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Sheikh S, Ho ML, Eisner M, Gushue C, Paul G, Holtzlander M, Johnson T, McCoy KS, Lind M. Elexacaftor-Tezacaftor-Ivacaftor Therapy for Chronic Sinus Disease in Cystic Fibrosis. JAMA Otolaryngol Head Neck Surg 2023; 149:1075-1082. [PMID: 37676668 PMCID: PMC10485743 DOI: 10.1001/jamaoto.2023.2701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/10/2023] [Indexed: 09/08/2023]
Abstract
Importance Cystic fibrosis (CF) is a multiorgan genetic disease with progressive upper and lower airway involvement. The effects of CF transmembrane conductance regulator (CFTR) modifier therapies on CF-related upper airway disease, specifically chronic rhinosinusitis (CRS), are not characterized. Objective To determine the outcome of elexacaftor-tezacaftor-ivacaftor (ETI) on CRS as measured by changes in sinus computed tomography (CT) metrics and on clinical parameters in individuals with CF. Design, Setting, and Participants This prospective longitudinal cohort study was conducted at the CF center of a tertiary care hospital between October 1, 2019, and July 31, 2021. A total of 64 participants with CF were included in the analysis. Intervention Sinus CT was obtained within 1 month of initiation of ETI therapy (baseline), and within 1 month of 1 year of ETI therapy. Images were independently analyzed by pulmonology, radiology, and otolaryngology physicians, using the Lund-Mackay and Sheikh-Lind scoring systems. Percent predicted forced expiratory volume in 1 second (ppFEV1), body mass index (BMI), and microbiologic data collected at initiation of ETI therapy and 3-month intervals for 1 year were also measured. Main Outcomes and Measures The study hypothesis was that ETI therapy will improve CRS as measured by changes in sinus CT at initiation and 1 year after ETI therapy and clinical parameters in individuals with CF. Results Among the 64 participants (39 [60.9%] female; median age, 18.5 [IQR, 16.0-28.5] years; 64 [100%] White), improvement in CRS was noted by improvements in sinus CT scans using both sinus CT scoring systems after 1 year of ETI therapy. The reduction in the median total score using the Lund-Mackay sinus CT scoring system (from 5.8 [IQR, 5.0-7.0] to 3.3 [IQR, 2.6-4.2]) and the Sheikh-Lind scoring system (from 3.8 [IQR, 3.0-5.0] to 2.2 [IQR, 2.0-2.5]) was noted. Increases in ppFEV1 and BMI were also observed by 3 months of ETI therapy with persistent improvement through 1 year of treatment. Similarly, after 1 year of ETI therapy, participants with CF had reductions in positivity for Pseudomonas aeruginosa and Staphylococcus aureus in oropharyngeal cultures. Conclusion and Relevance This cohort study found that use of ETI therapy was associated with improved CRS outcomes in participants with CF as quantified by improved sinus CT scans measured by 2 radiographic scoring systems and was also associated with improved clinical outcomes. Despite improvement in CT scan scores, most people with CF continue to have scores that indicate severe sinus disease.
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Affiliation(s)
- Shahid Sheikh
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus
- Division of Pulmonary Medicine, Nationwide Children’s Hospital, Columbus, Ohio
- Nationwide Children’s Hospital, Columbus, Ohio
| | - Mai-Lan Ho
- Nationwide Children’s Hospital, Columbus, Ohio
- Department of Radiology, The Ohio State University College of Medicine, Columbus
| | - Mariah Eisner
- Nationwide Children’s Hospital, Columbus, Ohio
- Biostatistics Resource, Nationwide Children’s Hospital, Columbus, Ohio
| | - Courtney Gushue
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus
- Division of Pulmonary Medicine, Nationwide Children’s Hospital, Columbus, Ohio
- Nationwide Children’s Hospital, Columbus, Ohio
| | - Grace Paul
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus
- Division of Pulmonary Medicine, Nationwide Children’s Hospital, Columbus, Ohio
- Nationwide Children’s Hospital, Columbus, Ohio
| | - Melissa Holtzlander
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus
- Division of Pulmonary Medicine, Nationwide Children’s Hospital, Columbus, Ohio
- Nationwide Children’s Hospital, Columbus, Ohio
| | - Terri Johnson
- Division of Pulmonary Medicine, Nationwide Children’s Hospital, Columbus, Ohio
- Nationwide Children’s Hospital, Columbus, Ohio
| | - Karen S. McCoy
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus
- Division of Pulmonary Medicine, Nationwide Children’s Hospital, Columbus, Ohio
- Nationwide Children’s Hospital, Columbus, Ohio
| | - Meredith Lind
- Nationwide Children’s Hospital, Columbus, Ohio
- Department of Otolaryngology, The Ohio State University College of Medicine, Columbus
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Shih MC, Edwards TS, Snyder J, Germroth M, Nguyen SA, Schlosser RJ. Impact of Nasal Cavity CT Opacification Upon Sinonasal Quality of Life. Ann Otol Rhinol Laryngol 2023; 132:1590-1599. [PMID: 37246346 DOI: 10.1177/00034894231176329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Current methods of quantifying inflammation in chronic rhinosinusitis (CRS) on computed tomography (CT) imaging focus on opacification of the paranasal sinuses and show limited correlation with patient-reported outcome measures. OBJECTIVE This study aimed to determine if quantifying CT opacification of the nasal cavity correlated with Sino-Nasal Outcomes Test scores (SNOT-22). METHODS Thirty patients with CRS were enrolled. Lund-Mackay and SNOT-22 scores were measured. Nasal cavity regions of interest (ROIs) were measured by 2 independent raters using ImageJ at 3 points on coronal CT scans: anteriorly at the lacrimal duct, at the approximate midpoint demarcated by the posterior aspect of the globe, and posteriorly at the transition from the hard to soft palate. Superior and inferior regions were defined based upon the root of the inferior turbinate. Percent opacification was calculated for each ROI. Analyses were conducted bilaterally and for the side with greater opacification (worse side). RESULTS Interrater reliability was strong for all ROIs. Lund-Mackay scores correlated with nasal blockage only (r = .495, P = .01) and did not correlate with nasal cavity ROI opacification. Inferior nasal cavity opacification for worse-sided anterior ROI and middle ROI correlated with SNOT-22 scores for nasal blockage (anterior r = .41, P = .03) (middle r = .42, P = .023) and runny nose (anterior r = .44, P = .02) (middle r = .38, P = .04). Posterior ROIs did not correlate with SNOT-22. CONCLUSIONS Traditional CT scoring of sinus opacification does not correlate well with nasal cavity opacification or SNOT-22. Inferior nasal cavity inflammation provides unique correlations with SNOT-22 nasal questions and may guide targeted interventions in these regions.
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Affiliation(s)
- Michael C Shih
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Thomas S Edwards
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Jacob Snyder
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Matthew Germroth
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Shaun A Nguyen
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Rodney J Schlosser
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
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Maspero JF, Khan AH, Philpott C, Hellings PW, Hopkins C, Wagenmann M, Siddiqui S, Msihid J, Nash S, Chuang CC, Kamat S, Rowe PJ, Deniz Y, Jacob-Nara JA. Health-Related Quality of Life Impairment Among Patients with Severe Chronic Rhinosinusitis with Nasal Polyps in the SINUS-24 Trial. J Asthma Allergy 2023; 16:323-332. [PMID: 37016622 PMCID: PMC10066887 DOI: 10.2147/jaa.s372598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 03/08/2023] [Indexed: 03/30/2023] Open
Abstract
Purpose Chronic rhinosinusitis with nasal polyps (CRSwNP) is a predominantly type 2 inflammatory disease with a high symptom burden. Data are lacking on the comparative health status of patients with CRSwNP. This analysis compared baseline physical and mental health-related quality of life (HRQoL) and overall health status of patients with severe CRSwNP enrolled in a Phase 3 clinical trial with general population norms and with other chronic diseases. Methods In this post hoc cross-sectional analysis of baseline data from the SINUS-24 study (NCT02912468), HRQoL was measured using the 36-item Short Form (SF-36) questionnaire and general health status was measured using the EuroQol-5 Dimension visual analog scale (EQ-VAS). Analyses included the intention-to-treat (ITT) population and subgroups defined by prior sinonasal surgery, systemic corticosteroid use, and coexisting asthma or non-steroidal anti-inflammatory drug-exacerbated respiratory disease (NSAID-ERD). Scores were compared with published values for population norms (50 for SF-36 physical component summary (PCS) and mental component summary (MCS), 70.4-83.3 for EQ-VAS) and for rheumatoid arthritis, type 2 diabetes, and asthma. Results In the ITT population (n=276), mean SF-36 physical component summary (PCS), SF-36 mental component summary (MCS), and EQ-VAS scores were below general population norms (46.4, 48.6, and 66.0, respectively). Mean SF-36 PCS and EQ-VAS scores were below population norms across all subgroups; mean SF-36 MCS scores were below the population norm in all subgroups except no prior surgery. SF-36 PCS and MCS scores from SINUS-24 were generally similar to other chronic diseases, except SF-36 PCS which was lower in rheumatoid arthritis. EQ-VAS scores in SINUS-24 were lower than in other chronic diseases. HRQoL scores weakly correlated with objective measures of disease severity. Conclusion In patients with severe CRSwNP, including those with coexisting asthma/NSAID-ERD, HRQoL was worse than population norms and as burdensome as diseases such as type 2 diabetes, asthma, and rheumatoid arthritis.
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Affiliation(s)
- Jorge F Maspero
- Allergy & Respiratory Research Unit, Fundación CIDEA, Buenos Aires, Argentina
- Correspondence: Jorge F Maspero, Allergy & Respiratory Research Unit, Fundación CIDEA, Paraguay 2035, 2SS, Buenos Aires, Argentina, Tel +54 9 11 4183-7294, Email
| | - Asif H Khan
- Global Medical Affairs, Sanofi, Chilly-Mazarin, France
| | - Carl Philpott
- Rhinology and ENT Research Group, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Peter W Hellings
- Department of Otorhinolaryngology – Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Claire Hopkins
- Department of Otorhinolaryngology, King’s College London, London, UK
| | - Martin Wagenmann
- Department of Otorhinolaryngology, Düsseldorf University Hospital (UKD), Düsseldorf, Germany
| | - Shahid Siddiqui
- Medical Affairs, Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA
| | - Jérôme Msihid
- Health Economics and Value Assessment, Sanofi, Chilly-Mazarin, France
| | - Scott Nash
- Medical Affairs, Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA
| | | | - Siddhesh Kamat
- Medical Affairs, Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA
| | - Paul J Rowe
- Global Medical Affairs, Sanofi, Bridgewater, NJ, USA
| | - Yamo Deniz
- Medical Affairs, Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA
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Brijith KVR, Aishwarya JG, Shah AS, Nair S. Modified CT Scan Scoring System for Evaluating Symptom Severity of Chronic Rhinosinusitis. Indian J Otolaryngol Head Neck Surg 2022; 74:1178-1182. [PMID: 36452666 PMCID: PMC9702113 DOI: 10.1007/s12070-020-02259-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 10/31/2020] [Indexed: 11/29/2022] Open
Abstract
There are various subjective as well as objective tools to evaluate the severity of chronic rhinosinusitis (CRS). SNOT-22 is the most commonly used subjective scoring system to determine the severity of CRS. Lund-Mackay (LM) CT scan scoring is widely used as an objective tool in CRS. However LM scores does not correlate well with the subjective tools. We evaluated the modified CT scan scoring system (SN score) for its efficacy in determining the severity of CRS in both subjective as well as objective manner. To correlate the severity of symptoms and CT scan findings in adult patients with chronic rhinosinusitis by estimating the strength of correlation of severity of symptoms of CRS assessed by SNOT-22 scorings with CT scan findings by Lund Mackay scoring system and SN CT scan scoring system. A prospective, observational study was conducted in the tertiary care center from June 2019 to August 2020. The study included 150 adult patients diagnosed with Chronic Rhino Sinusitis resistant to primary medical therapy, who were subjected to CT scan imaging. The symptom severity of CRS was assessed by the SNOT 22 scores. CT scan was done and Lund Mackay scores and SN CT scan scores by the senior author were calculated. The correlation of SNOT 22 score with LM score and Modified CT score were assessed. The correlation of LM score with SNOT 22 score was assessed by plotting Scattered plot diagram, which showed a moderate positive, statistically significant correlation (Person correlation co-efficient: 0.466; p value: 0.032). The correlation of SN CT score with SNOT 22 was assessed by Chi Square test which showed a highly significant, positive correlation (p value of 0.000793). Our study shows a positive correlation of symptoms assessed by SNOT 22 system with radiological findings analyzed by both LM system as well as SN CT scan scoring system. However, SN CT scan scoring system showed a highly significant positive correlation over LM system as it correlates well with symptoms and also provides a grading of disease severity. SN CT scan scoring system can be considered as a tool for assessing the disease severity both in subjective and objective manner. It can be used in place of subjective tools like SNOT 22 for assessing the severity of symptoms in CRS where subjective analysis of the disease is difficult.
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Affiliation(s)
- K. V. R. Brijith
- Department of ENT-HNS, Apollo Hospitals, Opp. IIM, Bannerghatta Road, Bangalore, Karnataka 560076 India
| | - J. G. Aishwarya
- Department of ENT-HNS, Apollo Hospitals, Opp. IIM, Bannerghatta Road, Bangalore, Karnataka 560076 India
| | - Ashish S. Shah
- Department of ENT-HNS, Apollo Hospitals, Opp. IIM, Bannerghatta Road, Bangalore, Karnataka 560076 India
| | - Satish Nair
- Department of ENT-HNS, Apollo Hospitals, Opp. IIM, Bannerghatta Road, Bangalore, Karnataka 560076 India
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Massey CJ, Ramos L, Beswick DM, Ramakrishnan VR, Humphries SM. Clinical Validation and Extension of an Automated, Deep Learning-Based Algorithm for Quantitative Sinus CT Analysis. AJNR Am J Neuroradiol 2022; 43:1318-1324. [PMID: 36538385 PMCID: PMC9451634 DOI: 10.3174/ajnr.a7616] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/18/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND PURPOSE Sinus CT is critically important for the diagnosis of chronic rhinosinusitis. While CT is sensitive for detecting mucosal disease, automated methods for objective quantification of sinus opacification are lacking. We describe new measurements and further clinical validation of automated CT analysis using a convolutional neural network in a chronic rhinosinusitis population. This technology produces volumetric segmentations that permit calculation of percentage sinus opacification, mean Hounsfield units of opacities, and percentage of osteitis. MATERIALS AND METHODS Demographic and clinical data were collected retrospectively from adult patients with chronic rhinosinusitis, including serum eosinophil count, Lund-Kennedy endoscopic scores, and the SinoNasal Outcomes Test-22. CT scans were scored using the Lund-Mackay score and the Global Osteitis Scoring Scale. CT images were automatically segmented and analyzed for percentage opacification, mean Hounsfield unit of opacities, and percentage osteitis. These readouts were correlated with visual scoring systems and with disease parameters using the Spearman ρ. RESULTS Eighty-eight subjects were included. The algorithm successfully segmented 100% of scans and calculated features in a diverse population with CT images obtained on different scanners. A strong correlation existed between percentage opacification and the Lund-Mackay score (ρ = 0.85, P < .001). Both percentage opacification and the Lund-Mackay score exhibited moderate correlations with the Lund-Kennedy score (ρ = 0.58, P < .001, and ρ = 0.58, P < .001, respectively). The percentage osteitis correlated moderately with the Global Osteitis Scoring Scale (ρ = 0.48, P < .001). CONCLUSIONS Our quantitative processing of sinus CT images provides objective measures that correspond well to established visual scoring methods. While automation is a clear benefit here, validation may be needed in a prospective, multi-institutional setting.
