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The effectiveness of endoscopic sinus surgery in nasal polyposis

Year 2008, Volume: 18 Issue: 5, 306 - 311, 10.10.2008

Abstract

Objectives: We evaluated the effectiveness and outcomes of functional endoscopic sinus surgery in the treatment of nasal polyposis. Patients and Methods: The study included 407 patients 262 males, 145 females; mean age 42±12 years; range 20 to 76 years with nasal polyposis. Of these, 102 patients 25% had asthma, 25 patients 6.1% had asthma and aspirin sensitivity, and 142 patients 34.8% had anatomic variations. The patients were operated on using the Messerklinger and Wigand techniques. Functional endoscopic sinus surgery was performed bilaterally. Evaluations were made preoperatively and at six months by endoscopic examination and paranasal sinus computed tomography LundMackay score . Postoperatively, the patients were treated with nasal irrigation and topical steroid spray. Results: Following surgery, the mean computed tomography score decreased from preoperative 17.0±4.3 to 8.5±4.7. Major complication occurred in one patient. Nasal mucosal adhesion was the most frequent minor complication 5.4% . Nasal polyposis recurred in 78 patients 19.1% , of whom 57 patients underwent revision surgery. Conclusion: Our data show that functional endoscopic sinus surgery combined with corticosteroid administration is effective in the treatment of nasal polyposis.

References

  • Bernstein JM, Gorfien J, Noble B. Role of allergy in nasal polyposis: a review. Otolaryngol Head Neck Surg 1995;113:724-32.
  • Bateman ND, Fahy C, Woolford TJ. Nasal polyps: still more questions than answers. J Laryngol Otol 2003; 117:1-9.
  • Stammberger H. Surgical treatment of nasal polyps: past, present, and future. Allergy 1999;54 Suppl 53:7-11.
  • Erkan AN, Tarhan E, Yilmazer C, Cagici A, Cakmak O. Endoscopic removal of sinonasal tumors. [Article in Turkish] Kulak Burun Bogaz Ihtis Derg 2006;16:72-9.
  • Lund VJ, Mackay IS. Staging in rhinosinusitus. Rhinology 1993;31:183-4.
  • Rasp G, Kramer MF, Ostertag P, Kastenbauer E. A new system for the classification of ethmoid polyposis. Effect of combined local and systemic steroid therapy. Laryngorhinootologie 2000;79:266-72.
  • Bachert C, Gevaert P, Holtappels G, Cuvelier C, van Cauwenberge P. Nasal polyposis: from cytokines to growth. Am J Rhinol 2000;14:279-90.
  • Larsen K. The clinical relationship of nasal polyps to asthma. In: Settipane GA, Lund VJ, Bernstein JM, Tos M, editors. Nasal polyps: epidemiology, patho- genesis and treatment. Providence, RI: Ocean Side Publications; 1997. p. 97-104.
  • Drake-Lee AB, Lowe D, Swanston A, Grace A. Clinical profile and recurrence of nasal polyps. J Laryngol Otol 1984;98:783-93.
  • Senior BA, Kennedy DW, Tanabodee J, Kroger H, Hassab M, Lanza D. Long-term results of functional endoscopic sinus surgery. Laryngoscope 1998;108:151-7.
  • Levine HL. Functional endoscopic sinus surgery: evaluation, surgery, and follow-up of 250 patients. Laryngoscope 1990;100:79-84.
  • Gosepath J, Mann WJ. Current concepts in therapy of chronic rhinosinusitis and nasal polyposis. ORL J Otorhinolaryngol Relat Spec 2005;67:125-36.
  • Klossek JM, Peloquin L, Friedman WH, Ferrier JC, Fontanel JP. Diffuse nasal polyposis: postoperative long-term results after endoscopic sinus surgery and frontal irrigation. Otolaryngol Head Neck Surg 1997;117:355-61.
  • Wynn R, Har-El G. Recurrence rates after endo- scopic sinus surgery for massive sinus polyposis. Laryngoscope 2004;114:811-3.
  • Schaefer SD, Manning S, Close LG. Endoscopic para- nasal sinus surgery: indications and considerations. Laryngoscope 1989;99:1-5.
  • Uslu C, Gürsan Ö, Oysu Ç, Koldaş Ç, Türk Ö, Öğrendik EA. Kronik sinüzitli hastalarda endoskopik sinüs cer- rahisi sonuçlarımız. KBB ve BBC Dergisi 2006;14:33-8.
  • Ceylan S, Köroğlu U, Yazıcı MF, Güvener G, Serin B, Güder F. Endoskopik sinüs cerrahisi sonuçlarımız. Turk Arch Otolaryngol 2004;42:93-7.
  • Stoop AE, van der Heijden HA, Biewenga J, van der Baan S. Clinical aspects and distribution of immuno- logically active cells in the nasal mucosa of patients with nasal polyps after endoscopic sinus surgery and treatment with topical corticosteroids. Eur Arch Otorhinolaryngol 1992;249:313-7.
  • Kennedy DW. Middle turbinate resection: evaluating the issues-should we resect normal middle turbinates? Arch Otolaryngol Head Neck Surg 1998;124:107.
  • Lale AM, Mason JD, Jones NS. Mucociliary transport and its assessment: a review. Clin Otolaryngol Allied Sci 1998;23:388-96.
  • Stammberger H, Posawetz W. Functional endoscopic sinus surgery. Concept, indications and results of the Messerklinger technique. Eur Arch Otorhinolaryngol 1990;247:63-76.
  • Sobol SE, Wright ED, Frenkiel S. One-year outcome analysis of functional endoscopic sinus surgery for chronic sinusitis. J Otolaryngol 1998;27:252-7.
  • Dursun E, Bayiz U, Korkmaz H, Akmansu H, Uygur K. Follow-up results of 415 patients after endoscopic sinus surgery. Eur Arch Otorhinolaryngol 1998;255:504-10.
  • Hebert RL 2nd, Bent JP 3rd. Meta-analysis of out- comes of pediatric functional endoscopic sinus sur- gery. Laryngoscope 1998;108:796-9.
  • Schaitkin B, May M, Shapiro A, Fucci M, Mester SJ. Endoscopic sinus surgery: 4-year follow-up on the first 100 patients. Laryngoscope 1993;103:1117-20.
  • Aktürk T, Meco C. Nazal polipli hastalarda cerrahi tedavi. Turkiye Klinikleri J Surg Med Sci 2006;2:38-48.
  • Jiang RS, Hsu CY. Functional endoscopic sinus surgery in children and adults. Ann Otol Rhinol Laryngol 2000;109:1113-6.

