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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
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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

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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