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Affiliation(s)
- C J Massey
- From the Department of Otolaryngology-Head and Neck Surgery (C.J.M., L.R., V.R.R.), University of Colorado School of Medicine, Aurora, Colorado
| | - L Ramos
- From the Department of Otolaryngology-Head and Neck Surgery (C.J.M., L.R., V.R.R.), University of Colorado School of Medicine, Aurora, Colorado
| | - D M Beswick
- Department of Otolaryngology-Head and Neck Surgery (D.M.B.), University of California-Los Angeles School of Medicine, Los Angeles, California
| | - V R Ramakrishnan
- From the Department of Otolaryngology-Head and Neck Surgery (C.J.M., L.R., V.R.R.), University of Colorado School of Medicine, Aurora, Colorado
| | - S M Humphries
- Quantitative Imaging Laboratory (S.M.H.), Department of Radiology, National Jewish Health, Denver, Colorado
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Mamat Nasir MSN, Aziz ME, Tuan Sharif SE, Ibrahim R, Abdullah B. Clinical symptoms of chronic rhinosinusitis with nasal polyps (eosinophilic and non-eosinophilic) are related to sinus computed tomography but not to endoscopic findings. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2022; 73:203-209. [PMID: 35908813 DOI: 10.1016/j.otoeng.2021.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 03/05/2021] [Indexed: 10/16/2022]
Abstract
BACKGROUND In the clinical assessment of chronic rhinosinusitis with nasal polyps (CRSwNP), evaluation of symptoms, nasoendoscopy findings and sinus computed tomography (CT) scan staging is employed in the management plan. Although prior studies have been done to assess the correlation of the three modalities in CRSwNP, such evaluation in patients with eosinophilic and non-eosinophilic types of CRSwNP requires further investigation. The aim of this study was to correlate the sinus CT scan staging to symptom and endoscopic scores in both types of CRSwNP. MATERIAL AND METHOD Patients with CRSwNP were classified into 2 types, eosinophilic and non-eosinophilic. Both types were assessed by Sino-Nasal Outcome Test 22 (SNOT-22) symptom score, nasal endoscopy Lund Kennedy grading (LK) score and sinus CT Lund Mackay (LM) staging score. All three modalities were correlated. RESULTS Forty-four patients were recruited for this study. There was significant correlation between sinus CT and symptom scores in the eosinophilic (r=.51, p=.031) and the non-eosinophilic (r=.76, p<.001) types. There was no significant correlation between symptom and nasoendoscopic scores in the eosinophilic (r=.12, p=.641) and the non-eosinophilic (r=.22, p=.276) types. There was also no significant correlation between sinus CT and nasoendoscopic scores in the eosinophilic (r=.20, p=.418) and the non-eosinophilic (r=.14, p=.508) types. CONCLUSIONS Sinus CT staging correlates well with the symptom score for both the eosinophilic and the non-eosinophilic types of CRSwNP. The good correlation suggests both modalities are a reliable guide for their evaluation and management planning.
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Affiliation(s)
- Mohd Shaiful Nizam Mamat Nasir
- Department of Otorhinolaryngology-Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Mohd Ezane Aziz
- Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Sharifah Emilia Tuan Sharif
- Department of Pathology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Rohaida Ibrahim
- Department of Otorhinolaryngology, Hospital Tengku Ampuan Afzan, 25100 Kuantan, Pahang, Malaysia
| | - Baharudin Abdullah
- Department of Otorhinolaryngology-Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
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Computed Tomography Assessment of Maxillary Sinus and Inferior Nasal Airway After Le Fort I Osteotomy. J Craniofac Surg 2022; 33:1835-1839. [PMID: 35761444 DOI: 10.1097/scs.0000000000008502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 01/12/2022] [Indexed: 11/26/2022] Open
Abstract
PURPOSE This study aimed to evaluate and predict the factors that affect the postoperative maxillary sinus and inferior nasal cavity conditions after Le Fort I osteotomy. SUBJECTS AND METHODS The rate of aerated (healthy) sinus area and the inferior nasal airway area were calculated by preoperative computed tomography measurements and at 1 week and 1 year postoperatively. Factors predicting the rate of aerated sinus area and the ratio of the inferior nasal cavity area after 1-week were examined using these variables. RESULTS The subjects consisted of 112 patients (224 sides) who underwent Le Fort I osteotomy with sagittal split ramus osteotomy. The rate of aerated sinus area after 1 week was significantly correlated with sex, age, and amount of blood loss (P < 0.0001). The rate of the inferior nasal cavity area after 1 week was significantly correlated with the anterior impaction amount of the maxilla and the preoperative rate of the inferior nasal airway area (P= 0.0017). CONCLUSIONS This study suggests that attention should be paid to females, older patients, and the amount of blood loss to prevent sinusitis, and larger maxillary impaction at the anterior site should be carefully planned to prevent severe nasal obstruction immediately after Le Fort I osteotomy.
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Early postoperative endoscopic score can predict the long-term endoscopic outcomes in eosinophilic chronic rhinosinusitis (ECRS) patients. Braz J Otorhinolaryngol 2022; 89:136-143. [PMID: 35428603 PMCID: PMC9874357 DOI: 10.1016/j.bjorl.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 10/31/2021] [Accepted: 12/14/2021] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE Eosinophilic Chronic Rhinosinusitis (ECRS) is refractory and recurrent, requiring long-term follow-up after Endoscopic Sinus Surgery (ESS). Endoscopic evaluation is common during postoperative assessment, but how the findings vary over time in postoperative ECRS patients who were treated by the recent standardized management is unclear. We assessed the long-term change in postoperative endoscopic score in ECRS patients using a novel endoscopic scoring system (Escore). METHODS This retrospective study included 80 ECRS patients who underwent full-house ESS and were followed for longer than 1-year. Endoscopic procedures were repeated at every follow-up visit and postoperative Escores were assessed from 3-months up to 5-years (median follow-up period was 3-years). RESULTS The Escore did not significantly change from that at 3-months (3m-Escore). The Escore at the final observation point (f-Escore) among 80 patients was 9.2 ± 5.6 and there was no significant difference from the 3m-Escore (8.5 ± 4.1, p = 0.363). Twenty-one patients (21/80, 26.3%) were considered to have endoscopically uncontrolled ECRS at their final observation points and the 3m-Escore was identified as an independent predictive factor by multivariate logistic regression analysis. The 3m-Escore cut-off value that was able to predict endoscopically uncontrolled ECRS after long-term follow-up was ≥12. CONCLUSION We demonstrated the long-term endoscopic outcomes after full-house ESS and continuous outpatient treatment. Early endoscopic findings (3m-Escore) were a potential predictive factor for the later endoscopic outcome, and a 3m-Escore of 12 or higher may be an indicator of the poor long-term prognosis of sinus mucosa. LEVEL OF EVIDENCE: 4
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Adamu A, Shirama Y, Iseh K, Ahmed S, Baba S, Ma'aji S. Correlation between Lund-Mackay CT scan score and Sinonasal Outcome Test-20 symptoms score in the evaluation of chronic rhinosinusitis. JOURNAL OF CLINICAL SCIENCES 2022. [DOI: 10.4103/jcls.jcls_54_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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10
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Wu AW, Borrelli M, Raskin J, Hopp ML, Mirocha J, Tang DM. Correlation of chronic rhinosinusitis-related symptoms with CT subsite. Int Forum Allergy Rhinol 2021; 12:791-794. [PMID: 34694704 DOI: 10.1002/alr.22920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/19/2021] [Accepted: 10/13/2021] [Indexed: 11/12/2022]
Affiliation(s)
- Arthur W Wu
- Cedars-Sinai Sinus Center of Excellence, Division of Otolaryngology, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
| | - Michela Borrelli
- Cedars-Sinai Sinus Center of Excellence, Division of Otolaryngology, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
| | - Jonathan Raskin
- Cedars-Sinai Sinus Center of Excellence, Division of Otolaryngology, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
| | - Martin L Hopp
- Cedars-Sinai Sinus Center of Excellence, Division of Otolaryngology, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
| | - James Mirocha
- Biostatistics and Bioinformatics Research Center, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
| | - Dennis M Tang
- Cedars-Sinai Sinus Center of Excellence, Division of Otolaryngology, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
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Mamat Nasir MSN, Aziz ME, Tuan Sharif SE, Ibrahim R, Abdullah B. Clinical symptoms of chronic rhinosinusitis with nasal polyps (eosinophilic and non-eosinophilic) are related to sinus computed tomography but not to endoscopic findings. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2021; 73:S0001-6519(21)00043-1. [PMID: 34045046 DOI: 10.1016/j.otorri.2021.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/30/2021] [Accepted: 03/05/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND In the clinical assessment of chronic rhinosinusitis with nasal polyps (CRSwNP), evaluation of symptoms, nasoendoscopy findings and sinus computed tomography (CT) scan staging is employed in the management plan. Although prior studies have been done to assess the correlation of the three modalities in CRSwNP, such evaluation in patients with eosinophilic and non-eosinophilic types of CRSwNP requires further investigation. The aim of this study was to correlate the sinus CT scan staging to symptom and endoscopic scores in both types of CRSwNP. MATERIAL AND METHOD Patients with CRSwNP were classified into 2 types, eosinophilic and non-eosinophilic. Both types were assessed by Sino-Nasal Outcome Test 22 (SNOT-22) symptom score, nasal endoscopy Lund Kennedy grading (LK) score and sinus CT Lund Mackay (LM) staging score. All three modalities were correlated. RESULTS Forty-four patients were recruited for this study. There was significant correlation between sinus CT and symptom scores in the eosinophilic (r=.51, p=.031) and the non-eosinophilic (r=.76, p<.001) types. There was no significant correlation between symptom and nasoendoscopic scores in the eosinophilic (r=.12, p=.641) and the non-eosinophilic (r=.22, p=.276) types. There was also no significant correlation between sinus CT and nasoendoscopic scores in the eosinophilic (r=.20, p=.418) and the non-eosinophilic (r=.14, p=.508) types. CONCLUSIONS Sinus CT staging correlates well with the symptom score for both the eosinophilic and the non-eosinophilic types of CRSwNP. The good correlation suggests both modalities are a reliable guide for their evaluation and management planning.
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Affiliation(s)
- Mohd Shaiful Nizam Mamat Nasir
- Department of Otorhinolaryngology-Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Mohd Ezane Aziz
- Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Sharifah Emilia Tuan Sharif
- Department of Pathology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Rohaida Ibrahim
- Department of Otorhinolaryngology, Hospital Tengku Ampuan Afzan, 25100 Kuantan, Pahang, Malaysia
| | - Baharudin Abdullah
- Department of Otorhinolaryngology-Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
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D'Agostino A, Lombardo G, Favero V, Signoriello A, Bressan A, Lonardi F, Nocini R, Trevisiol L. Complications related to zygomatic implants placement: A retrospective evaluation with 5 years follow-up. J Craniomaxillofac Surg 2021; 49:620-627. [PMID: 33581959 DOI: 10.1016/j.jcms.2021.01.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 12/03/2020] [Accepted: 01/31/2021] [Indexed: 10/22/2022] Open
Abstract
This retrospective study assessed zygoma implants in patients treated for upper maxilla extreme atrophy, trauma, cleft palate, or failed reconstruction. The implants were placed using Quad (4 zygoma implants) or mixed (zygoma and conventional implants in premaxilla) surgical technique, with intra-sinus or extra-sinus approach, followed by immediate or deferred loading. Clinical and radiographic evaluations were carried out at 5-year follow-up from loading. Implant survival, symptoms and signs of sinusitis, radiological alterations in terms of mucosal thickening or obliteration of the maxillary sinuses, oroantral communications, and peri-implant soft tissues were examined. A total of 42 patients, with 116 zygoma implants, were included in the study. The cumulative survival rate was 97.41%. One zygomatic bone fracture was assessed. Eight patients reported sinusitis, and two showed oro-antral communications. A comparison between mean pre- and post-operative Lund-Mackay scores showed a statistically significant increase of sino-nasal disease in the post-operative scores (p = 0.0019). Mucositis and gingival recession was observed in 21 and 8 implants respectively. Average recession was 2.52 ± 2.35 mm. According to our results, placement of zygoma implants has proved to be a predictable procedure, with a lower rate of severe complications compared to other treatment options in extreme upper jaw atrophy.
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Affiliation(s)
- Antonio D'Agostino
- Unit of Maxillo-Facial Surgery and Dentistry, University of Verona, P.le L.A. Scuro 10, 37134, Verona, Italy
| | - Giorgio Lombardo
- Unit of Maxillo-Facial Surgery and Dentistry, University of Verona, P.le L.A. Scuro 10, 37134, Verona, Italy
| | - Vittorio Favero
- Unit of Maxillo-Facial Surgery and Dentistry, University of Verona, P.le L.A. Scuro 10, 37134, Verona, Italy.
| | - Annarita Signoriello
- Unit of Maxillo-Facial Surgery and Dentistry, University of Verona, P.le L.A. Scuro 10, 37134, Verona, Italy
| | - Anna Bressan
- Unit of Maxillo-Facial Surgery and Dentistry, University of Verona, P.le L.A. Scuro 10, 37134, Verona, Italy
| | - Fabio Lonardi
- Unit of Maxillo-Facial Surgery and Dentistry, University of Verona, P.le L.A. Scuro 10, 37134, Verona, Italy
| | - Riccardo Nocini
- Unit of Otolaryngology, University of Verona, P.le L.A. Scuro 10, 37134, Verona, Italy
| | - Lorenzo Trevisiol
- Unit of Maxillo-Facial Surgery and Dentistry, University of Verona, P.le L.A. Scuro 10, 37134, Verona, Italy
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Abdullah B, Vengathajalam S, Md Daud MK, Wan Mohammad Z, Hamizan A, Husain S. The Clinical and Radiological Characterizations of the Allergic Phenotype of Chronic Rhinosinusitis with Nasal Polyps. J Asthma Allergy 2020; 13:523-531. [PMID: 33149624 PMCID: PMC7602905 DOI: 10.2147/jaa.s275536] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 09/22/2020] [Indexed: 12/31/2022] Open
Abstract
Purpose The allergic phenotype of chronic rhinosinusitis (CRS) and central compartment atopic disease (CCAD) have been described. The CCAD is a radiological phenotype in patients with CRS that presents as a central mucosal disease due to allergy. The subset of patients having chronic rhinosinusitis with nasal polyps (CRSwNP) has not been well characterized. We aim to describe the clinical and radiological characterizations of patients presenting with the allergic phenotype of CRSwNP. Patients and Methods A cross-sectional study at a tertiary hospital was performed. Adult patients diagnosed with CRSwNP who had both allergology and radiological assessments were enrolled. The symptoms of allergic rhinitis, Lund-Kennedy (LK) endoscopic scoring, Lund-Mackay (LM) computed tomography scan of paranasal sinuses (CTPNS) scoring, CCAD features, skin prick test (SPT) and level of specific IgE were assessed. All the patients underwent SPT for house dust mites. Results A total of 38 patients were enrolled. Symptoms, endoscopic and CTPNS scores were higher in the allergy and CCAD groups compared to the nonallergy and nonCCAD groups. The symptom of "need to blow nose" was statistically significant in allergy vs nonallergy (p=0.01) and CCAD vs nonCCAD (p=0.02). There were significant differences in the endoscopic scores in both allergy and CCAD (allergy vs nonallergy, p=0.01; CCAD vs nonCCAD, p=0.03), and CT scores in both allergy and CCAD (allergy vs nonallergy, p=0.02; CCAD vs nonCCAD, p=0.02). All patients with CCAD have worse scoring than nonCCAD (LK score, p=0.03; LM score, p=0.02). Patients with allergy have more polypoidal involvement of the middle turbinates (left middle turbinate, p=0.141; right middle turbinate, p=0.074) and CCAD (left middle turbinate, p=0.017; right middle turbinate, p=0.009) than nonallergy and nonCCAD patients. Conclusion Allergic phenotype of CRSwNP has a worse clinical and radiological disease burden. Optimal treatment of allergy is essential for a better outcome.
