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Chronic rhinosinusitis (CRS) is a common disease that restricts the quality of life of millions of involved patients. The aim of the study was to evaluate how functional endoscopic sinus surgery (FESS) modifies patients symptom profile and to also confirm that FESS is the modality of treatment in patients with refractory CRS. The study was retrospe...
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Context 1
... there were no permanent sequelae encountered. The overall patient satisfaction postoperatively at the end of 6 months was high (Table 3) (86.66%, P \ 0.001)0.7 patients had no change, 4 felt worse and three patients were lost in followup. ...
Context 2
... of them with headache had improvement. 86.41% with anosmia, 87.01% with facial pressure/pain, 86.48% with post nasal drip and 85.24% with purulent nasal discharge, showed improvement after surgery at the end of 6 month followup (Table 3). Purulent nasal discharge responded the least after FESS. ...
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Citations
... According to the world health organization, health is a multidimensional concept that encompasses physical, social, and mental states of being. 11 The QOL is assessed using the SNOT-20 questionnaire which contains 20 parameters, and each one is scored from 0-5. The score is then summed and the total score obtained before and after FESS were compared. ...
... requiring no medical treatment after the initial postoperative period. 11 According to Mishra et al, the overall success rate after surgery on patient's own evaluation was found to be 94%, which is significant (p<0.05). 9 ...
Background: Chronic sinusitis (CRS) includes all inflammatory diseases of the nose and paranasal sinuses with a minimum duration of 12 weeks. Physical examination (anterior rhinoscopy, endoscopy) and/or radiography, ideally from sinus computed tomography, can provide objective proof of the same. After failure of conservative treatment, functional endoscopic sinus surgery (FESS) is the preferred modality for chronic rhinosinusitis that has been frequently used over the past years. Methods: The present prospective study aimed to assess the quality of life (QOL), the nasal endoscopy scores- before and after FESS in 60 patients aged more than 18 years suffering from chronic rhinosinusitis. QOL was assessed using SNOT-20 questionnaire and endoscopy was quantified using Lund-Kennedy sinonasal endoscopy scoring system. Results: QOL scores were significantly higher (p<0.001) before surgery (41.28±15.30) than after FESS (6.83±5.96) indicating improvement in QOL. Lund-Kennedy endoscopy scores of patients suffering from chronic rhinosinusitis before and after surgery was also significantly reduced (p<0.001). Conclusions: This study concludes that there is significant improvement in the QOL and reduction in the severity of symptoms in patients suffering from chronic rhinosinusitis after FESS.
... In our study, we found the effectiveness and comprehensiveness of FESS that resulted in significant improvement in mucociliary clearance of all patients of CRS from 45% preoperatively to 85% postoperatively after 3 months. 19 Another study was conducted by Rudmik and Smith depicting the status of mucociliary clearance pre-and postoperatively after FESS. They employed saccharine test and concluded that around 65-80% of patients suffering from CRS showed characteristic improvement only after FESS irrespective of undergoing long-term medical treatment. ...
Introduction: Mucociliary clearance is a nonspecific defense mechanism that removes mucus and other materials from the nose and lungs. During functional endoscopic sinus surgery (FESS) sometimes there is damage to a lot of healthy sinonasal mucosa. This study was carried out to measure the outcome of mucociliary clearance test before and after FESS. Materials and methods: Study group included 44 patients diagnosed with chronic rhinosinusitis (CRS) posted for FESS. Mucociliary clearance testing was performed with saccharine pellets. Observations: The age of patients ranged between 10 and 80 years with 25% between 20 and 30 years and 20% between 30 and 40 years of age. Forty percent of patients had bilateral nasal obstruction as the primary nasal complaint. Nasal discharge was seen in 30% of patients. One-third of patients had complete loss of smell. It was observed that the mean time taken for the concentration of saccharine appreciation in the oropharynx for mucociliary clearance preoperative was 58 minutes.
... ESS has been a widely adopted therapeutic modality for CRS, especially in cases refractory to medical treatment, with variable long-term results (64) . Its beneficial effect on QoL appears to be more pronounced in patients with nasal polyposis and asthma (65,66) . ...
