Journal ArticleDOI
Beyond the "central sinus": radiographic findings in patients undergoing revision functional endoscopic sinus surgery.
TLDR
The purpose of this study was to identify previously incompletely dissected anatomic structures associated with mucosal thickening found in patients undergoing revision FESS for persistent or recurrent CRS.Abstract:
Background
Functional endoscopic sinus surgery (FESS) is widely used by otolaryngologists to treat chronic rhinosinusitis (CRS). The sinonasal anatomy and pathology found in patients with CRS varies widely, as does the FESS technique practiced by otolaryngologists. Variations in the completeness of cell group dissection, combined with the technical challenge of angled endoscopy, result in a wide variation of the post-FESS cavities harboring persistent disease. The purpose of this study was to identify previously incompletely dissected anatomic structures associated with mucosal thickening found in patients undergoing revision FESS for persistent or recurrent CRS.
Methods
Retrospective review of axial, coronal, and sagittal computed tomography (CT) scans of patients undergoing revision FESS by 3 fellowship-trained rhinologists at a tertiary referral center.
Results
The CT scans of 55 patients undergoing revision FESS were reviewed. The most frequent radiographic findings were residual anterior and posterior ethmoid cells or septations, found in 65% of sides and 75% of patients. In addition, residual anterior ethmoid agger nasi cells, unopened sphenoid, and residual uncinates were found in 52%, 51%, and 46% of sides, respectively. A large percentage of the patients demonstrated residual ethmoid cells present on the lamina papyracea and skull base, with a lower number found posterior to the middle turbinate basal lamella. A greater number of residual right-sided vs left-sided ethmoid cells was noted, with the difference being significant (p < 0.05) at the skull base.
Conclusion
Analysis of CT scans of patients undergoing revision FESS for persistent or recurrent CRS frequently reveals persistent anatomical structures or incompletely resected cells associated with persistent mucosal thickening. Meticulous, complete cell group dissection combined with use of angled endoscopy along with identification of possible predisposing structures may aid in the reduction of need for revision surgery.read more
Citations
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Journal ArticleDOI
Comprehensive review on endonasal endoscopic sinus surgery
Rainer Weber,Werner Hosemann +1 more
TL;DR: A comprehensive review on the most recent state of the art in endonasal endoscopic sinus surgery according to the literature is given with the following aspects: principles and fundamentals, surgical techniques, indications, outcome, postoperative care, nasal packing and stents, technical equipment.
Journal ArticleDOI
Using postoperative SNOT-22 to help predict the probability of revision sinus surgery.
TL;DR: Outcomes from this study suggest that identifying MCID changes in the SNOT-22 score within 12 months after primary ESS can identify patients at increased risk for needing revision surgery.
Journal ArticleDOI
The impact of balloon catheter dilation on frequency of sinus surgery in the United States.
TL;DR: There was no evidence that the number of distinct sinus surgeries per 100,000 people increased despite the introduction and utilization of balloon catheter dilation tools that enabled migration of sinus surgery to the office.
Journal ArticleDOI
Radiological and endoscopic findings in patients undergoing revision endoscopic sinus surgery
TL;DR: A prospective cross sectional study was conducted for 24 patients presenting for revision functional endoscopic sinus surgery (FESS), finding anatomical findings that may contribute to recurrent disease to improve the success rate in the primary surgery.
Journal ArticleDOI
What is the optimal maxillary antrostomy size during sinus surgery
TL;DR: Balloon sinuplasty can be effective in dilating the ethmoid infundibulum and natural ostium for select patients with isolated maxillary sinusitis or mild disease.
References
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Journal ArticleDOI
Staging for rhinosinusitis
Valerie J. Lund,David W. Kennedy +1 more
TL;DR: Any assessment of medical or surgical therapeutic response requires a method of quantifying disease severity that will be widely accepted by practitioners in the field, and this acceptance will largely depend on how easy the method is to apply.
Journal Article
Prognostic factors, outcomes and staging in ethmoid sinus surgery.
TL;DR: A strong correlation was identified between the extent of disease and the surgical outcome and a staging system for inflammatory sinus disease based on the extentof disease is suggested.
Journal ArticleDOI
Surgical causes of failure in endoscopic sinus surgery
TL;DR: Review of surgical causes of failure in endoscopic sinus surgery patients revealed that residual air cells and stenotic maxillary or frontal sinus ostium were the most common causes of failures.
Journal ArticleDOI
The national comparative audit of surgery for nasal polyposis and chronic rhinosinusitis
Claire Hopkins,John Browne,John Browne,Slack R,Valerie J. Lund,John Topham,Barnaby C Reeves,Lynn P. Copley,Peter Brown,J van der Meulen,J van der Meulen +10 more
TL;DR: The results of a National Audit of sino‐nasal surgery carried out in England and Wales are summarized and patient and operative characteristics as well as patient outcomes up to 36 months after surgery are described.