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Affiliation(s)
- Baharudin Abdullah
- Department of Otorhinolaryngology-Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Selvamalar Vengathajalam
- Department of Otorhinolaryngology-Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Mohd Khairi Md Daud
- Department of Otorhinolaryngology-Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Zahiruddin Wan Mohammad
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Aneeza Hamizan
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Malaysia
| | - Salina Husain
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Malaysia
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Lu H, Liu Z, Hu L, Feng X, Hu L, Gu Y, Li H, Li H, Wang D. Are objective 'findings' the same as subjective 'severity'? A study of the relationship between computed tomography findings and subjective severity in preoperative CRSwNP patients. Exp Ther Med 2020; 20:2985-2992. [PMID: 32855664 PMCID: PMC7444383 DOI: 10.3892/etm.2020.9032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Accepted: 01/22/2020] [Indexed: 01/20/2023] Open
Abstract
In pre-surgical patients with chronic rhinosinusitis with nasal polyps (CRSwNPs), positive findings on computed tomography (CT) scans and an exacerbation of symptoms are two possible factors that indicate surgery. However, the relationship between these factors remains unclear. Confirmed CRSwNP patients ready for sinus surgery were consecutively enrolled. The Sino-Nasal Outcome Test 22 (SNOT-22) and visual analog scale (VAS) scoring were completed by these patients, and scores were subjected to factor analysis using a principal component analysis (PCA) to evaluate subjective symptom components related to CRS. Patient CT scores, measured by the Lund-Mackay score (LMS), together with their demographics, medical treatment, and atopy status, were collected and analyzed. A total of 288 patients who met the criteria for CRSwNP and underwent CT scanning prior to surgery in the Eye, Ear, Nose, and Throat Hospital of Fudan University were enrolled. Five components were identified from the PCA of the SNOT-22 results and VAS scores related to subjective symptoms. More severe ‘nasal’ symptoms (P=0.03; 95% CI, 0.092-1.824), loss of smell and taste (P<0.001; 95% CI, 0.961-1.767) and lower facial pain (P=0.001; 95% CI 1.811 to -0.475), derived from the SNOT-22, were significantly associated with total CT score. For the VAS PCA components, less severe ‘ocular’ symptoms (P=0.004; 95% CI -1.852 to -0.352), a reduced ‘pain’ component (P<0.001; 95% CI -2.133 to -0.715), a higher ‘nasal’ symptom component (P<0.001; 95% CI 0.752-2.257) and, again, loss of smell and taste (P<0.001; 95% CI 0.437-0.811) showed an association with total CT score. ‘Allergy-associated symptoms’ in both the SNOT-22 and VAS scores and ‘loss of smell or taste’ and ‘hyposmia’ were significantly more severe in patients with ethmoid sinus/maxillary sinus (E/M) ratios of >2.59 compared with patients with E/M ratios <2.59. Loss of smell and taste alone was correlated with the LMS in patients with highly positive CT scores. The present study demonstrated associations between several subjective symptoms and objective severity in preoperative CRSwNP patients. Nasal symptoms, including olfaction loss, were correlated positively with CT scores, while ocular- and pain-related symptoms showed an opposite pattern. However, this relationship was not confirmed in patients with highly positive CT scores. A subset analysis confirmed, in terms of symptoms, the value of the E/M ratio for indicating eosinophilic chronic rhinosinusitis.
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Affiliation(s)
- Hanyu Lu
- Department of Otorhinolaryngology, Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai 200031, P.R. China
| | - Zhuofu Liu
- Department of Otorhinolaryngology, Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai 200031, P.R. China
| | - Li Hu
- Department of Otorhinolaryngology, Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai 200031, P.R. China
| | - Xian Feng
- Department of Clinical Laboratory, Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai 200031, P.R. China
| | - Li Hu
- Department of Otorhinolaryngology, Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai 200031, P.R. China
| | - Yurong Gu
- Department of Otorhinolaryngology, Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai 200031, P.R. China
| | - Houyong Li
- Department of Otorhinolaryngology, Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai 200031, P.R. China
| | - Huabin Li
- Department of Otorhinolaryngology, Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai 200031, P.R. China
| | - Dehui Wang
- Department of Otorhinolaryngology, Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai 200031, P.R. China
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15
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Quality of Life Outcomes in Frontal Sinus Surgery. J Clin Med 2020; 9:jcm9072145. [PMID: 32650386 PMCID: PMC7408842 DOI: 10.3390/jcm9072145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 07/03/2020] [Indexed: 12/31/2022] Open
Abstract
Introduction: Although significant experience has been gained in the technical nuances of endoscopic sinus surgery procedures, the patient-reported outcomes of frontal endoscopic sinus surgery procedures are still poorly understood. In this study we used the validated patient outcome measure Sino Nasal Outcome Test-22 (SNOT-22) to assess the preoperative and postoperative quality of life in patients undergoing extended endoscopic frontal sinus surgery (Draf type 2 and Draf type 3 procedures). Methods: Out of a total of 680 patients undergoing endoscopic sinus and skull base surgery and 186 patients undergoing frontal sinus surgery, 99 chronic rhinosinusitis patients with (CRSwNP) or without (CRSnNP) nasal polyps undergoing Draf 2 or Draf 3 were assessed. Results: The mean preoperative SNOT-22 was 45.6 points for patients undergoing Draf 2 and 59 for patients undergoing Draf 3, while the mean radiological Lund–Mackay Score was 14.3 and 14.5, respectively. Mean SNOT 22 improvement was 22.9 points for Draf 2 and 37 points for Draf 3 respectively and remained significant in all time intervals, including at 4 years after surgery. With the exception of loss of smell/taste, all symptoms improved by a far bigger extent in Draf 3 group, despite the considerably worse starting point. Effect size (Cohen / Standard Deviations) of Draf 3 was greatest in the following symptoms: “being frustrated/restless/irritable” (1.63), “nasal blockage” (1.43), “reduced concentration” (1.35), “fatigue” (1.29) “runny nose” (1.26) and “need to blow nose” (1.17). Frontal sinus (neo) ostium was patent (fully or partly) at last follow up in 98% of Draf 2 patients and in 88% of patients following Draf 3. Patients with non-patent frontal (neo-) ostium however had a mean postoperative SNOT 22 score of 43 compared to 20 of those with patent frontal sinus (neo-) ostium, although the difference was not statistically significant. Conclusion: Patients undergoing Draf 3 have a greater burden of disease, including both nasal and emotional/general symptoms compared to Draf 2 patients; surgery results in improvement in both groups, although Draf 3 patients have the greatest benefit, especially in emotional / general symptons. In this way both groups achieve similar postoperative quality of life, despite the different starting points.
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Xu Y, Zheng Y, Cao M, Yang W, Ren J, Song Y, Cheng D, Wang J, Huang L, Xu W, Zhao Y, Liu G. Association of Single-Nucleotide Polymorphisms With Chronic Rhinosinusitis in a Southwestern Han Chinese Population: A Replication Study. Am J Rhinol Allergy 2019; 34:352-360. [PMID: 31870168 DOI: 10.1177/1945892419896540] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Yang Xu
- Department of Otorhinolaryngology Head and Neck Surgery, West China Hospital, West China Medical School, Sichuan University, Chengdu, China
| | - Yongbo Zheng
- Department of Otorhinolaryngology Head and Neck Surgery, West China Hospital, West China Medical School, Sichuan University, Chengdu, China
| | - Min Cao
- General Affairs Office of Logistic Department, West China Hospital, Sichuan University, Chengdu, China
| | - Wen Yang
- Department of Otorhinolaryngology Head and Neck Surgery, West China Hospital, West China Medical School, Sichuan University, Chengdu, China
| | - Jianjun Ren
- Department of Otorhinolaryngology Head and Neck Surgery, West China Hospital, West China Medical School, Sichuan University, Chengdu, China
| | - Yao Song
- Department of Otorhinolaryngology Head and Neck Surgery, West China Hospital, West China Medical School, Sichuan University, Chengdu, China
| | - Danni Cheng
- Department of Otorhinolaryngology Head and Neck Surgery, West China Hospital, West China Medical School, Sichuan University, Chengdu, China
| | - Jing Wang
- Department of Otorhinolaryngology Head and Neck Surgery, West China Hospital, West China Medical School, Sichuan University, Chengdu, China
| | - Ligao Huang
- Department of Otorhinolaryngology, Chengdu Renpin Otorhinolaryngology Hospital, Chengdu, China
| | - Wei Xu
- Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Yu Zhao
- Department of Otorhinolaryngology Head and Neck Surgery, West China Hospital, West China Medical School, Sichuan University, Chengdu, China
| | - Geoffrey Liu
- Medical Oncology and Medical Biophysics, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.,Medicine and Epidemiology Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Kirsch CF, Bykowski J, Aulino JM, Berger KL, Choudhri AF, Conley DB, Luttrull MD, Nunez D, Shah LM, Sharma A, Shetty VS, Subramaniam RM, Symko SC, Cornelius RS. ACR Appropriateness Criteria ® Sinonasal Disease. J Am Coll Radiol 2017; 14:S550-S559. [DOI: 10.1016/j.jacr.2017.08.041] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 08/14/2017] [Indexed: 01/09/2023]
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18
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Association between computed tomography findings and clinical symptoms in chronic rhinosinusitis with and without nasal polyps. Eur Arch Otorhinolaryngol 2017; 274:2165-2173. [DOI: 10.1007/s00405-016-4446-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 12/27/2016] [Indexed: 12/18/2022]
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Ueki K, Yoshizawa K, Moroi A, Hotta A, Tsutsui T, Fukaya K, Hiraide R, Takayama A, Tsunoda T, Saito Y, Iguchi R, Kosaka A, Ikawa H. Evaluation of maxillary sinus after Le Fort I osteotomy using various fixation materials. J Craniomaxillofac Surg 2017; 45:552-557. [PMID: 28238562 DOI: 10.1016/j.jcms.2017.01.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 12/19/2016] [Accepted: 01/23/2017] [Indexed: 11/27/2022] Open
Abstract
PURPOSE The purpose of this study was to evaluate maxillary sinus and predict the factors affecting the postoperative sinus condition after Le Fort I osteotomy using various fixation materials. MATERIALS AND METHODS The study subjects consisted of 71 patients (21 male and 50 female, 142 sides) who underwent Le Fort I osteotomy with sagittal split ramus osteotomy. The maxillary sinus bony area and the inside air area were measured in the coronal plane across the mesial aspect of the first molar perpendicular to the Frankfurt horizontal plane of a computed tomography (CT) image preoperatively and at 1 week and 1 year after surgery. The rate of intact sinus area (the inside air area/the maxillary sinus bony area) was calculated. Subjects were divided into groups according to gender, preoperative diagnosis (Angle class II and III with and without asymmetry), plate fixation material (PLLA and uHA/PLLA), and use or non-use of bone alternative material (α-tricalcium phosphate). Statistic comparisons between groups were performed in each division. Furthermore, age, operation time, amount of blood loss, and direction and amount of movement were examined as the continuous variables to statistically predict the rate of intact sinus area after 1 week and 1 year. RESULTS The rate of intact sinus area after 1 week was significantly correlated with age, amount of anterio-posterior movement, and preoperative rate of the intact sinus area (p < 0.0001). Rate of intact sinus area after 1 year was significantly low in the group that used the bone alternative material compared to the group that did not (p < 0.0282). CONCLUSION The study suggests that the bone alternative material might be a cause of inflammation in the sinus after 1 year. Moreover, attention needs to be paid to older age, backward movement of the maxillary segment, and preoperative sinusitis including hypertrophy of sinus membrane in Le Fort I osteotomy.
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Affiliation(s)
- Koichiro Ueki
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. K. Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan.
| | - Kunio Yoshizawa
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. K. Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan
| | - Akinori Moroi
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. K. Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan
| | - Asami Hotta
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. K. Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan
| | - Takamitsu Tsutsui
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. K. Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan
| | - Kenichi Fukaya
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. K. Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan
| | - Ryota Hiraide
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. K. Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan
| | - Akihiro Takayama
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. K. Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan
| | - Tatsuya Tsunoda
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. K. Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan
| | - Yuki Saito
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. K. Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan
| | - Ran Iguchi
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. K. Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan
| | - Akihiko Kosaka
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. K. Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan
| | - Hiroumi Ikawa
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. K. Ueki), Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan
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Nguyen DT, Bonfort G, Arous F, Felix-Ravelo M, Nguyen-Thi PL, Jankowski R. Evaluation of residual symptoms: A method to assess surgical outcomes for nasal polyposis. Am J Rhinol Allergy 2016; 30:e36-41. [PMID: 26980384 DOI: 10.2500/ajra.2016.30.4279] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The assessment of residual symptoms after endoscopic sinus surgery for nasal polyposis (NP) could be an accurate way to evaluate surgical outcomes. OBJECTIVE To assess the residual symptoms and their severity at 6 weeks and 7 months after radical ethmoidectomy for NP. METHODS Sixty-five patients who had surgery for NP were included in this prospective study. Six residual symptoms (nasal obstruction, anterior rhinorrhea, postnasal discharge, olfactory disturbances, facial pain, and cough) were assessed by using the validated Dysfonctionnement Nasal Chronique (French) or Chronic Nasal Dysfunction (English) questionnaire at 6 weeks and 7 months after surgery. Olfactory measurements were performed with the Sniffin' Stick test. A self-rating score of ≥1 was considered as "having a complaint." RESULTS Radical ethmoidectomy for NP improved not only the number of symptoms but also the intensity of symptoms. Before surgery, 64 of 65 patients (98.46%) reported at least three of the six symptoms, whereas 26 patients (40%) reported six symptoms, 16 (24.62%) reported five symptoms, and 14 (21.54%) reported four symptoms. At 6 weeks and at 7 months after surgery, one-third of the patients had fewer than three symptoms. Olfactory disturbance remained the most mentioned postoperative disabling problem. Posterior discharge tended to become more pronounced at 7 months than at 6 weeks after surgery but remained considerably improved compared with the preoperative state. CONCLUSION This information is useful to warn patients about the difficulty of getting rid of all symptoms and that there is a chance that some symptoms remain or even reappear after NP surgery.
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Affiliation(s)
- Duc Trung Nguyen
- Department of Ear, Nose & Throat-Head and Neck Surgery University Hospital of Nancy, Nancy, France
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21
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Sinonasal symptom assessment by the self-reported DyNaChron questionnaire: Before or after consultation? Eur Ann Otorhinolaryngol Head Neck Dis 2016; 134:19-22. [PMID: 27726976 DOI: 10.1016/j.anorl.2016.09.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Assessment of sinonasal symptoms on a self-reported questionnaire is thoroughly subjective, but indispensable for quantifying symptoms. The present study sought to compare responses on the DyNaChron questionnaire just before and just after consultation for chronic sinonasal dysfunction. MATERIALS AND METHODS 78 patients (mean age, 43.1±16.9 years) consulting for chronic sinonasal dysfunction took part in a prospective study, responding to the computerized version of the DyNaChron self-reported questionnaire, in a dedicated room, just before and just after medical interview and physical examination. RESULTS Most patients tended to grade symptoms as less severe after consultation. Significant differences in mean score were found for nasal obstruction (difference of 0.94/10), anterior (0.40) and posterior rhinorrhea (0.26), olfactory disorder (0.65), and facial pain and headache (0.65), but not for chronic cough. CONCLUSION Self-reported scores for chronic sinonasal dysfunction differ slightly from before to after consultation. They are therefore to be interpreted with caution, taking account of possible factors of bias.
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Marino MJ, Riley CA, Patel AS, Pou JD, Kessler RH, McCoul ED. Paranasal sinus opacification-to-pneumatization ratio applied as a rapid and validated clinician assessment. Int Forum Allergy Rhinol 2016; 7:24-29. [PMID: 27509354 DOI: 10.1002/alr.21833] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 07/01/2016] [Accepted: 07/13/2016] [Indexed: 11/06/2022]
Abstract
BACKGROUND The utility of clinician-applied instruments, particularly the Lund-Mackay score, in the assessment of paranasal sinus computed tomography (CT) in chronic rhinosinusitis (CRS) remains incompletely defined. The purpose of this study was to determine if a new approach to the evaluation of sinus CT could accurately predict the extent of opacification while remaining simple for clinician use. METHODS Twenty-four sinus CT scans were measured for the percent of sinus opacification using three-dimensional (3D) volumetric analyses. The same scans were also evaluated using the Lund-Mackay score to measure opacification and the Assessment of Pneumatization of the Paranasal Sinuses (APPS) score to measure total sinus volume (TSV). Correlation analysis was performed for the Lund-Mackay to APPS score ratio as a predictor of percent opacification. Validation analysis was also performed to determine the optimal orientation for Lund-Mackay scoring, which has not previously been described. RESULTS The Lund-Mackay to APPS score ratio was very strongly correlated with the percentage of sinus opacification measured by 3D volumetric analysis (r = 0.862, r2 = 0.743, p < 0.001). Lund-Mackay scoring was not statistically different between axial-only, coronal-only, or triplanar groups for interrater (p = 0.379) and intrarater reliability (p = 0.312). CONCLUSION The Lund-Mackay score is validated for rater reliability in multiple orientations. Using the APPS score as a measure of TSV, the Lund-Mackay-to-APPS ratio very strongly correlates with the percentage of sinus opacification by 3D volumetric analysis. Further study will be required to determine if this ratio is predictive of symptom severity.
