Our Summary

This research paper is about a study on the outcomes of endoscopic sinus surgery (ESS) for different types of chronic rhinosinusitis (CRS), a condition where the cavities around nasal passages become inflamed. The researchers looked at the medical records of 424 adult CRS patients who had ESS between 2010 and 2015. They found that most of the patients (73%) couldn’t be specifically categorized into a subtype of CRS, but the remaining 27% could be categorized into different subtypes including aspirin-exacerbated respiratory disease (AERD), allergic fungal sinusitis (AFS), immunodeficiency, and two types of conditions involving inflammation of the blood vessels.

The researchers found that all types of CRS showed significant improvement after the surgery, as measured by a test that evaluates symptoms of sinusitis. They also found that 4% of the patients needed to have the surgery again. The rate of needing another surgery was slightly higher for CRS patients without nasal polyps (5.1%) compared to those with nasal polyps (3.5%). Among the different subtypes, patients with immunodeficiency and a type of inflammation of the blood vessels had a higher rate of needing another surgery.

In conclusion, the researchers suggest that understanding the different types of CRS can help to improve the outcomes of ESS. They also suggest that more research is needed for patients with CRS without nasal polyps who have immunodeficiency and a certain type of inflammation of the blood vessels.

FAQs

  1. What were the findings of the research study on outcomes of endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS)?
  2. Did the study find any difference in the need for reoperation among different subtypes of CRS?
  3. Why do the researchers suggest it is important to understand the different types of CRS?

Doctor’s Tip

A helpful tip a doctor might tell a patient about sinus surgery is to follow post-operative care instructions carefully, including keeping the nasal passages clean and moist, avoiding strenuous activities, and attending follow-up appointments with your healthcare provider. Additionally, it is important to maintain good overall health habits, such as staying hydrated, getting enough rest, and avoiding allergens or irritants that may worsen sinus symptoms. By following these recommendations, patients can help ensure a successful recovery and long-term improvement in their sinus condition.

Suitable For

Therefore, patients who are typically recommended sinus surgery include those with chronic rhinosinusitis (CRS) who have not responded well to other treatments, have severe symptoms, or have specific subtypes of CRS such as aspirin-exacerbated respiratory disease (AERD), allergic fungal sinusitis (AFS), immunodeficiency, or certain types of inflammation of the blood vessels. It is important for healthcare providers to carefully evaluate each patient’s individual condition and subtype of CRS to determine if sinus surgery is the best course of treatment for them.

Timeline

Timeline of patient experiences before and after sinus surgery:

Before surgery:

  • Patient experiences symptoms of chronic rhinosinusitis such as nasal congestion, facial pain, headache, and decreased sense of smell.
  • Patient may undergo various tests and treatments such as nasal steroid sprays, antibiotics, and allergy medications.
  • Patient may be referred to an otolaryngologist (ENT doctor) for further evaluation and consideration of sinus surgery.

During surgery:

  • Patient undergoes endoscopic sinus surgery (ESS) to remove blockages in the sinus cavities and improve drainage.
  • Surgery is typically performed under general anesthesia and may involve the use of small cameras and instruments inserted through the nostrils.

After surgery:

  • Patient may experience some discomfort, swelling, and congestion in the days following surgery.
  • Patient may need to use nasal saline rinses and follow post-operative care instructions provided by their surgeon.
  • Patient will have follow-up appointments with their surgeon to monitor healing and address any concerns.
  • Patient should gradually experience improvement in symptoms such as improved breathing, reduction in facial pain, and improved sense of smell.

Overall, the goal of sinus surgery is to improve the quality of life for patients with chronic rhinosinusitis by relieving symptoms and improving sinus function.

What to Ask Your Doctor

  1. What specific type of chronic rhinosinusitis do I have, and how will this impact the outcome of the surgery?
  2. What are the potential risks and complications associated with sinus surgery?
  3. How long is the recovery period, and what can I expect in terms of pain and discomfort after the surgery?
  4. Will I need any follow-up procedures or treatments after the surgery?
  5. How successful is sinus surgery in improving symptoms of chronic rhinosinusitis in general, and specifically for my subtype of the condition?
  6. Are there any lifestyle changes or medications I should consider post-surgery to prevent recurrence of symptoms?
  7. Will I need any additional tests or evaluations before undergoing sinus surgery?
  8. How experienced are you in performing endoscopic sinus surgery, and what is your success rate with patients who have similar conditions to mine?
  9. Are there any alternative treatments or therapies I should consider before opting for sinus surgery?
  10. How long do the effects of sinus surgery typically last, and what can I do to maintain the benefits of the surgery long-term?

Reference

Authors: Miglani A, Divekar RD, Azar A, Rank MA, Lal D. Journal: Int Forum Allergy Rhinol. 2018 Sep;8(9):1047-1051. doi: 10.1002/alr.22146. Epub 2018 May 31. PMID: 29851243