Our Summary

This research paper is about a study that looked at the effectiveness of a specific type of sinus surgery, called large cavity functional endoscopic sinus surgery, for patients who have chronic sinusitis with nasal polyps and whose symptoms get worse when they take non-steroidal anti-inflammatory drugs (like aspirin).

The researchers looked back at the records of patients who had this surgery between January 2016 and March 2022. They checked things like the patients’ characteristics, how many surgeries they had before and after the study, the size of their nasal polyps, their Lund-Mackay score (a way to measure how severe their sinusitis is), and their nasal symptoms.

The study included 13 patients who were around 47 years old on average. All of these patients had tried other treatments, including medications and a less invasive type of surgery, without success before they had the large cavity sinus surgery. After the surgery, they all continued to take medications.

The results showed that all the patients had improved symptoms and better Lund-Mackay scores after the surgery. They were followed up for about 1.5 years on average.

The researchers concluded that this type of sinus surgery may stop the worsening of chronic sinusitis with nasal polyps for patients who react badly to non-steroidal anti-inflammatory drugs. The surgery, combined with continued medication use after the operation, appeared to effectively treat the sinusitis and nasal polyps in these patients.

FAQs

  1. What is the role of large cavity functional endoscopic sinus surgery in managing chronic rhinosinusitis with nasal polyps?
  2. How does large cavity functional endoscopic sinus surgery affect nasal symptoms and Lund-Mackay scores in patients with non-steroidal anti-inflammatory drug-exacerbated respiratory disease?
  3. What were the general results and conclusions from the retrospective review of patients undergoing large cavity functional endoscopic sinus surgery for non-steroidal anti-inflammatory drug-exacerbated respiratory disease?

Doctor’s Tip

One helpful tip a doctor might tell a patient about sinus surgery is to follow all post-operative care instructions carefully, including taking any prescribed medications and attending follow-up appointments. It is important to communicate any concerns or changes in symptoms to your doctor promptly to ensure the best possible outcome from the surgery.

Suitable For

Patients who are typically recommended sinus surgery are those with chronic rhinosinusitis with nasal polyps, particularly in cases where the condition is exacerbated by non-steroidal anti-inflammatory drugs. These patients may have failed maximal medical treatment and/or conservative functional endoscopic sinus surgery, and may benefit from large cavity functional endoscopic sinus surgery followed by post-operative maximal medical therapy. The surgery can help improve nasal symptoms and halt the progression of the disease. Patients with conditions such as asthma and aspirin sensitivity may also benefit from sinus surgery in these cases.

Timeline

Before sinus surgery:

  • Patients experience symptoms of chronic rhinosinusitis with nasal polyps, such as nasal congestion, facial pain, and reduced sense of smell.
  • Patients may have tried various medical treatments, including steroids and antibiotics, without significant improvement.
  • Patients may undergo imaging studies, such as a CT scan, to assess the extent of sinus disease.
  • Patients may have a functional endoscopic sinus surgery (FESS) to remove polyps and open up the sinus cavities.

After sinus surgery:

  • Patients undergo large cavity functional endoscopic sinus surgery for non-steroidal anti-inflammatory drug exacerbated respiratory disease.
  • Patients receive post-operative maximal medical therapy to manage symptoms and prevent recurrence.
  • Patients experience improvement in nasal symptoms and see improved Lund-Mackay scores on follow-up visits.
  • Patients have regular follow-up appointments to monitor their progress and ensure long-term success of the surgery.

What to Ask Your Doctor

  1. What is the goal of large cavity functional endoscopic sinus surgery in managing chronic rhinosinusitis with nasal polyps in patients with non-steroidal anti-inflammatory drug exacerbated respiratory disease?
  2. What are the potential risks and complications associated with this type of sinus surgery?
  3. How long is the recovery process typically after large cavity functional endoscopic sinus surgery?
  4. How long do the benefits of the surgery typically last for patients with non-steroidal anti-inflammatory drug exacerbated respiratory disease?
  5. What is the expected outcome in terms of improvement in nasal symptoms and quality of life after the surgery?
  6. Will additional treatments or medications be needed after the surgery to maintain the results?
  7. How often will follow-up appointments be needed after the surgery?
  8. Are there any lifestyle changes or precautions that should be taken after the surgery to prevent recurrence of symptoms?
  9. Are there any specific criteria or factors that would make a patient a good candidate for large cavity functional endoscopic sinus surgery in this context?
  10. Are there any alternative treatment options that should be considered before proceeding with sinus surgery?

Reference

Authors: Pendolino AL, Bandino F, Navaratnam A, Ross T, Qureishi A, Randhawa P, Andrews P. Journal: J Laryngol Otol. 2023 Aug;137(8):883-889. doi: 10.1017/S0022215122002468. Epub 2022 Nov 29. PMID: 36443933