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Affiliation(s)
- Michael J Marino
- Department of Otolaryngology-Head and Neck Surgery, Tulane University School of Medicine, New Orleans, LA
| | - Charles A Riley
- Department of Otolaryngology-Head and Neck Surgery, Tulane University School of Medicine, New Orleans, LA
| | - Amit S Patel
- Department of Otolaryngology-Head and Neck Surgery, Tulane University School of Medicine, New Orleans, LA
| | - Jason D Pou
- Department of Otolaryngology-Head and Neck Surgery, Tulane University School of Medicine, New Orleans, LA
| | - Raymond H Kessler
- Department of Otolaryngology-Head and Neck Surgery, Tulane University School of Medicine, New Orleans, LA
| | - Edward D McCoul
- Department of Otolaryngology-Head and Neck Surgery, Tulane University School of Medicine, New Orleans, LA.,Department of Otorhinolaryngology, Ochsner Clinic Foundation, New Orleans, LA.,Ochsner Clinical School, University of Queensland School of Medicine, New Orleans, LA
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Korkmaz H, Yao W, Korkmaz M, Bleier BS. Benefit of Preoperative Oral Steroids during Sinus Surgery when Utilizing Concentrated Topical Epinephrine. ORL J Otorhinolaryngol Relat Spec 2016; 78:216-22. [PMID: 27383647 DOI: 10.1159/000446806] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 05/13/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Oral steroids have been advocated in the preoperative setting as a means of reducing intraoperative blood loss and surgical time during sinus surgery. The purpose of this study was to analyze the impact of preoperative oral steroid administration on intraoperative bleeding and surgical duration when coupled with concentrated topical epinephrine. METHODS The medical records of 302 patients who underwent bilateral 'full house' sinus surgery were reviewed. Concentrated topical epinephrine and inhalational anesthesia was used in all patients. Surgical duration and estimated blood loss were compared between the preoperative steroid-exposed and steroid-naive groups. χ2 and Student's t tests were used for statistical analysis. RESULTS One hundred and forty-two patients were exposed to steroid, while the remaining 160 were steroid naive. No significant differences were found with respect to surgical time between the steroid-exposed (96.91 ± 25.97 min) and steroid-naive patients (91.24 ± 32.29 min, p = 0.100). The steroid-exposed group demonstrated a marginally increased blood loss (66.03 ± 55.81 ml) as compared to steroid-naive patients (55.00 ± 38.71 ml, p = 0.048). CONCLUSION When coupled with intraoperative concentrated topical epinephrine use, preoperative oral steroid administration provides no clinically significant benefit with respect to reduced intraoperative bleeding or surgical duration.
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Affiliation(s)
- Hakan Korkmaz
- Otorhinolaryngology Department, Ordu University Faculty of Medicine, Ordu, Turkey
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24
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Sheikh SI, Handly B, Ryan-Wenger NA, Hayes D, Kirkby SE, McCoy KS, Lind M. Novel Computed Tomography Scoring System for Sinus Disease in Adults With Cystic Fibrosis. Ann Otol Rhinol Laryngol 2016; 125:838-43. [PMID: 27357973 DOI: 10.1177/0003489416656645] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE There is no easy to use scoring system for computed tomography (CT) scans of the sinuses that is specific to cystic fibrosis (CF). We propose a simple and easily implemented scoring system to quantify severity of sinus disease in adults with CF. STUDY DESIGN Case series with chart review. SETTING Academic tertiary-care referral center. SUBJECTS Sixty-nine adult patients with CF and 50 age-matched controls. METHODS We validated a scoring system for CF sinus disease. The CT scans were interpreted by 3 physicians on 2 separate sittings. Parameters include maxillary opacification, nasal obstruction, lateral nasal wall displacement, uncinate process absence/demineralization, and presence/absence of mucocele. RESULTS Patients with CF aged 21 to 30 years (mean = 24.7 ± 2.49). In CF cohort (n = 69), intrarater reliability for the 10 CT categories ranged from .70 to 1.00. Twenty-six (87%) were in the excellent range, and the remaining 4 (13%) were evaluated as good. In the non-CF cohort (n = 50), reliabilities ranged from .44 to 1.00. Twenty-seven (90%) were in the excellent range. For interrater reliability, in the CF cohort, 10 CT categories across the 3 raters ranged from .55 to 1.00. Excellent reliability was achieved in 15 (50%) of the observations. In the non-CF cohort, reliabilities ranged from .44 to 1.00. CONCLUSION A novel and easy to use CT scoring system for CF sinus disease in adults was validated with inter- and intrarater reliability. This new CF sinus disease-specific scoring system can be used by clinicians, surgeons, and radiologists.
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Affiliation(s)
- Shahid I Sheikh
- Departments of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Brian Handly
- Radiology, The Ohio State University College of Medicine, Columbus, Ohio, USA Radiological Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Nancy A Ryan-Wenger
- Departments of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Don Hayes
- Departments of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Stephen E Kirkby
- Departments of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Karen S McCoy
- Departments of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Meredith Lind
- Otolaryngology, The Ohio State University College of Medicine, Columbus, Ohio, USA Department of Otolaryngology, Nationwide Children's Hospital, Columbus, Ohio, USA
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Moroi A, Yoshizawa K, Tsutsui T, Saida Y, Hotta A, Fukaya K, Hiraide R, Takayama A, Tunoda T, Saito Y, Ueki K. Assessment of nasal septum after Le Fort I osteotomy with computer tomography. J Craniomaxillofac Surg 2016; 44:1187-93. [PMID: 27397093 DOI: 10.1016/j.jcms.2016.05.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 04/15/2016] [Accepted: 05/31/2016] [Indexed: 11/29/2022] Open
Abstract
The purpose of this study was to evaluate the effects of Le Fort I osteotomy on nasal septum deviation and differences in left and right airway sizes, and to determine whether the nasal septum was affected by differences in the direction of movement. Forty patients underwent conventional Le Fort I osteotomy, and computed tomography (CT) was performed preoperatively, and 1 week and 1 year postoperatively. The nasal septum angle and airway area were measured at the anterior, middle, and posterior positions on the CT images Patients were divided into 2 groups depending on each difference in movement (impaction ≥5 mm or other; anterior movement or other; and impaction asymmetry or other). There were no significant differences in the nasal septum angle and the airway of all patients. Among the patient groups, there were no significant differences in the nasal septum angle and airway. We concluded that conventional LI osteotomy did not influence the nasal septum deviation or the left and right airway asymmetry. Differences in the method of moving the maxilla have not been shown to affect changes in the nasal septum.
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Affiliation(s)
- Akinori Moroi
- Department of Oral & Maxillofacial Surgery (Chief: Prof. Koichiro Ueki, DDS, PhD), Division of Clinical Medicine, Graduate Faculty of Interdisciplinary Research, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, 409-3898, Japan.
| | - Kunio Yoshizawa
- Department of Oral & Maxillofacial Surgery (Chief: Prof. Koichiro Ueki, DDS, PhD), Division of Clinical Medicine, Graduate Faculty of Interdisciplinary Research, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, 409-3898, Japan
| | - Takamitsu Tsutsui
- Department of Oral & Maxillofacial Surgery (Chief: Prof. Koichiro Ueki, DDS, PhD), Division of Clinical Medicine, Graduate Faculty of Interdisciplinary Research, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, 409-3898, Japan
| | - Yuriko Saida
- Department of Oral & Maxillofacial Surgery (Chief: Prof. Koichiro Ueki, DDS, PhD), Division of Clinical Medicine, Graduate Faculty of Interdisciplinary Research, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, 409-3898, Japan
| | - Asami Hotta
- Department of Oral & Maxillofacial Surgery (Chief: Prof. Koichiro Ueki, DDS, PhD), Division of Clinical Medicine, Graduate Faculty of Interdisciplinary Research, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, 409-3898, Japan
| | - Kenichi Fukaya
- Department of Oral & Maxillofacial Surgery (Chief: Prof. Koichiro Ueki, DDS, PhD), Division of Clinical Medicine, Graduate Faculty of Interdisciplinary Research, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, 409-3898, Japan
| | - Ryota Hiraide
- Department of Oral & Maxillofacial Surgery (Chief: Prof. Koichiro Ueki, DDS, PhD), Division of Clinical Medicine, Graduate Faculty of Interdisciplinary Research, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, 409-3898, Japan
| | - Akihiro Takayama
- Department of Oral & Maxillofacial Surgery (Chief: Prof. Koichiro Ueki, DDS, PhD), Division of Clinical Medicine, Graduate Faculty of Interdisciplinary Research, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, 409-3898, Japan
| | - Tatsuya Tunoda
- Department of Oral & Maxillofacial Surgery (Chief: Prof. Koichiro Ueki, DDS, PhD), Division of Clinical Medicine, Graduate Faculty of Interdisciplinary Research, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, 409-3898, Japan
| | - Yuuki Saito
- Department of Oral & Maxillofacial Surgery (Chief: Prof. Koichiro Ueki, DDS, PhD), Division of Clinical Medicine, Graduate Faculty of Interdisciplinary Research, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, 409-3898, Japan
| | - Koichiro Ueki
- Department of Oral & Maxillofacial Surgery (Chief: Prof. Koichiro Ueki, DDS, PhD), Division of Clinical Medicine, Graduate Faculty of Interdisciplinary Research, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, 409-3898, Japan
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D'Agostino A, Trevisiol L, Favero V, Pessina M, Procacci P, Nocini PF. Are Zygomatic Implants Associated With Maxillary Sinusitis? J Oral Maxillofac Surg 2016; 74:1562-73. [PMID: 27070844 DOI: 10.1016/j.joms.2016.03.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 03/15/2016] [Accepted: 03/15/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE The purpose of the present study was to analyze the relation between zygomatic implants and symptomatic and radiologic modifications of the maxillary sinuses. MATERIALS AND METHODS A retrospective cohort study of patients who underwent zygomatic implant rehabilitation at the Clinic of Dentistry and Maxillofacial Surgery of the University of Verona from January 2005 through May 2014 was designed. The primary predictor variable was time (pre- vs postoperative). Concerning outcome variables, radiologic findings of thickened mucosa or opacification of the maxillary sinuses were evaluated on computed tomograms using the Lund-Mackay Staging System. Clinical symptoms were evaluated using the Sino-Nasal Outcome Test-20 (SNOT-20). The parameters assessed underwent descriptive statistical analysis. RESULTS The sample was composed of 41 patients (mean age, 54 yr; 61% women). Preoperatively, 12% had sinus findings. Postoperatively, 46% had sinus findings (P = .0001 by McNemar paired test). Preoperatively, 12% had a SNOT-20 score higher than 11. Postoperatively, 15% had a SNOT-20 score higher than 11 (P = 1 by McNemar paired test). CONCLUSIONS In accordance with data in the literature data, placement of zygomatic implants does not seem to be associated with severe rhinosinusitis complications. However, in a considerable number of patients, asymptomatic radiologic alterations of the paranasal sinuses were observed. Therefore, it is important to plan assessments of the prosthetic and peri-implant components of the procedure and the postoperative homeostasis of the maxillary sinuses.
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Affiliation(s)
- Antonio D'Agostino
- Associate Professor, Section of Oral and Maxillofacial Surgery, University of Verona, Verona, Italy
| | - Lorenzo Trevisiol
- Associate Professor, Section of Oral and Maxillofacial Surgery, University of Verona, Verona, Italy
| | - Vittorio Favero
- Clinical Assistant, Section of Oral and Maxillofacial Surgery, University of Verona, Verona, Italy.
| | - Mattia Pessina
- Clinical Assistant, Section of Oral and Maxillofacial Surgery, University of Verona, Verona, Italy
| | - Pasquale Procacci
- Assistant Professor, Section of Oral and Maxillofacial Surgery, University of Verona, Verona, Italy
| | - Pier Francesco Nocini
- Professor and Chief, Section of Oral and Maxillofacial Surgery, University of Verona, Verona, Italy
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Nocini PF, D'Agostino A, Trevisiol L, Favero V, Pessina M, Procacci P. Is Le Fort I Osteotomy Associated With Maxillary Sinusitis? J Oral Maxillofac Surg 2015; 74:400.e1-400.e12. [PMID: 26546843 DOI: 10.1016/j.joms.2015.10.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 09/30/2015] [Accepted: 10/07/2015] [Indexed: 11/29/2022]
Abstract
PURPOSE The purpose of the present study was to investigate the association between Le Fort I osteotomy and the anatomic, radiologic, and symptomatic modifications of the maxillary sinus. MATERIALS AND METHODS Subjects who had undergone Le Fort I osteotomy from January 2008 to December 2013 were enrolled in a retrospective cohort study. The eligibility criteria were the availability of a cone beam computed tomography (CBCT) scan taken before and 12 to 24 months after the procedure. The exclusion criteria were the unavailability of CBCT scans, the use of tobacco, and previous orthognathic procedures. The primary predictor variable was time (pre-vs postoperative). The primary outcome variables were the sinus volume, mucosal thickening, iatrogenic alterations in the sinus anatomy, and rhinosinusitis symptoms, evaluated using the Sino-Nasal Outcome 20-item Test (SNOT-20). Descriptive statistics were computed for each variable, and paired analyses were used to compare the pre- and postoperative values. RESULTS The data from 64 subjects (mean age 27; 59.4% were female; median follow-up 32.4 months, range 13 to 66 months) were studied. Postoperatively, 1.6% of the sample (0% preoperatively) had moderate-to-severe and 15.6% (3.1% preoperatively) had mild-to-moderate sinusitis symptoms. The rest of the sample presented with mild to no symptoms. The increase in the SNOT scores after surgery was statistically significant (P = .016). Radiologic evidence of postoperative inflammatory processes affecting the paranasal sinuses was found in 27.3% of the sinuses (9.4% preoperatively). The postoperative Lund-Mackay scores were significantly greater (P = .0005). A 19% decrease was found in the mean postoperative sinus volume, with a 37% incidence of iatrogenic injury. CONCLUSIONS The study results indicate that Le Fort I osteotomies can have an important impact on sinus health. The postoperative radiologic evidence of maxillary sinus inflammatory processes and the incidence of rhinosinusitis symptoms and iatrogenic damage in these patients have led us to conclude that CBCT scans and the SNOT-20 questionnaire should be used routinely during postoperative monitoring. Larger long-term studies are warranted to clarify the postoperative outcomes and complications.
