nasal packing with trans-septal suturing following septoplasty: a randomized clinical trial. Eur Arch Otorhinolaryngol 2017;274:3513–18CrossRefGoogle ScholarPubMed
Eren, SB, Tugrul, S, Dogan, R, Ozucer, B, Ozturan, O. Objective and subjective evaluation of operation success in patients with nasal septal deviation based on septum type. Am J Rhinol Allergy 2014;28:e158–62CrossRefGoogle ScholarPubMed
Kim, J-Y, Cha, M-J, Kwon, S-S, Kim, D-K. Factors that contribute to disagreement in satisfaction between surgeons and patients after corrective septorhinoplasty. Am J Rhinol Allergy 2017;31:416–19CrossRefGoogle ScholarPubMed
Colclasure, JC, Gross, CW, Kountakis, SE. Endoscopic sinus surgery in patients older than sixty. Otolaryngol Head Neck Surg 2004;131:946–9CrossRefGoogle ScholarPubMed
Ban, JH, Kwon, HJ, Lee, KC. Outcomes of endoscopic sinus surgery in an elderly population: comparison with those in an adult population. Clin Otolaryngol 2010;35:300–6CrossRefGoogle Scholar