Repetitive endoscopic sinus surgery failure: a role for radical surgery?

Autor: Videler WJ; Department of Otorhinolaryngology-Head and Neck Surgery, Academic Medical Center, Amsterdam, The Netherlands. W.J.Videler@amc.uva.nl, Wreesmann VB, van der Meulen FW, Knegt PP, Fokkens WJ
Jazyk: angličtina
Zdroj: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery [Otolaryngol Head Neck Surg] 2006 Apr; Vol. 134 (4), pp. 586-91.
DOI: 10.1016/j.otohns.2005.11.013
Abstrakt: Objectives: Endoscopic sinus surgery (ESS) is considered to be the golden standard for surgery in patients with chronic rhinosinusitis and nasal polyposis. However, there is still a small group of patients unresponsive despite repetitive surgery. Radical surgery aimed at reduction of the inflammatory burden and optimization of drainage of the sinuses has been suggested as a last resort for these patients.
Study Design: A prospective, questionnaire-based study was conducted in a group of 23 patients who underwent Denker's procedure for refractory chronic rhinosinusitis. Symptoms were evaluated before Denker's procedure and 12 months and 2 years after surgery.
Results: Patients reported improvement of feelings of congestion in 74%, rhinorrhea in 70%, and nasal obstruction in 60% of the cases. The following postoperative improvements were statistically significant: rhinorrhea (P = 0.001), feelings of congestion (P = 0.02), and nasal obstruction (P = 0.03). Reduced olfactory perception and asthma did not improve.
Conclusion: Radical surgery may be a viable treatment option in case of recurrent ESS failure.
Ebm Rating: C-4.
Databáze: MEDLINE
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