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Affiliation(s)
- Pier Francesco Nocini
- Professor and Chief, Section of Oral and Maxillofacial Surgery, Department of Surgery, University of Verona, Verona, Italy
| | - Antonio D'Agostino
- Associate Professor, Section of Oral and Maxillofacial Surgery, Department of Surgery, University of Verona, Verona, Italy
| | - Lorenzo Trevisiol
- Associate Professor, Section of Oral and Maxillofacial Surgery, Department of Surgery, University of Verona, Verona, Italy.
| | - Vittorio Favero
- Maxillo-Facial Surgeon, Section of Oral and Maxillofacial Surgery, Department of Surgery, University of Verona, Verona, Italy
| | - Mattia Pessina
- Maxillo-Facial Surgeon, Section of Oral and Maxillofacial Surgery, Department of Surgery, University of Verona, Verona, Italy
| | - Pasquale Procacci
- Assistant Professor, Section of Oral and Maxillofacial Surgery, Department of Surgery, University of Verona, Verona, Italy
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Carroll WW, O'Connell BP, Schlosser RJ, Gudis DA, Karnezis TT, Lawrence LA, Soler ZM, Mulligan JK. Fibroblast levels are increased in chronic rhinosinusitis with nasal polyps and are associated with worse subjective disease severity. Int Forum Allergy Rhinol 2015; 6:162-8. [DOI: 10.1002/alr.21636] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 07/24/2015] [Accepted: 08/04/2015] [Indexed: 12/18/2022]
Affiliation(s)
- William W. Carroll
- Department of Otolaryngology-Head and Neck Surgery; Medical University of South Carolina; Charleston SC
| | - Brendan P. O'Connell
- Department of Otolaryngology-Head and Neck Surgery; Medical University of South Carolina; Charleston SC
| | - Rodney J. Schlosser
- Department of Otolaryngology-Head and Neck Surgery; Medical University of South Carolina; Charleston SC
- Ralph H. Johnson VA Medical Center; Charleston SC
| | - David A. Gudis
- Department of Otolaryngology-Head and Neck Surgery; Medical University of South Carolina; Charleston SC
| | - Tom T. Karnezis
- Department of Otolaryngology-Head and Neck Surgery; Medical University of South Carolina; Charleston SC
| | - Lauren A. Lawrence
- Department of Otolaryngology-Head and Neck Surgery; Medical University of South Carolina; Charleston SC
| | - Zachary M. Soler
- Department of Otolaryngology-Head and Neck Surgery; Medical University of South Carolina; Charleston SC
| | - Jennifer K. Mulligan
- Department of Otolaryngology-Head and Neck Surgery; Medical University of South Carolina; Charleston SC
- Ralph H. Johnson VA Medical Center; Charleston SC
- Department of Pediatrics; Medical University of South Carolina; Charleston SC
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Lind H, Joergensen G, Lange B, Svendstrup F, Kjeldsen AD. Efficacy of ESS in chronic rhinosinusitis with and without nasal polyposis: a Danish cohort study. Eur Arch Otorhinolaryngol 2015; 273:911-9. [PMID: 26031891 DOI: 10.1007/s00405-015-3667-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 05/22/2015] [Indexed: 11/25/2022]
Abstract
Endoscopic sinus surgery (ESS) for patients with severe chronic rhinosinusitis (CRS) has become a well-established treatment in cases where medical therapy fails. Even though CRS patients are divided into two subgroups, CRS with nasal polyposis (CRSwNP) and CRS without nasal polyposis (CRSsNP), most studies present only results for the total cohort. This prospective cohort study evaluated the efficacy of ESS on both quality of life and olfactory function measures, in a cohort of Danish CRS patients diagnosed according to the EPOS criteria, with results analysed separately for the CRSwNP and CRSsNP subgroups. All 97 CRS patients who underwent ESS over an 18-month trial period were evaluated preoperative by SNOT-22 score, Sniffin' Sticks score, modified Lund-Kennedy endoscopic score and Lund-Mackay CT score. Patient outcomes were reevaluated at clinical follow-up 1 and 6 months postoperative. ESS efficiently and immediately improved quality of life for both CRSwNP and CRSsNP patients, with over 50 % reduction in SNOT-22 score 1 month after surgery, which sustained 6 months postoperative. Olfactory function measured by Sniffin' Sticks score showed overall improvement in both groups. ESS efficiently improved quality of life in both CRSwNP and CRSsNP patients, and surgery lead to an overall improvement in olfactory function. However, a minor proportion of patients experienced deterioration in olfactory function after ESS.
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Affiliation(s)
- Henrik Lind
- Department of Otorhinolaryngology, Odense University Hospital, Odense, Denmark.
| | - G Joergensen
- Department of Otorhinolaryngology, Svendborg Hospital, Svendborg, Denmark
| | - B Lange
- Department of Otorhinolaryngology, Odense University Hospital, Odense, Denmark
| | - F Svendstrup
- Department of Otorhinolaryngology, Svendborg Hospital, Svendborg, Denmark
| | - A D Kjeldsen
- Department of Otorhinolaryngology, Odense University Hospital, Odense, Denmark
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30
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Choi JW, Kim EH, Ryu IS, Lim HW, Song YJ, Yeo NK. Headache Characteristics in Rhinologic Patients and the Role of Surgical Treatment. JOURNAL OF RHINOLOGY 2015. [DOI: 10.18787/jr.2015.22.1.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Jae Won Choi
- Department of Otorhinolaryngology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Eung Ho Kim
- Department of Otorhinolaryngology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - In Sun Ryu
- Department of Otorhinolaryngology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Hyun Woo Lim
- Department of Otorhinolaryngology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Yong Jin Song
- Department of Otorhinolaryngology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Nam-Kyung Yeo
- Department of Otorhinolaryngology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
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31
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Hong SJ, Lee JK, Lee HS, Lee JY, Pyo JS, Lee KC. Availability of preoperative systemic steroids on endoscopic sinus surgery for chronic rhinosinusitis with nasal polyposis. Yonsei Med J 2014; 55:1683-90. [PMID: 25323909 PMCID: PMC4205712 DOI: 10.3349/ymj.2014.55.6.1683] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
PURPOSE To analyze the outcome of endoscopic sinus surgery (ESS) after preoperative systemic steroid (PSS) treatment for chronic rhinosinusitis (CRS) with nasal polyposis (NP) and to investigate and compare clinicopathological factors associated with the outcome. MATERIALS AND METHODS We performed a retrospective chart review of 468 patients with CRS with NP who underwent primary ESS between January 2005 and October 2011. 124 patients who met the inclusion criteria were included. Beginning from 2008, our clinic administered steroid preoperatively in patients of CRS with NP, thus there were 84 patients with preoperative systemic steroid (PSS group) and another 40 patients without such regimen (no PSS group). To evaluate the outcome after ESS, poor outcome and complication were analyzed according to the following parameters: age, sex, follow-up duration, eosinophilic infiltration, atopy, asthma, Lund-Mackay score, and polyp grade. RESULTS There was no significant difference in poor outcome rates between the PSS and no PSS group (35.0% vs. 47.6%, p=0.185). There was no significant difference in complication rates between the PSS and no PSS group (10% vs. 6%, p=0.468). As with the multivariate analysis of the clinicopathological factors to the poor outcome rate, presence of asthma and eosinophilic infiltration were significantly related (odds ratio as 6.555 and 4.505, respectively), whereas PSS was confirmed as less likely related (odds ratio 0.611). CONCLUSION Low dose PSS administration does not seem to have an effect on the outcome after ESS in patients who have CRS with NP. Eosinophilic infiltration and presence of asthma are important predictors of surgical outcome.
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Affiliation(s)
- Seok Jin Hong
- Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jong Kyu Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyun Sub Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung Yup Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung Soo Pyo
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyung Chul Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Nguyen DT, Guillemin F, Arous F, Jankowski R. Assessment of quality-of-life outcomes after surgery for nasal polyposis with the DyNaChron questionnaire. Eur Arch Otorhinolaryngol 2014; 272:367-75. [PMID: 24899410 DOI: 10.1007/s00405-014-3109-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 05/19/2014] [Indexed: 01/11/2023]
Abstract
This prospective study assesses outcomes at 6 weeks and 7 months after radical ethmoid surgery in 65 patients with nasal polyposis using a new and detailed instrument, the DyNaChron questionnaire, which was filled in the day prior to surgery and at 6 weeks and 7 months after surgery at follow-up visits. Before surgery, the leading bothersome symptoms were olfactory disturbances (7.74 ± 2.81) and nasal obstruction (6.66 ± 2.28). After surgery (6th week and 7th month), there was a clear improvement of all symptoms including nasal obstruction, olfactory disturbances, anterior rhinorrhea, postnasal discharge, facial pain/headache and cough in comparison to baseline (p < 0.0001). Nasal obstruction was the most improved symptom (effect size of 2.24). At 7th post-operative month, the sense of smell continued to improve slightly. By contrast, the postnasal discharge score that was significantly improved at 6th post-operative week tended to worsen at 7 months (p = 0.0045). Before surgery, strong psychosocial impacts were observed in association with nasal obstruction and anterior rhinorrhea. The physical impacts of each symptom were proportionally correlated to the symptom score before and after surgery. The quality of life (QOL) related to each symptom was clearly better at 6 weeks and remained steady at 7 months after surgery. In conclusion, olfactory disorders and postnasal rhinorrhea were the main remaining symptoms after sinus surgery despite a global improvement of symptoms and quality of life. The earlier time point to stabilize QOL outcomes of endoscopic sinus surgery could be suggested at 6 weeks after surgery.
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Affiliation(s)
- Duc Trung Nguyen
- Departments of ENT, Head and Neck Surgery, Nancy University Hospital - Service d'Otorhinolaryngologie et Chirurgie Cervico-Faciale, Hôpital Central, Centre Hospitalier Universitaire de Nancy, 29, Av. du Maréchal de Lattre de Tassigny, 54000, Nancy, France,
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Amodu EJ, Fasunla AJ, Akano AO, Daud Olusesi A. Chronic rhinosinusitis: correlation of symptoms with computed tomography scan findings. Pan Afr Med J 2014; 18:40. [PMID: 25368729 PMCID: PMC4215380 DOI: 10.11604/pamj.2014.18.40.2839] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 01/06/2014] [Indexed: 11/21/2022] Open
Abstract
Introduction Symptomatology, nasal endoscopy and Computerised Tomographic (CT) scan have been used to diagnose chronic rhinosinusitis. The value of disease severity score in the assessment of chronic rhinosinusitis has not been well investigated. Hence, this study aims to correlate the pre-operative symptom severity score as well as overall disease severity scoreof patients with chronic rhinosinusitis with CT scan scores. Methods This is a prospective study of 60 patients diagnosed clinically with chronic rhinosinusitis. Each patientsubjectively assessed his/her presenting symptoms and severity of disease on a visual analogue scale. The patients had CT scan of the paranasal sinuses which were graded and scored using Lund-Mackay grading system. The correlation study between severity of symptoms/disease severity and CT scores was performed. The level of statistical significance was considered at p < 0.05 and confidence interval at 95%. Results All patients had more than one symptom with mean symptom severity scores highest for nasal discharge and nasal obstruction. There was a significant correlation between CT scores and nasal discharge (r = -0.132; p = 0.03)and nasal obstruction (r = 0.193; p = 0.049). No correlation with other symptoms. There wasno correlation between the overall disease severity scores and the Lund-Mackay CT scores (r = 0.195; p = 0.6). Conclusion This study showed that CT scan scores can help clinicians to predict severity of symptom for nasal obstruction and discharge but not for other symptoms of chronic rhinosinusitis. However, there was no association of CT score with the overall disease severity score.
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Affiliation(s)
- Enema Job Amodu
- Department of ENT, National Hospital, Plot 132, Central district, (Phase II), PMB 425, Garki-Abuja, Nigeria
| | - Ayotunde James Fasunla
- Department of Otorhinolaryngology, University College Hospital & College of Medicine, University of Ibadan, Ibadan, Oyo-State, Nigeria
| | - Aliu Oyebamiji Akano
- Department of Radiology, National Hospital, Plot 132, Central district, (Phase II), PMB 425, Garki-Abuja, Nigeria
| | - Abiodun Daud Olusesi
- Department of ENT, National Hospital, Plot 132, Central district, (Phase II), PMB 425, Garki-Abuja, Nigeria
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Pallanch J, Yu L, Delone D, Robb R, Holmes DR, Camp J, Edwards P, McCollough CH, Ponikau J, Dearking A, Lane J, Primak A, Shinkle A, Hagan J, Frigas E, Ocel JJ, Tombers N, Siwani R, Orme N, Reed K, Jerath N, Dhillon R, Kita H. Three-dimensional volumetric computed tomographic scoring as an objective outcome measure for chronic rhinosinusitis: clinical correlations and comparison to Lund-Mackay scoring. Int Forum Allergy Rhinol 2013; 3:963-72. [PMID: 24106202 PMCID: PMC3971423 DOI: 10.1002/alr.21219] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 06/28/2013] [Accepted: 08/01/2013] [Indexed: 11/06/2022]
Abstract
BACKGROUND We aimed to test the hypothesis that three-dimensional (3D) volume-based scoring of computed tomography (CT) images of the paranasal sinuses was superior to Lund-Mackay CT scoring of disease severity in chronic rhinosinusitis (CRS). We determined correlation between changes in CT scores (using each scoring system) with changes in other measures of disease severity (symptoms, endoscopic scoring, and quality of life) in patients with CRS treated with triamcinolone. METHODS The study group comprised 48 adult subjects with CRS. Baseline symptoms and quality of life were assessed. Endoscopy and CT scans were performed. Patients received a single systemic dose of intramuscular triamcinolone and were reevaluated 1 month later. Strengths of the correlations between changes in CT scores and changes in CRS signs and symptoms and quality of life were determined. RESULTS We observed some variability in degree of improvement for the different symptom, endoscopic, and quality-of-life parameters after treatment. Improvement of parameters was significantly correlated with improvement in CT disease score using both CT scoring methods. However, volumetric CT scoring had greater correlation with these parameters than Lund-Mackay scoring. CONCLUSION Volumetric scoring exhibited higher degree of correlation than Lund-Mackay scoring when comparing improvement in CT score with improvement in score for symptoms, endoscopic exam, and quality of life in this group of patients who received beneficial medical treatment for CRS.