Nazal polipoziste endoskopik sinüs cerrahisinin etkinliği

Year 2008, Volume: 18 Issue: 5, 306 - 311, 10.10.2008

Abstract

Amaç: Nazal polipozisli hastalarda uygulanan fonksiyonel endoskopik sinüs cerrahisinin etkinliği ve sonuçları değerlendirildi.Hastalar ve Yöntemler: Çalışmada nazal polipozisli 407 hasta değerlendirildi. Bu hastaların 102’sinde %25 astım, 25’inde %6.1 astım ve aspirin hipersensitivitesi, 142’sinde %34.8 anatomik varyasyon saptandı. Cerrahi tedavide Messerklinger ve Wigand teknikleri uygulandı. Fonksiyonel endoskopik sinüs cerrahisi tekniği iki taraflı uygulandı. Hastalar ameliyat öncesinde ve ameliyattan altı ay sonra endoskopik nazal muayene ve paranazal sinüs bilgisayarlı tomografisi Lund-Mackay skoru ile değerlendirildi. Ameliyat sonrasında nazal yıkama ve topikal steroid tedavisi uygulandı.Bulgular: Ameliyat öncesinde ortalama 17.0±4.3 olan bilgisayarlı tomografi puanı ameliyat sonrasında 8.5±4.7’ye geriledi. Bir hastada majör komplikasyon gelişti. Nazal mukozada yapışıklık en sık görülen komplikasyon %5.4 idi. Nazal polipozis 78 hastada %19.1 nüks etti. Nüks görülen hastaların 57’si yeniden ameliyat edildi.Sonuç: Çalışmamız, fonksiyonel endoskopik sinüs cerrahisinin ve sonrasında kortikosteroid uygulamasının nazal polipozis tedavisinde etkili olduğunu göstermektedir