Abstract Background: Chronic rhinosinusitis has been shown to have a significant impact on patients’ quality of life (QoL). We present and summarize current knowledge on assessment methods of Chronic Rhinosinusitis (CRS) burden and QoL.Methodology: Review of the literature using the PubMed database (search of terms “chronic rhinosinusitis”, “CRS”, “quality of life”, “QoL”, “outcome measures”, “assessment of CRS”, “CRS burden” separately or combined) limited to articles published in the English language.Results: Despite the plethora of objective methods available to assess and quantify burden of CRS, discrepancies are occasionally encountered when correlation with subjective measures of QoL is attempted via numerous patient self-reporting tools.Conclusion: CRS has a detrimental effect on QoL and assessing disease severity and burden is a difficult goal. The applicability of known assessment methodologies should be re-evaluated and validated according to research findings on CRS pathophysiology, and new tools should be developed based on the emerging knowledge and the need for personalized treatment and evaluation methods.Key words: chronic rhinosinusitis, QoL, burden of disease, outcome measures, disease-specific QoL questionnaires
(3) (PDF) Assessing quality of life and burden of disease in chronic rhinosinusitis: a review. Available from: https://www.researchgate.net/publication/333254771_Assessing_quality_of_life_and_burden_of_disease_in_chronic_rhinosinusitis_a_review [accessed Mar 13 2020].
... Bhattacharya N et al (16) had 51.8% patients with nasal block. Mohammed Naieni et al (20) had 79.31% and T Shivakumar et al (21) had 86.66% patients with nasal block. Y Bajaj et al (22) and S P Gulati et al (15) showed the most common symptom as nasal block. ...
... D Hastan et al (24) had 64.7% patients with facial pain. T Shivakumar et al (21) had 73.3% patients with facial pain; 57% patients presented with facial congestion in our study. Bhattacharya N et al (23) had approximately 47% patients with facial congestion. ...
... Francis T K et al (14) had 79% patients with facial congestion. In this study, 59% of patients had history of nasal discharge which coincides with the study of T Shivakumar et al (21) where 58.09% patients had nasal discharge. Mohammed Naiemi et al (20) had 75.64% patients with nasal discharge. ...
... condition and surgeon's judgment. FESS, often coupled with septoplasty, is aimed to re-establish adequate nasal aerial flow, to increase sinus ventilation and to improve sinus drainage [9,19,24]. ...
The article focuses on the robustness of a CFD-based procedure for the quantitative evaluation of the nasal airflow. CFD ability to yield robust results with respect to the unavoidable procedural and modeling inaccuracies must be demonstrated to allow this tool to become part of the clinical practice in this field. The present article specifically addresses the sensitivity of the CFD procedure to the spatial resolution of the available CT scans, as well as to the choice of the segmentation level of the CT images. We found no critical problems concerning these issues; nevertheless, the choice of the segmentation level is potentially delicate if carried out by an untrained operator.
p class="abstract"> Background: Chronic rhinosinusitis (CRS) is a common chronic disease, that have considerable impact on quality of life, functional and emotional impairments of affected beings. Post-surgical improvement of quality of life indicates the surgical success. Functional endoscopic sinus surgery (FESS) is the dominating surgical procedure for CRS. This study was designed to assess the symptom profile of patient before and after surgery and the complications after FESS in the post-operative period.
Methods: A total of 50 cases attending ENT outpatient department with clinical features and investigations suggestive of chronic sinusitis with infective pathology were randomly considered for this study. Cases were assessed for CRS symptoms pre and post operatively using grading symptoms.
Results: Common major symptom was nasal obstruction (93.3%, N=28) followed by post nasal drip (83.33%, N=25), purulent nasal discharge (76.66%, N=23), facial pain/pressure (66.66%, N=20) and hyposmia (60%, N=18). None of the patients reported fever and facial congestion or fullness. Post operatively, cases with nasal obstruction (92.8%), purulent nasal discharge (86.9%), facial pain or pressure (85%), headache (81.8%), post nasal drip (84%), ear pain or fullness or pressure (92.8%) and hyposmia (61.1%) showed improvement after FESS at the end of three follow-up.