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Affiliation(s)
- John Pallanch
- Department of Otorhinolaryngology–Head and Neck Surgery (Drs Pallanch and Dearking, and Ms Tombers), Department of Radiology (Drs DeLone, Yu, Lane, and McCollough), Department of Physiology and Biomedical Engineering (Messrs Camp and Edwards, and Drs Holmes and Robb), Division of Allergic Diseases (Drs Hagan, Frigas and Kita), and Department of Immunology (Dr Kita), Department of Pediatric and Adolescent Medicine (Dr. Siwani), Department of Cardiovascular Diseases (Dr. Orme), Department of Dermatologic Surgery (Dr. Reed), Mayo Clinic, Rochester, Minnesota. University of Alabama, Birmingham (Dr. Shinkle); Radiologists of North Iowa, Mason City, Iowa (Dr. Ocel); University of Buffalo, Buffalo, New York (Dr. Ponikau); Siemens Corporation: (Dr. Primak); Wayne State University: (Dr. Dhillon); University of Iowa: (Dr. Jerath)
| | - Lifeng Yu
- Department of Otorhinolaryngology–Head and Neck Surgery (Drs Pallanch and Dearking, and Ms Tombers), Department of Radiology (Drs DeLone, Yu, Lane, and McCollough), Department of Physiology and Biomedical Engineering (Messrs Camp and Edwards, and Drs Holmes and Robb), Division of Allergic Diseases (Drs Hagan, Frigas and Kita), and Department of Immunology (Dr Kita), Department of Pediatric and Adolescent Medicine (Dr. Siwani), Department of Cardiovascular Diseases (Dr. Orme), Department of Dermatologic Surgery (Dr. Reed), Mayo Clinic, Rochester, Minnesota. University of Alabama, Birmingham (Dr. Shinkle); Radiologists of North Iowa, Mason City, Iowa (Dr. Ocel); University of Buffalo, Buffalo, New York (Dr. Ponikau); Siemens Corporation: (Dr. Primak); Wayne State University: (Dr. Dhillon); University of Iowa: (Dr. Jerath)
| | - David Delone
- Department of Otorhinolaryngology–Head and Neck Surgery (Drs Pallanch and Dearking, and Ms Tombers), Department of Radiology (Drs DeLone, Yu, Lane, and McCollough), Department of Physiology and Biomedical Engineering (Messrs Camp and Edwards, and Drs Holmes and Robb), Division of Allergic Diseases (Drs Hagan, Frigas and Kita), and Department of Immunology (Dr Kita), Department of Pediatric and Adolescent Medicine (Dr. Siwani), Department of Cardiovascular Diseases (Dr. Orme), Department of Dermatologic Surgery (Dr. Reed), Mayo Clinic, Rochester, Minnesota. University of Alabama, Birmingham (Dr. Shinkle); Radiologists of North Iowa, Mason City, Iowa (Dr. Ocel); University of Buffalo, Buffalo, New York (Dr. Ponikau); Siemens Corporation: (Dr. Primak); Wayne State University: (Dr. Dhillon); University of Iowa: (Dr. Jerath)
| | - Rich Robb
- Department of Otorhinolaryngology–Head and Neck Surgery (Drs Pallanch and Dearking, and Ms Tombers), Department of Radiology (Drs DeLone, Yu, Lane, and McCollough), Department of Physiology and Biomedical Engineering (Messrs Camp and Edwards, and Drs Holmes and Robb), Division of Allergic Diseases (Drs Hagan, Frigas and Kita), and Department of Immunology (Dr Kita), Department of Pediatric and Adolescent Medicine (Dr. Siwani), Department of Cardiovascular Diseases (Dr. Orme), Department of Dermatologic Surgery (Dr. Reed), Mayo Clinic, Rochester, Minnesota. University of Alabama, Birmingham (Dr. Shinkle); Radiologists of North Iowa, Mason City, Iowa (Dr. Ocel); University of Buffalo, Buffalo, New York (Dr. Ponikau); Siemens Corporation: (Dr. Primak); Wayne State University: (Dr. Dhillon); University of Iowa: (Dr. Jerath)
| | - David R. Holmes
- Department of Otorhinolaryngology–Head and Neck Surgery (Drs Pallanch and Dearking, and Ms Tombers), Department of Radiology (Drs DeLone, Yu, Lane, and McCollough), Department of Physiology and Biomedical Engineering (Messrs Camp and Edwards, and Drs Holmes and Robb), Division of Allergic Diseases (Drs Hagan, Frigas and Kita), and Department of Immunology (Dr Kita), Department of Pediatric and Adolescent Medicine (Dr. Siwani), Department of Cardiovascular Diseases (Dr. Orme), Department of Dermatologic Surgery (Dr. Reed), Mayo Clinic, Rochester, Minnesota. University of Alabama, Birmingham (Dr. Shinkle); Radiologists of North Iowa, Mason City, Iowa (Dr. Ocel); University of Buffalo, Buffalo, New York (Dr. Ponikau); Siemens Corporation: (Dr. Primak); Wayne State University: (Dr. Dhillon); University of Iowa: (Dr. Jerath)
| | - Jon Camp
- Department of Otorhinolaryngology–Head and Neck Surgery (Drs Pallanch and Dearking, and Ms Tombers), Department of Radiology (Drs DeLone, Yu, Lane, and McCollough), Department of Physiology and Biomedical Engineering (Messrs Camp and Edwards, and Drs Holmes and Robb), Division of Allergic Diseases (Drs Hagan, Frigas and Kita), and Department of Immunology (Dr Kita), Department of Pediatric and Adolescent Medicine (Dr. Siwani), Department of Cardiovascular Diseases (Dr. Orme), Department of Dermatologic Surgery (Dr. Reed), Mayo Clinic, Rochester, Minnesota. University of Alabama, Birmingham (Dr. Shinkle); Radiologists of North Iowa, Mason City, Iowa (Dr. Ocel); University of Buffalo, Buffalo, New York (Dr. Ponikau); Siemens Corporation: (Dr. Primak); Wayne State University: (Dr. Dhillon); University of Iowa: (Dr. Jerath)
| | - Phil Edwards
- Department of Otorhinolaryngology–Head and Neck Surgery (Drs Pallanch and Dearking, and Ms Tombers), Department of Radiology (Drs DeLone, Yu, Lane, and McCollough), Department of Physiology and Biomedical Engineering (Messrs Camp and Edwards, and Drs Holmes and Robb), Division of Allergic Diseases (Drs Hagan, Frigas and Kita), and Department of Immunology (Dr Kita), Department of Pediatric and Adolescent Medicine (Dr. Siwani), Department of Cardiovascular Diseases (Dr. Orme), Department of Dermatologic Surgery (Dr. Reed), Mayo Clinic, Rochester, Minnesota. University of Alabama, Birmingham (Dr. Shinkle); Radiologists of North Iowa, Mason City, Iowa (Dr. Ocel); University of Buffalo, Buffalo, New York (Dr. Ponikau); Siemens Corporation: (Dr. Primak); Wayne State University: (Dr. Dhillon); University of Iowa: (Dr. Jerath)
| | - Cynthia H. McCollough
- Department of Otorhinolaryngology–Head and Neck Surgery (Drs Pallanch and Dearking, and Ms Tombers), Department of Radiology (Drs DeLone, Yu, Lane, and McCollough), Department of Physiology and Biomedical Engineering (Messrs Camp and Edwards, and Drs Holmes and Robb), Division of Allergic Diseases (Drs Hagan, Frigas and Kita), and Department of Immunology (Dr Kita), Department of Pediatric and Adolescent Medicine (Dr. Siwani), Department of Cardiovascular Diseases (Dr. Orme), Department of Dermatologic Surgery (Dr. Reed), Mayo Clinic, Rochester, Minnesota. University of Alabama, Birmingham (Dr. Shinkle); Radiologists of North Iowa, Mason City, Iowa (Dr. Ocel); University of Buffalo, Buffalo, New York (Dr. Ponikau); Siemens Corporation: (Dr. Primak); Wayne State University: (Dr. Dhillon); University of Iowa: (Dr. Jerath)
| | - Jens Ponikau
- Department of Otorhinolaryngology–Head and Neck Surgery (Drs Pallanch and Dearking, and Ms Tombers), Department of Radiology (Drs DeLone, Yu, Lane, and McCollough), Department of Physiology and Biomedical Engineering (Messrs Camp and Edwards, and Drs Holmes and Robb), Division of Allergic Diseases (Drs Hagan, Frigas and Kita), and Department of Immunology (Dr Kita), Department of Pediatric and Adolescent Medicine (Dr. Siwani), Department of Cardiovascular Diseases (Dr. Orme), Department of Dermatologic Surgery (Dr. Reed), Mayo Clinic, Rochester, Minnesota. University of Alabama, Birmingham (Dr. Shinkle); Radiologists of North Iowa, Mason City, Iowa (Dr. Ocel); University of Buffalo, Buffalo, New York (Dr. Ponikau); Siemens Corporation: (Dr. Primak); Wayne State University: (Dr. Dhillon); University of Iowa: (Dr. Jerath)
| | - Amy Dearking
- Department of Otorhinolaryngology–Head and Neck Surgery (Drs Pallanch and Dearking, and Ms Tombers), Department of Radiology (Drs DeLone, Yu, Lane, and McCollough), Department of Physiology and Biomedical Engineering (Messrs Camp and Edwards, and Drs Holmes and Robb), Division of Allergic Diseases (Drs Hagan, Frigas and Kita), and Department of Immunology (Dr Kita), Department of Pediatric and Adolescent Medicine (Dr. Siwani), Department of Cardiovascular Diseases (Dr. Orme), Department of Dermatologic Surgery (Dr. Reed), Mayo Clinic, Rochester, Minnesota. University of Alabama, Birmingham (Dr. Shinkle); Radiologists of North Iowa, Mason City, Iowa (Dr. Ocel); University of Buffalo, Buffalo, New York (Dr. Ponikau); Siemens Corporation: (Dr. Primak); Wayne State University: (Dr. Dhillon); University of Iowa: (Dr. Jerath)
| | - John Lane
- Department of Otorhinolaryngology–Head and Neck Surgery (Drs Pallanch and Dearking, and Ms Tombers), Department of Radiology (Drs DeLone, Yu, Lane, and McCollough), Department of Physiology and Biomedical Engineering (Messrs Camp and Edwards, and Drs Holmes and Robb), Division of Allergic Diseases (Drs Hagan, Frigas and Kita), and Department of Immunology (Dr Kita), Department of Pediatric and Adolescent Medicine (Dr. Siwani), Department of Cardiovascular Diseases (Dr. Orme), Department of Dermatologic Surgery (Dr. Reed), Mayo Clinic, Rochester, Minnesota. University of Alabama, Birmingham (Dr. Shinkle); Radiologists of North Iowa, Mason City, Iowa (Dr. Ocel); University of Buffalo, Buffalo, New York (Dr. Ponikau); Siemens Corporation: (Dr. Primak); Wayne State University: (Dr. Dhillon); University of Iowa: (Dr. Jerath)
| | - Andrew Primak
- Department of Otorhinolaryngology–Head and Neck Surgery (Drs Pallanch and Dearking, and Ms Tombers), Department of Radiology (Drs DeLone, Yu, Lane, and McCollough), Department of Physiology and Biomedical Engineering (Messrs Camp and Edwards, and Drs Holmes and Robb), Division of Allergic Diseases (Drs Hagan, Frigas and Kita), and Department of Immunology (Dr Kita), Department of Pediatric and Adolescent Medicine (Dr. Siwani), Department of Cardiovascular Diseases (Dr. Orme), Department of Dermatologic Surgery (Dr. Reed), Mayo Clinic, Rochester, Minnesota. University of Alabama, Birmingham (Dr. Shinkle); Radiologists of North Iowa, Mason City, Iowa (Dr. Ocel); University of Buffalo, Buffalo, New York (Dr. Ponikau); Siemens Corporation: (Dr. Primak); Wayne State University: (Dr. Dhillon); University of Iowa: (Dr. Jerath)
| | - Aaron Shinkle
- Department of Otorhinolaryngology–Head and Neck Surgery (Drs Pallanch and Dearking, and Ms Tombers), Department of Radiology (Drs DeLone, Yu, Lane, and McCollough), Department of Physiology and Biomedical Engineering (Messrs Camp and Edwards, and Drs Holmes and Robb), Division of Allergic Diseases (Drs Hagan, Frigas and Kita), and Department of Immunology (Dr Kita), Department of Pediatric and Adolescent Medicine (Dr. Siwani), Department of Cardiovascular Diseases (Dr. Orme), Department of Dermatologic Surgery (Dr. Reed), Mayo Clinic, Rochester, Minnesota. University of Alabama, Birmingham (Dr. Shinkle); Radiologists of North Iowa, Mason City, Iowa (Dr. Ocel); University of Buffalo, Buffalo, New York (Dr. Ponikau); Siemens Corporation: (Dr. Primak); Wayne State University: (Dr. Dhillon); University of Iowa: (Dr. Jerath)
| | - John Hagan
- Department of Otorhinolaryngology–Head and Neck Surgery (Drs Pallanch and Dearking, and Ms Tombers), Department of Radiology (Drs DeLone, Yu, Lane, and McCollough), Department of Physiology and Biomedical Engineering (Messrs Camp and Edwards, and Drs Holmes and Robb), Division of Allergic Diseases (Drs Hagan, Frigas and Kita), and Department of Immunology (Dr Kita), Department of Pediatric and Adolescent Medicine (Dr. Siwani), Department of Cardiovascular Diseases (Dr. Orme), Department of Dermatologic Surgery (Dr. Reed), Mayo Clinic, Rochester, Minnesota. University of Alabama, Birmingham (Dr. Shinkle); Radiologists of North Iowa, Mason City, Iowa (Dr. Ocel); University of Buffalo, Buffalo, New York (Dr. Ponikau); Siemens Corporation: (Dr. Primak); Wayne State University: (Dr. Dhillon); University of Iowa: (Dr. Jerath)
| | - Evangelo Frigas
- Department of Otorhinolaryngology–Head and Neck Surgery (Drs Pallanch and Dearking, and Ms Tombers), Department of Radiology (Drs DeLone, Yu, Lane, and McCollough), Department of Physiology and Biomedical Engineering (Messrs Camp and Edwards, and Drs Holmes and Robb), Division of Allergic Diseases (Drs Hagan, Frigas and Kita), and Department of Immunology (Dr Kita), Department of Pediatric and Adolescent Medicine (Dr. Siwani), Department of Cardiovascular Diseases (Dr. Orme), Department of Dermatologic Surgery (Dr. Reed), Mayo Clinic, Rochester, Minnesota. University of Alabama, Birmingham (Dr. Shinkle); Radiologists of North Iowa, Mason City, Iowa (Dr. Ocel); University of Buffalo, Buffalo, New York (Dr. Ponikau); Siemens Corporation: (Dr. Primak); Wayne State University: (Dr. Dhillon); University of Iowa: (Dr. Jerath)
| | - Joseph J. Ocel
- Department of Otorhinolaryngology–Head and Neck Surgery (Drs Pallanch and Dearking, and Ms Tombers), Department of Radiology (Drs DeLone, Yu, Lane, and McCollough), Department of Physiology and Biomedical Engineering (Messrs Camp and Edwards, and Drs Holmes and Robb), Division of Allergic Diseases (Drs Hagan, Frigas and Kita), and Department of Immunology (Dr Kita), Department of Pediatric and Adolescent Medicine (Dr. Siwani), Department of Cardiovascular Diseases (Dr. Orme), Department of Dermatologic Surgery (Dr. Reed), Mayo Clinic, Rochester, Minnesota. University of Alabama, Birmingham (Dr. Shinkle); Radiologists of North Iowa, Mason City, Iowa (Dr. Ocel); University of Buffalo, Buffalo, New York (Dr. Ponikau); Siemens Corporation: (Dr. Primak); Wayne State University: (Dr. Dhillon); University of Iowa: (Dr. Jerath)
| | - Nicole Tombers
- Department of Otorhinolaryngology–Head and Neck Surgery (Drs Pallanch and Dearking, and Ms Tombers), Department of Radiology (Drs DeLone, Yu, Lane, and McCollough), Department of Physiology and Biomedical Engineering (Messrs Camp and Edwards, and Drs Holmes and Robb), Division of Allergic Diseases (Drs Hagan, Frigas and Kita), and Department of Immunology (Dr Kita), Department of Pediatric and Adolescent Medicine (Dr. Siwani), Department of Cardiovascular Diseases (Dr. Orme), Department of Dermatologic Surgery (Dr. Reed), Mayo Clinic, Rochester, Minnesota. University of Alabama, Birmingham (Dr. Shinkle); Radiologists of North Iowa, Mason City, Iowa (Dr. Ocel); University of Buffalo, Buffalo, New York (Dr. Ponikau); Siemens Corporation: (Dr. Primak); Wayne State University: (Dr. Dhillon); University of Iowa: (Dr. Jerath)
| | - Rizwan Siwani
- Department of Otorhinolaryngology–Head and Neck Surgery (Drs Pallanch and Dearking, and Ms Tombers), Department of Radiology (Drs DeLone, Yu, Lane, and McCollough), Department of Physiology and Biomedical Engineering (Messrs Camp and Edwards, and Drs Holmes and Robb), Division of Allergic Diseases (Drs Hagan, Frigas and Kita), and Department of Immunology (Dr Kita), Department of Pediatric and Adolescent Medicine (Dr. Siwani), Department of Cardiovascular Diseases (Dr. Orme), Department of Dermatologic Surgery (Dr. Reed), Mayo Clinic, Rochester, Minnesota. University of Alabama, Birmingham (Dr. Shinkle); Radiologists of North Iowa, Mason City, Iowa (Dr. Ocel); University of Buffalo, Buffalo, New York (Dr. Ponikau); Siemens Corporation: (Dr. Primak); Wayne State University: (Dr. Dhillon); University of Iowa: (Dr. Jerath)
| | - Nicholas Orme
- Department of Otorhinolaryngology–Head and Neck Surgery (Drs Pallanch and Dearking, and Ms Tombers), Department of Radiology (Drs DeLone, Yu, Lane, and McCollough), Department of Physiology and Biomedical Engineering (Messrs Camp and Edwards, and Drs Holmes and Robb), Division of Allergic Diseases (Drs Hagan, Frigas and Kita), and Department of Immunology (Dr Kita), Department of Pediatric and Adolescent Medicine (Dr. Siwani), Department of Cardiovascular Diseases (Dr. Orme), Department of Dermatologic Surgery (Dr. Reed), Mayo Clinic, Rochester, Minnesota. University of Alabama, Birmingham (Dr. Shinkle); Radiologists of North Iowa, Mason City, Iowa (Dr. Ocel); University of Buffalo, Buffalo, New York (Dr. Ponikau); Siemens Corporation: (Dr. Primak); Wayne State University: (Dr. Dhillon); University of Iowa: (Dr. Jerath)
| | - Kurtis Reed
- Department of Otorhinolaryngology–Head and Neck Surgery (Drs Pallanch and Dearking, and Ms Tombers), Department of Radiology (Drs DeLone, Yu, Lane, and McCollough), Department of Physiology and Biomedical Engineering (Messrs Camp and Edwards, and Drs Holmes and Robb), Division of Allergic Diseases (Drs Hagan, Frigas and Kita), and Department of Immunology (Dr Kita), Department of Pediatric and Adolescent Medicine (Dr. Siwani), Department of Cardiovascular Diseases (Dr. Orme), Department of Dermatologic Surgery (Dr. Reed), Mayo Clinic, Rochester, Minnesota. University of Alabama, Birmingham (Dr. Shinkle); Radiologists of North Iowa, Mason City, Iowa (Dr. Ocel); University of Buffalo, Buffalo, New York (Dr. Ponikau); Siemens Corporation: (Dr. Primak); Wayne State University: (Dr. Dhillon); University of Iowa: (Dr. Jerath)