References

  • Bernstein JM, Gorfien J, Noble B. Role of allergy in nasal polyposis: a review. Otolaryngol Head Neck Surg 1995;113:724-32.
  • Bateman ND, Fahy C, Woolford TJ. Nasal polyps: still more questions than answers. J Laryngol Otol 2003; 117:1-9.
  • Stammberger H. Surgical treatment of nasal polyps: past, present, and future. Allergy 1999;54 Suppl 53:7-11.
  • Erkan AN, Tarhan E, Yilmazer C, Cagici A, Cakmak O. Endoscopic removal of sinonasal tumors. [Article in Turkish] Kulak Burun Bogaz Ihtis Derg 2006;16:72-9.
  • Lund VJ, Mackay IS. Staging in rhinosinusitus. Rhinology 1993;31:183-4.
  • Rasp G, Kramer MF, Ostertag P, Kastenbauer E. A new system for the classification of ethmoid polyposis. Effect of combined local and systemic steroid therapy. Laryngorhinootologie 2000;79:266-72.
  • Bachert C, Gevaert P, Holtappels G, Cuvelier C, van Cauwenberge P. Nasal polyposis: from cytokines to growth. Am J Rhinol 2000;14:279-90.
  • Larsen K. The clinical relationship of nasal polyps to asthma. In: Settipane GA, Lund VJ, Bernstein JM, Tos M, editors. Nasal polyps: epidemiology, patho- genesis and treatment. Providence, RI: Ocean Side Publications; 1997. p. 97-104.
  • Drake-Lee AB, Lowe D, Swanston A, Grace A. Clinical profile and recurrence of nasal polyps. J Laryngol Otol 1984;98:783-93.
  • Senior BA, Kennedy DW, Tanabodee J, Kroger H, Hassab M, Lanza D. Long-term results of functional endoscopic sinus surgery. Laryngoscope 1998;108:151-7.
  • Levine HL. Functional endoscopic sinus surgery: evaluation, surgery, and follow-up of 250 patients. Laryngoscope 1990;100:79-84.
  • Gosepath J, Mann WJ. Current concepts in therapy of chronic rhinosinusitis and nasal polyposis. ORL J Otorhinolaryngol Relat Spec 2005;67:125-36.
  • Klossek JM, Peloquin L, Friedman WH, Ferrier JC, Fontanel JP. Diffuse nasal polyposis: postoperative long-term results after endoscopic sinus surgery and frontal irrigation. Otolaryngol Head Neck Surg 1997;117:355-61.
  • Wynn R, Har-El G. Recurrence rates after endo- scopic sinus surgery for massive sinus polyposis. Laryngoscope 2004;114:811-3.
  • Schaefer SD, Manning S, Close LG. Endoscopic para- nasal sinus surgery: indications and considerations. Laryngoscope 1989;99:1-5.
  • Uslu C, Gürsan Ö, Oysu Ç, Koldaş Ç, Türk Ö, Öğrendik EA. Kronik sinüzitli hastalarda endoskopik sinüs cer- rahisi sonuçlarımız. KBB ve BBC Dergisi 2006;14:33-8.
  • Ceylan S, Köroğlu U, Yazıcı MF, Güvener G, Serin B, Güder F. Endoskopik sinüs cerrahisi sonuçlarımız. Turk Arch Otolaryngol 2004;42:93-7.
  • Stoop AE, van der Heijden HA, Biewenga J, van der Baan S. Clinical aspects and distribution of immuno- logically active cells in the nasal mucosa of patients with nasal polyps after endoscopic sinus surgery and treatment with topical corticosteroids. Eur Arch Otorhinolaryngol 1992;249:313-7.
  • Kennedy DW. Middle turbinate resection: evaluating the issues-should we resect normal middle turbinates? Arch Otolaryngol Head Neck Surg 1998;124:107.
  • Lale AM, Mason JD, Jones NS. Mucociliary transport and its assessment: a review. Clin Otolaryngol Allied Sci 1998;23:388-96.
  • Stammberger H, Posawetz W. Functional endoscopic sinus surgery. Concept, indications and results of the Messerklinger technique. Eur Arch Otorhinolaryngol 1990;247:63-76.
  • Sobol SE, Wright ED, Frenkiel S. One-year outcome analysis of functional endoscopic sinus surgery for chronic sinusitis. J Otolaryngol 1998;27:252-7.
  • Dursun E, Bayiz U, Korkmaz H, Akmansu H, Uygur K. Follow-up results of 415 patients after endoscopic sinus surgery. Eur Arch Otorhinolaryngol 1998;255:504-10.
  • Hebert RL 2nd, Bent JP 3rd. Meta-analysis of out- comes of pediatric functional endoscopic sinus sur- gery. Laryngoscope 1998;108:796-9.
  • Schaitkin B, May M, Shapiro A, Fucci M, Mester SJ. Endoscopic sinus surgery: 4-year follow-up on the first 100 patients. Laryngoscope 1993;103:1117-20.
  • Aktürk T, Meco C. Nazal polipli hastalarda cerrahi tedavi. Turkiye Klinikleri J Surg Med Sci 2006;2:38-48.
  • Jiang RS, Hsu CY. Functional endoscopic sinus surgery in children and adults. Ann Otol Rhinol Laryngol 2000;109:1113-6.
There are 27 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Cem Saka This is me