Conclusions: The most common symptom pre operatively was nasal obstruction which also responded best to FESS, along with all the other minor symptoms including headache. The results of this study confirm that FESS is an excellent method of treatment in patients with CRS refractory to medical treatment.</p
Chronic rhinosinusitis (CRS) significantly affect the quality of life (QoL) of patients. The study was conducted in CRS patients who were treated with functional endoscopic sinus surgery (FESS) after failure of medical treatment to analyze clinical outcome using prospectively collected data through a symptom-based rhinosinusitis outcome measure, the Sino-nasal Outcome Test-22 (SNOT-22). The aim of the study was to evaluate and compare the QoL in patients of chronic rhinosinusitis pre-operative and after FESS by SNOT-22. The prospective study was conducted on 40 patients of chronic rhinosinusitis with or without nasal polyposis. Demographic, clinical, diagnostic nasal endoscopy and radiological findings were recorded. Visual analogue scoring and SNOT-22 questionnaire scoring were done preoperatively and at 3rd and 6th months post-operatively. These scores were compared and a value of p < 0.01 was considered statistical significant. Nasal obstruction (80%) was the most commonly reported disabling condition followed by rhinorrhea (75%), facial pain-pressure (72.5%), headache and sneezing. The mean preoperative nasal endoscopy score was 8.08 ± 3.65. The mean preoperative Lund Mackay CT scan score was 11.725 ± 3.64. The mean preoperative SNOT-22 score was 46.25 ± 20.44. After FESS, nasal discharge was improved in 86% patients. Average VAS scores showed significant postoperative improvement at 6 months (p < 0.01). The mean postoperative diagnostic nasal endoscopy score improved to 2.80 ± 1.64 at 6 months (p < 0.01). The mean postoperative SNOT-22 scores decreased at postoperative follow up visits at 3 and 6 months to 14.58 ± 4.90 at 3 months and 22.38 ±7.93 at 6 months (p < 0.01). CRS patient refractory to medical treatment showed statistical significant improvement after FESS. The SNOT-22 scoring was easy to use scoring used for QoL assessment showed significant improvement after FESS.
To correlate Saccharin clearance time before and after endoscopic sinus surgery (ESS) in chronic maxillary sinusitis patients. Hospital based prospective study done in the department of otorhinolaryngology at our tertiary care hospital from January 2017 to December 2017. We selected 40 patients based on inclusion and exclusion criteria. Saccharin clearance time was measured by the subjective perception of sweet taste following placement of saccharin pellet over the anterior end of inferior turbinate. It was measured preoperatively and postoperatively after 3 months of ESS and the values are compared with normal uninvolved sinuses of the patients. Out of 40 patients, 26 were male and 14 were female. Normal Saccharin Clearance Time was found to be 9.50 and 9.89 min with a standard deviation of 2.76 and 2.62 on the left and right side respectively. There was no significant difference between right and left side mucociliary clearance values. The respective mean preoperative and postoperative mucociliary clearance values of right and left side together were 39.5 min and 17.6 min among unilateral maxillary sinusitis patients, 49.69 min and 20.87 min among unilateral CRS with polyposis patients, 69.42 min and 25.97 min among bilateral maxillary sinusitis patients, 63.71 min and 24.21 min among CRS with bilateral polyposis patients. ESS not only treats the pathology of paranasal sinuses but also helps in returning the normal mucociliary function.
Chronic inflammatory disorders of the upper airways are extremely prevalent and have a major impact on public health. Sinusitis and bronchial asthma are closely interrelated diseases and sinusitis is known to influence bronchial asthma in its severity and chronicity. Causal relationships have been proposed but not yet proved. The relationship between sinusitis and asthma is academically interesting and has important diagnostic and therapeutic implications. The present study is designed to evaluate the efficacy of functional endoscopic sinus surgery done as treatment for chronic rhinosinusitis on bronchial asthma patients, in terms of quality of life and pattern of improvement. Objectives of the study were to determine whether bronchial asthma and quality of life improved after functional endoscopic sinus surgery. This was an open labelled randomised control trial, done at ENT Department of Medical College, Thiruvananthapuram. Those in Group A underwent functional endoscopic sinus surgery and group B patients were given only medicines as per standard protocol. All of them received asthma treatment depending on asthma attacks and severity and followed up at specific intervals. Quality of life status and pattern of improvement of bronchial asthma among these patients were evaluated. Patients of chronic rhinosinusitis treated by functional endoscopic sinus surgery showed significant improvement in the mean asthma symptom score, asthma medication use score, pulmonary function test results, and quality of life assessment scores. Functional endoscopic sinus surgery could be considered early in the natural course of chronic rhinosinusitis with concomitant bronchial asthma.