| | - Nivedita Jerath
- Department of Otorhinolaryngology–Head and Neck Surgery (Drs Pallanch and Dearking, and Ms Tombers), Department of Radiology (Drs DeLone, Yu, Lane, and McCollough), Department of Physiology and Biomedical Engineering (Messrs Camp and Edwards, and Drs Holmes and Robb), Division of Allergic Diseases (Drs Hagan, Frigas and Kita), and Department of Immunology (Dr Kita), Department of Pediatric and Adolescent Medicine (Dr. Siwani), Department of Cardiovascular Diseases (Dr. Orme), Department of Dermatologic Surgery (Dr. Reed), Mayo Clinic, Rochester, Minnesota. University of Alabama, Birmingham (Dr. Shinkle); Radiologists of North Iowa, Mason City, Iowa (Dr. Ocel); University of Buffalo, Buffalo, New York (Dr. Ponikau); Siemens Corporation: (Dr. Primak); Wayne State University: (Dr. Dhillon); University of Iowa: (Dr. Jerath)
| | - Robinder Dhillon
- Department of Otorhinolaryngology–Head and Neck Surgery (Drs Pallanch and Dearking, and Ms Tombers), Department of Radiology (Drs DeLone, Yu, Lane, and McCollough), Department of Physiology and Biomedical Engineering (Messrs Camp and Edwards, and Drs Holmes and Robb), Division of Allergic Diseases (Drs Hagan, Frigas and Kita), and Department of Immunology (Dr Kita), Department of Pediatric and Adolescent Medicine (Dr. Siwani), Department of Cardiovascular Diseases (Dr. Orme), Department of Dermatologic Surgery (Dr. Reed), Mayo Clinic, Rochester, Minnesota. University of Alabama, Birmingham (Dr. Shinkle); Radiologists of North Iowa, Mason City, Iowa (Dr. Ocel); University of Buffalo, Buffalo, New York (Dr. Ponikau); Siemens Corporation: (Dr. Primak); Wayne State University: (Dr. Dhillon); University of Iowa: (Dr. Jerath)
| | - Hirohito Kita
- Department of Otorhinolaryngology–Head and Neck Surgery (Drs Pallanch and Dearking, and Ms Tombers), Department of Radiology (Drs DeLone, Yu, Lane, and McCollough), Department of Physiology and Biomedical Engineering (Messrs Camp and Edwards, and Drs Holmes and Robb), Division of Allergic Diseases (Drs Hagan, Frigas and Kita), and Department of Immunology (Dr Kita), Department of Pediatric and Adolescent Medicine (Dr. Siwani), Department of Cardiovascular Diseases (Dr. Orme), Department of Dermatologic Surgery (Dr. Reed), Mayo Clinic, Rochester, Minnesota. University of Alabama, Birmingham (Dr. Shinkle); Radiologists of North Iowa, Mason City, Iowa (Dr. Ocel); University of Buffalo, Buffalo, New York (Dr. Ponikau); Siemens Corporation: (Dr. Primak); Wayne State University: (Dr. Dhillon); University of Iowa: (Dr. Jerath)
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Nazri M, Bux SI, Tengku-Kamalden TF, Ng KH, Sun Z. Incidental detection of sinus mucosal abnormalities on CT and MRI imaging of the head. Quant Imaging Med Surg 2013; 3:82-8. [PMID: 23630655 DOI: 10.3978/j.issn.2223-4292.2013.03.06] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Accepted: 03/27/2013] [Indexed: 12/21/2022]
Abstract
PURPOSE To investigate the prevalence of incidental sinus abnormalities on CT and MRI imaging of the head, and identify if there is any correlation between patient symptomatology and image findings. MATERIALS AND METHODS One hundred and fifteen patients who underwent head CT or MRI for
non-sinus related indications were included in this study, with image findings being analysed based on the Lund-Mackay Grading System (LMS). These were compared with their symptomatology based on the SNAQ-11 questionnaire. Two reviewers who were blinded to the patients' SNAQ-11 scores analysed the images. Patients were also referred to an ENT surgeon for anterior rhinoscopy in an attempt to seek a correlation between symptomatology and/or imaging findings against clinical assessment. RESULTS The prevalence of incidental sinus abnormalities is between 14.8% and 37% for CT and 29.5% and 85.2% for MRI, depending upon the cutoff LMS used. There was no significant difference in the incidence rate between the different age groups or genders. Asymptomatic patients had a significantly lower incidence rate of sinus mucosal abnormalities (8.2-57.1%) when compared to the symptomatic patients (33.3-66.7%) (P<0.01). A significant correlation was found between the MRI sinus findings and patients' symptoms (r=0.59, P<0.001) with no correlation demonstrated in the CT group. The mean LM score for the patients with clinical sinusitis was 6.2, while the normal patients had a mean LM score of 2.2. CONCLUSIONS MRI is more sensitive than CT to detect sinus mucosal abnormalities. A significant correlation is noticed between MRI findings and patients' symptomatology.
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Affiliation(s)
- Mohammad Nazri
- University of Malaya Research and Imaging Centre (UMRIC), University of Malaya, 50603 Kuala Lumpur, Malaysia; ; Department of Biomedical Imaging, University of Malaya, Kuala Lumpur, 50603, Malaysia
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Cornelius RS, Martin J, Wippold FJ, Aiken AH, Angtuaco EJ, Berger KL, Brown DC, Davis PC, McConnell CT, Mechtler LL, Nussenbaum B, Roth CJ, Seidenwurm DJ. ACR Appropriateness Criteria Sinonasal Disease. J Am Coll Radiol 2013; 10:241-6. [DOI: 10.1016/j.jacr.2013.01.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Accepted: 01/02/2013] [Indexed: 10/27/2022]
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Development and validity of the DyNaChron questionnaire for chronic nasal dysfunction. Eur Arch Otorhinolaryngol 2011; 269:143-53. [PMID: 21739093 DOI: 10.1007/s00405-011-1690-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2011] [Accepted: 06/21/2011] [Indexed: 10/18/2022]
Abstract
Nasal symptoms are the main elements that lead to a therapeutic decision and allow for evaluating treatment effects or natural evolution. Despite availability of several questionnaires with good measurement qualities, no systematic assessment takes into account the specific physical and psychosocial consequences of each of the six main nasal symptoms, independently of the disease. We proposed to measure these symptoms with the use of a self-reporting questionnaire and to test the validity of the questionnaire in a large representative sample of patients attending outpatient rhinologic clinics. The study was conducted in two parts: (1) expert-based development and testing of the face validity of a questionnaire in French; and (2) validity testing, including construct validity by factor analysis, reproducibility by intraclass correlation coefficient (ICC) and Bland and Altman plots, and sensitivity to change by standardized response means, on a large sample of patients in a prospective multicenter study. DyNaChron, a questionnaire with 78 items divided into six domains and exploring both the physical and psychosocial repercussions of CND, was developed. In total, 759 patients completed the questionnaire at a first visit to a clinic, and 539 again 19.5 days later, on average. The questionnaire structure was confirmed to be composed of six domains (6 factors explaining 68.7% of the variance), with two dimensions in each domain. The questionnaire's convergent validity was confirmed; the Cronbach alpha coefficient for domains was high (0.93-0.96), the ICC ranged from 0.8 to 0.92, and the questionnaire's sensitivity to change was greater for patients with improved health status than for those with worsened status. DyNaChron is a well-structured questionnaire with a high degree of internal consistency and all properties needed to be used in research. It should now be compared with other questionnaires and objective measures to assess whether or not DyNaChron better measures disease severity and its changes. Further work will involve shortening the instrument for use in clinical practice and create a "patient symptomatology score".
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Rudmik L, Mace J, Smith T. Low-stage computed tomography chronic rhinosinusitis: what is the role of endoscopic sinus surgery? Laryngoscope 2011; 121:417-21. [PMID: 21271599 DOI: 10.1002/lary.21382] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES/HYPOTHESIS To measure the change in quality-of-life (QoL) after endoscopic sinus surgery (ESS) in patients with medically recalcitrant chronic rhinosinusitis (CRS) and minimally affected computed tomography (CT) scans of the paranasal sinuses. STUDY DESIGN Prospective, multicenter cohort study at three academic, tertiary care centers. METHODS A total of 778 patients with CRS were enrolled between January 2001 and April 2009 after electing ESS. For the purposes of this analysis, patients with nasal polyposis, history of prior sinus surgery, or follow-up <6 months were excluded. Final study patients were categorized as low-stage CT CRS (Lund-Mackay ≤3; n = 17) and high-stage CT CRS (Lund-Mackay >3; n = 207). Primary outcome measures included two disease-specific QoL instruments: the Rhinosinusitis Disability Index and the Chronic Sinusitis Survey. RESULTS In patients with low-stage CT CRS, a statistically significant improvement was found across all disease-specific QoL scores (all P ≤ .012), with the exception of the CSS medication usage subscale (P = .073). These QoL improvements were comparable to those in patients with high-stage CT CRS. CONCLUSIONS Some patients will present with CRS that is refractory to medical therapy even though their CT demonstrates relatively minimal disease. Based on the results of this study, ESS is associated with improved QoL in patients with low-stage CT CRS and can provide significant benefit to carefully selected patients with minimally affected CT scans.
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Affiliation(s)
- Luke Rudmik
- Division of Rhinology and Sinus Surgery, Oregon Sinus Center, Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon 97239, USA
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Braun JJ, Devillier P, Wallaert B, Rancé F, Jankowski R, Acquaviva JL, Beley G, Demoly P. Recommandations pour le diagnostic et la prise en charge de la rhinite allergique (épidémiologie et physiopathologie exclues) – Texte long. Rev Mal Respir 2010; 27 Suppl 2:S79-112. [DOI: 10.1016/s0761-8425(10)70012-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Ryan MW. Evaluation and management of the patient with "sinus". Med Clin North Am 2010; 94:881-90. [PMID: 20736100 PMCID: PMC7173008 DOI: 10.1016/j.mcna.2010.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The patient with "sinus" is common. However, an accurate diagnosis for a patient's sinus complaints may be elusive. The diagnostic uncertainty with these patients is a result of nonspecific symptoms, subtle or absent physical examination findings, and limited diagnostic testing options. Rhinitis should be distinguished from sinusitis. In acute illness, viral upper respiratory tract infection should be distinguished from acute bacterial sinusitis. For patients with chronic sinus symptoms, objective evidence of paranasal sinus inflammation should be confirmed before labeling the patient with chronic sinusitis.
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Affiliation(s)
- Matthew W Ryan
- Department of Otolaryngology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9035, USA.
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Kong W, Wu J, Wang Y, Yue J, Zhang S, Yu Y. Dysregulation of E-cadherin in chronic rhinosinusitis with nasal polyps. ACTA ACUST UNITED AC 2010; 30:509-13. [PMID: 20714880 DOI: 10.1007/s11596-010-0459-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2010] [Indexed: 10/19/2022]
Abstract
E-cadherin is a key epithelial protein and adhesive molecule. This study detected the E-cadherin expression in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and controls, and analyzed its possible role in the pathogenesis of CRSwNP. The expression of E-cadherin was detected by using Western blotting and immunohistochemistry in controls and patients with CRSwNP. Computed tomography (CT) scan findings were scored. The results showed that the E-cadherin expression was up-regulated in patients with CRSwNP as compared with controls (P=0.039) and the positive staining was predominantly localized on the epithelial cell membrane. E-cadherin level was correlated negatively with Lund-Mackay scores in patients with CRSwNP (r=-0.604, P=0.005). It is suggested that E-cadherin may be involved in the pathogenesis of CRSwNP and correlated with disease severity.
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Affiliation(s)
- Weijia Kong
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
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Foreman A, Psaltis AJ, Tan LW, Wormald PJ. Characterization of bacterial and fungal biofilms in chronic rhinosinusitis. Am J Rhinol Allergy 2010; 1:10. [PMID: 19958600 DOI: 10.2500/ajra.2009.23.3413] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Conclusive evidence exists that biofilms are present on the mucosa of chronic rhinosinusitis (CRS) patients. Less is known about the species constituting these biofilms. This study developed a fluorescence in situ hybridization (FISH) protocol for characterization of bacterial and fungal biofilms in CRS. METHODS Fifty CRS patients and 10 controls were recruited. Bacteria FISH probes for Staphylococcus aureus, Haemophilus influenzae, and Pseudomonas aeruginosa and a universal probe for fungi were applied to sinus mucosal specimens and then analyzed using confocal scanning laser microscopy. RESULTS Thirty-six of 50 CRS patients had biofilms present in contrast to 0/10 controls, suggesting a role for biofilms in the pathogenesis of this disease. S. aureus was the most common biofilm-forming organism. Eleven of 50 CRS patients had characteristic fungal biofilms present. CONCLUSION This is the largest study of biofilms in CRS. It has validated mucosal tissue cryopreservation for delayed biofilm analysis. Fungal biofilms have been identified and the importance of S. aureus biofilms in the polymicrobial etiology of CRS is highlighted.
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Affiliation(s)
- Andrew Foreman
- Department of Surgery-Otorhinolaryngology, Head and Neck Surgery, University of Adelaide, Adelaide, Australia
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Mace JC, Michael YL, Carlson NE, Litvack JR, Smith TL. Correlations between endoscopy score and quality of life changes after sinus surgery. ACTA ACUST UNITED AC 2010; 136:340-6. [PMID: 20403849 DOI: 10.1001/archoto.2010.34] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To assess whether change in endoscopy score correlates with change in health-related quality of life (HRQOL) following endoscopic sinus surgery for chronic rhinosinusitis. DESIGN Prospective open cohort. SETTING Tertiary rhinology clinic. PATIENTS One hundred two adult patients with and without nasal polyposis who elected to undergo endoscopic sinus surgery and were followed up for 12 +/- 2 months postoperatively. INTERVENTION Patient characteristics and Lund-Mackay computed tomography scores were recorded preoperatively. Lund-Kennedy endoscopy scores and 2 HRQOL surveys, the Rhinosinusitis Disability Index and Chronic Sinusitis Survey, were examined before and after surgery. MAIN OUTCOME MEASURES Postoperative changes in endoscopy score and HRQOL were examined using bivariate and multivariate analyses. RESULTS Statistically significant improvements were found in endoscopy score (P < .001) and for all total and subscale HRQOL measures (P < .001). After controlling for baseline status and comorbid factors, improvement in endoscopy score significantly correlated with 12-month improvement on the total Rhinosinusitis Disability Index (P = .01), the physical (P = .01) and functional (P = .02) subscales of the Rhinosinusitis Disability Index, and the symptom subscale of the Chronic Sinusitis Survey (P = .003) but could explain only 25.5% to 36.6% of the linear variation for these HRQOL improvements. CONCLUSIONS For most patients, endoscopy scores and disease-specific HRQOL significantly improve after endoscopic sinus surgery. Changes in endoscopy scores explain a portion of the improvement in HRQOL. For patients with chronic rhinosinusitis, improvements in disease-specific HRQOL outcomes are complex, multidimensional constructs that cannot be entirely explained by surgical changes measured by endoscopic examination. Trial Registration clinicaltrials.gov Identifier: NCT00799097.