Gökhan Kuran This is me

Erkan Vuralkan This is me

Ayhan Gökler This is me

İstemihan Akın This is me

Publication Date October 10, 2008
Published in Issue Year 2008 Volume: 18 Issue: 5

Cite

APA Saka, C., Kuran, G., Vuralkan, E., Gökler, A., et al. (2008). Nazal polipoziste endoskopik sinüs cerrahisinin etkinliği. The Turkish Journal of Ear Nose and Throat, 18(5), 306-311.
AMA Saka C, Kuran G, Vuralkan E, Gökler A, Akın İ. Nazal polipoziste endoskopik sinüs cerrahisinin etkinliği. Tr-ENT. October 2008;18(5):306-311.
Chicago Saka, Cem, Gökhan Kuran, Erkan Vuralkan, Ayhan Gökler, and İstemihan Akın. “Nazal Polipoziste Endoskopik sinüs Cerrahisinin etkinliği”. The Turkish Journal of Ear Nose and Throat 18, no. 5 (October 2008): 306-11.
EndNote Saka C, Kuran G, Vuralkan E, Gökler A, Akın İ (October 1, 2008) Nazal polipoziste endoskopik sinüs cerrahisinin etkinliği. The Turkish Journal of Ear Nose and Throat 18 5 306–311.
IEEE C. Saka, G. Kuran, E. Vuralkan, A. Gökler, and İ. Akın, “Nazal polipoziste endoskopik sinüs cerrahisinin etkinliği”, Tr-ENT, vol. 18, no. 5, pp. 306–311, 2008.
ISNAD Saka, Cem et al. “Nazal Polipoziste Endoskopik sinüs Cerrahisinin etkinliği”. The Turkish Journal of Ear Nose and Throat 18/5 (October 2008), 306-311.
JAMA Saka C, Kuran G, Vuralkan E, Gökler A, Akın İ. Nazal polipoziste endoskopik sinüs cerrahisinin etkinliği. Tr-ENT. 2008;18:306–311.
MLA Saka, Cem et al. “Nazal Polipoziste Endoskopik sinüs Cerrahisinin etkinliği”. The Turkish Journal of Ear Nose and Throat, vol. 18, no. 5, 2008, pp. 306-11.
Vancouver Saka C, Kuran G, Vuralkan E, Gökler A, Akın İ. Nazal polipoziste endoskopik sinüs cerrahisinin etkinliği. Tr-ENT. 2008;18(5):306-11.