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Affiliation(s)
- Jess C Mace
- Oregon Sinus Center, Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, 97239, USA
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Impact of pretreatment nasal symptoms on treatment outcome in allergic rhinitis. Otolaryngol Head Neck Surg 2010; 142:376-81. [PMID: 20172384 DOI: 10.1016/j.otohns.2009.11.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2009] [Revised: 11/10/2009] [Accepted: 11/25/2009] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The Allergic Rhinitis and its Impact on Asthma (ARIA) classification of allergic rhinitis (AR) is based on the severity and duration of nasal symptoms. Whether nasal symptoms have an impact on treatment outcome is unclear. The aim of this study was to evaluate the correlation between pretreatment nasal symptoms and therapeutic response in AR. STUDY DESIGN Case series with planned data collection. SETTING Tertiary medical center. SUBJECTS AND METHODS Sixty-nine AR patients were classified according to ARIA class: mild or moderate-severe intermittent AR (MIAR or MSIAR) and mild or moderate-severe persistent AR (MPAR or MSPAR). All patients were treated over 28 days with 220 microg of intranasal triamcinolone acetonide once daily. Nasal symptoms, peak expiratory flow index, and global symptom control were used to evaluate treatment outcome. RESULTS At 28 days after treatment, MSPAR patients showed the worst global symptom control, followed by MSIAR, MPAR, and MIAR (mean global symptom controls were 76.5%, 83.8%, 87.7%, and 89.0%, respectively). Pretreatment total nasal symptom score was inversely correlated with global symptom control (rho = -0.405, P < 0.001), but positively correlated with percent total nasal symptom score and peak expiratory flow index improvements (rho = 0.271, P = 0.024; and rho = 0.371, P = 0.002, respectively). Blocked nose had the best inverse correlation with global symptom control (rho = -0.389, P = 0.001). CONCLUSION A worse treatment outcome despite more clinical improvements during the treatment period in a higher severity score suggests the therapeutic predictive value of pretreatment nasal symptom scoring and the need for more dosing and continuing medication in higher scores, especially in blocked nose.
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Kirtsreesakul V, Somjareonwattana P, Ruttanaphol S. The correlation between nasal symptom and mucociliary clearance in allergic rhinitis. Laryngoscope 2009; 119:1458-62. [PMID: 19507239 DOI: 10.1002/lary.20146] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE/HYPOTHESIS The Allergic Rhinitis and Its Impact on Asthma (ARIA) classification of allergic rhinitis (AR) is based on the severity and duration of nasal symptoms. Whether the nasal symptoms actually represent underlying nasal inflammation is unclear. The aim of this study was to evaluate the correlation between nasal symptoms and nasal inflammation using mucociliary clearance time (MCCT) in AR. STUDY DESIGN A prospective cross-sectional study. METHODS 73 AR patients were classified according to ARIA class: mild or moderate-severe intermittent AR (MIAR or MSIAR) and mild or moderate-severe persistent AR (MPAR or MSPAR). Each nasal symptom was scored as 1 to 3 on a severity scale (mild-moderate-severe). The sum of the individual nasal symptom scores gave the total symptoms score (TSS). MCCT was determined with the charcoal-saccharin method. MCCTs between ARIA classes were compared and correlations between TSS or days with symptoms per week (DSW) and MCCT were analyzed. RESULTS Of the patients, 67.1% were moderate-severe degree. MSPAR had the worst MCCT, followed by MSIAR, MPAR, and MIAR (mean MCCTs of 14.32, 13.87, 11.94, and 10.28 minutes, respectively). TSS was well correlated with MCCT (P = .538, P < .001). DSW was also correlated with MCCT, but did not reach statistical significance (r = 0.217, P = .065). The mean MCCT of overall nasal symptoms increased along with each score step and a significant difference was noted between scores 2 and 3 (P < .001). CONCLUSIONS A high percentage of moderate-severe disease and a significant correlation of the severity and MCCTs suggest an important heterogeneity in this disease severity group. Discriminating between moderate and severe rhinitis should help to obtain homogeneous populations and develop improved disease management strategies.
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Affiliation(s)
- Virat Kirtsreesakul
- Department of Otolaryngology, Prince of Songkla University, Hat Yai, Thailand.
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Ling FTK, Kountakis SE. Important Clinical Symptoms in Patients Undergoing Functional Endoscopic Sinus Surgery for Chronic Rhinosinusitis. Laryngoscope 2009; 117:1090-3. [PMID: 17440425 DOI: 10.1097/mlg.0b013e31804b1a90] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the prevalence and severity of individual Rhinosinusitis Task Force (RSTF) symptoms in patients with chronic rhinosinusitis (CRS) undergoing functional endoscopic sinus surgery (FESS). METHODS Retrospective analysis of prospectively collected data in 201 patients treated with FESS. The prevalence and severity of individual RSTF major and minor symptom scores graded on a visual analogue scale (VAS) were compared. Correlation between absolute improvement in individual symptom scores at 1-year postoperative was performed. RESULTS One-hundred fifty-eight of 201 patients met inclusion criteria giving a response rate of 78%. The average age was 49.4 (range 18-80) with a male-to-female ratio of 1.1:1. The preoperative leading mean symptom scores were postnasal drip (5.8 +/- 0.3), nasal obstruction (5.7 +/- 0.3), and facial congestion (5.1 +/- 0.3). These symptoms were also the most prevalent with 82%, 84%, and 79% of patients reporting these symptoms, respectively. Postoperative symptom improvements were significant (P < .0001) across all RSTF domains except fever. The highest percentage improvement was seen with facial congestion (93%), nasal obstruction (92%), and postnasal drip (85%). Multivariate analysis revealed significant (P < .0001) high correlation between improvements of facial pain/pressure with facial congestion (R = 0.72), facial congestion with nasal obstruction (R = 0.65), and facial pain/pressure with headache (R = 0.72). CONCLUSION The top three RSTF symptoms were postnasal drip, nasal obstruction, and facial congestion in terms of prevalence and severity. Symptom scores improved after FESS. Of these symptoms, the degree of improvement of facial pain/pressure, facial congestion, nasal obstruction, and headache are highly correlated.
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Affiliation(s)
- Francis T K Ling
- Department of Otolaryngology-Head and Neck Surgery, Medical College of Georgia, Augusta, Georgia 30912, USA
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Gerlinger I, Fittler A, Mayer A, Patzkó A, Fónay F, Pytel J, Botz L. [Postoperative application of amphotericin B nasal spray in chronic rhinosinusitis with nasal polyposis. Can recidive polyposis be prevented?]. Orv Hetil 2008; 149:1737-46. [PMID: 18805757 DOI: 10.1556/oh.2008.28410] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
UNLABELLED Chronic rhinosinusitis affects 1-4% of the adult population. The aetiology of this multifactorial, chronic disease, which leads to a significant impairment of the quality of life, often accompanied by nasal polyposis, is not fully understood. In the past decade it was presumed that the disease, which causes characteristic eosinophilic infiltration of the nasal mucosa, is triggered by an enhanced (but not classical allergic IgE type) immune response. AIM If this supposition is correct, then it appears obvious that the administration of amphotericin B nasal spray in adequate concentration following endoscopic polypectomy should be advantageous for these patients, and might even reduce the number of recurrent cases. METHODS To check on this assumption, the authors conducted a prospective randomized placebo-controlled trial involving 33 patients, 30 of whom remained in the study throughout. Patients with nasal polyposis were operated on with an endoscopic technique between 1 November 2005 and 1 October 2006; one group of them (group A, 14 randomly selected patients) was treated with a nasal spray containing 5 mg/ml amphotericin B, while the placebo group (group B, 16 randomly selected patients) received a nasal spray lacking amphotericin B. The results were evaluated with the aid of a modified Lund-Mackay CT score, the SNAQ-11 test (which evaluates changes in the symptoms), the life-quality test and endoscopy. The SPSS 14.0 for Windows program was utilized to process the data of examinations performed preoperatively and one year postoperatively. RESULTS The CT scores of the group A patients exhibited wide scattering without signs of recovery one year after the operation. The CT scores of the group B patients indicated a slight improvement, though this did not prove significant in relation to group A. Both the SNAQ-11 test and the life-quality test revealed a significant improvement in each group, but the degrees of change in these tests did not significantly differ between the two groups of patients. The endoscopic findings indicated a slight improvement to the advantage of the amphotericin B-treated group 12 months after the operation. CONCLUSION These results lead to the conclusion that the administration of amphotericin B nasal spray to patients operated on for nasal polyposis does not give rise to a significant alteration in CT scores, clinical symptoms, or quality of life. The more favourable clinical aspects observed in the amphotericin B-treated group during the endoscopic follow-up did not correspond to an improvement in the symptoms. In connection with the conclusions drawn from this study the authors discuss the available data on the fungal theory. They critically analyse the contradictory observations of 7 recent clinical studies.
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Affiliation(s)
- Imre Gerlinger
- Pécsi Tudományegyetem, Orvos- és Egészségtudományi Koordinációs Központ, Altalános Orvostudományi Kar Fül-Orr-Gégészeti és Fej-Nyak Sebészeti Klinika, Pécs, Munkácsy utca 2. 7621.
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Gerlinger I, Fittler A, Fónai F, Patzkó A, Mayer A, Botz L. Postoperative application of amphotericin B nasal spray in chronic rhinosinusitis with nasal polyposis, with a review of the antifungal therapy. Eur Arch Otorhinolaryngol 2008; 266:847-55. [PMID: 18953552 DOI: 10.1007/s00405-008-0836-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2008] [Accepted: 10/01/2008] [Indexed: 11/28/2022]
Abstract
Chronic rhinosinusitis (CRS) affects 1-4% of the adult population. The etiology of this multifactorial, chronic disease, which leads to a significant impairment of the quality of life, often accompanied by nasal polyposis, is not fully understood. In the past decade, it was presumed that the disease, which causes characteristic eosinophilic infiltration of the nasal mucosa, is triggered by an enhanced (but not classical allergic IgE-type) immune response against fungal organisms in the nasal mucus. If this supposition is correct, then it appears obvious that the administration of amphotericin B nasal spray in adequate concentration following endoscopic polypectomy should be advantageous for these patients, and might even reduce the number of recurrent cases. To check on this assumption, we conducted a prospective randomized placebo-controlled trial involving 33 patients, 30 of whom remained in the study throughout. Patients with nasal polyposis were operated on with an endoscopic technique between 1 November 2005 and 1 October 2006; group A (14 randomly selected patients) were treated with a nasal spray containing 5 mg/ml amphotericin B, while the placebo group B (16 randomly selected patients) received a nasal spray lacking amphotericin B. We evaluated our results with the aid of a modified Lund-Mackay CT score, the SNAQ-11 test (which assesses changes in the symptoms), a quality of life test and endoscopy. The SPSS 14.0 for Windows program was utilized to process the data of examinations performed preoperatively and 1 year postoperatively. The CT scores of the group A patients 1 year after the operation exhibited wide scattering, without signs of recovery. The CT scores of the group B patients indicated a slight improvement, though this did not prove significant relative to group A. Both the SNAQ-11 test and the quality of life test revealed a significant improvement in each group, but the degrees of change in these tests did not differ significantly between the two groups of patients. The endoscopic findings indicated a slight improvement to the advantage of the amphotericin B-treated group 12 months after the operation. These results lead to the conclusion that the administration of amphotericin B nasal spray to patients operated on for nasal polyposis does not give rise to a significant alteration in either CT score, clinical symptoms, or quality of life. The more favorable clinical aspects observed in the amphotericin B-treated group during the endoscopic follow-up did not correspond to an improvement in the symptoms. In connection with the conclusions drawn from this study, the authors discuss the controversial data available on the fungal etiology of CRS. They critically analyze the contradictory observations and conclusions of seven recent clinical studies.
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Affiliation(s)
- I Gerlinger
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical School, University of Pécs, Munkácsy Mihály utca 2, 7621, Pecs, Hungary.
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Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, Zuberbier T, Baena-Cagnani CE, Canonica GW, van Weel C, Agache I, Aït-Khaled N, Bachert C, Blaiss MS, Bonini S, Boulet LP, Bousquet PJ, Camargos P, Carlsen KH, Chen Y, Custovic A, Dahl R, Demoly P, Douagui H, Durham SR, van Wijk RG, Kalayci O, Kaliner MA, Kim YY, Kowalski ML, Kuna P, Le LTT, Lemiere C, Li J, Lockey RF, Mavale-Manuel S, Meltzer EO, Mohammad Y, Mullol J, Naclerio R, O'Hehir RE, Ohta K, Ouedraogo S, Palkonen S, Papadopoulos N, Passalacqua G, Pawankar R, Popov TA, Rabe KF, Rosado-Pinto J, Scadding GK, Simons FER, Toskala E, Valovirta E, van Cauwenberge P, Wang DY, Wickman M, Yawn BP, Yorgancioglu A, Yusuf OM, Zar H, Annesi-Maesano I, Bateman ED, Ben Kheder A, Boakye DA, Bouchard J, Burney P, Busse WW, Chan-Yeung M, Chavannes NH, Chuchalin A, Dolen WK, Emuzyte R, Grouse L, Humbert M, Jackson C, Johnston SL, Keith PK, Kemp JP, Klossek JM, Larenas-Linnemann D, Lipworth B, Malo JL, Marshall GD, Naspitz C, Nekam K, Niggemann B, Nizankowska-Mogilnicka E, Okamoto Y, Orru MP, Potter P, Price D, Stoloff SW, Vandenplas O, Viegi G, Williams D. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy 2008; 63 Suppl 86:8-160. [PMID: 18331513 DOI: 10.1111/j.1398-9995.2007.01620.x] [Citation(s) in RCA: 3057] [Impact Index Per Article: 191.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
MESH Headings
- Adolescent
- Asthma/epidemiology
- Asthma/etiology
- Asthma/therapy
- Child
- Global Health
- Humans
- Prevalence
- Rhinitis, Allergic, Perennial/complications
- Rhinitis, Allergic, Perennial/diagnosis
- Rhinitis, Allergic, Perennial/epidemiology
- Rhinitis, Allergic, Perennial/therapy
- Rhinitis, Allergic, Seasonal/complications
- Rhinitis, Allergic, Seasonal/diagnosis
- Rhinitis, Allergic, Seasonal/epidemiology
- Rhinitis, Allergic, Seasonal/therapy
- Risk Factors
- World Health Organization
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Affiliation(s)
- J Bousquet
- University Hospital and INSERM, Hôpital Arnaud de Villeneuve, Montpellier, France
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Ling FTK, Kountakis SE. Rhinosinusitis Task Force symptoms versus the Sinonasal Outcomes Test in patients evaluated for chronic rhinosinusitis. ACTA ACUST UNITED AC 2007; 21:495-8. [PMID: 17882922 DOI: 10.2500/ajr.2007.21.3052] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The aim of this study was to compare Rhinosinusitis Task Force (RSTF) symptom scores with Sinonasal Outcome Test 20 (SNOT-20) in patients with chronic rhinosinusitis (CRS) and controls. METHODS An analysis was performed of prospectively collected data in patients with CRS (n=201) and controls (n=100). The severity of individual RSTF major and minor symptom scores graded on a visual analog scale and total symptom scores were compared between the two groups. Correlation of the RSTF symptoms with the SNOT-20 was performed using data collected from the CRS group at baseline and at 1 year postoperatively. RESULTS CRS patients had higher RSTF symptom scores compared with control patients when asked to rate the severity of nasal obstruction, facial pain/pressure, facial congestion, alteration of smell, nasal discharge, postnasal drip, headache, halitosis, fatigue, cough, and ear pain (p < 0.005). No statistically significant difference was seen for the symptoms of dental pain and fever. Total RSTF scores were 54.5 +/- 1.9 in CRS patients versus 23.4 +/- 3.0 in controls. Total SNOT-20 scores were 28.7 +/- 0.8 in CRS patients versus 15.2 +/- 0.6 in controls. In CRS patients, total RSTF scores correlated with total SNOT-20 scores at baseline (r = 0.36; p < 0.0001) and 1-year postoperatively (r = 0.37; p < 0.0001). CONCLUSION Total RSTF symptom scores are significantly different in patients with chronic rhinosinusitis compared with those without this disease. The total RSTF symptom scores also correlate with a validated outcome measures instrument.
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Affiliation(s)
- Francis T K Ling
- Department of Otolaryngology-Head and Neck Surgery, Medical College of Georgia, Augusta, Georgia 30912, USA
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