Outcome of Endoscopic Frontal Sinus Surgery for Chronic Rhinosinusitis with and without Polyps

Document Type : Original Article

Authors

1 Lecturer, Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Zagazig University, Egypt

2 Professor, Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Zagazig University, Egypt

3 Lecturer, Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Alazhar University (Assuit branch)

Abstract

Background: Endoscopic frontal sinus surgery (EFSS) for 
frontal chronic rhinosinusitis (CRS) is performed for patients 
with frontal CRS failing medical therapy or complicated cases in 
order to restore normal mucociliary clearance while minimizing 
trauma to the delicate frontal recess mucosa. Comparison of the 
results of EFSSin patients with chronic rhinosinusitis with nasal 
polyp (CRSwNP) versus chronic rhinosinusitis without nasal 
polyp (CRSsNP) is missed in the literature.
Objectives: to compare the outcome of EFSS in patients with 
CRS with nasal polyp (CRSwNP) versus CRS without nasal 
polyp (CRSsNP) by assessing the frontal sinus ostium patency 
and quality of life of patients as measured by the Sinonasal 
OutcomeTest-22 (SNOT-22)
Patients and methods: A forty six patient cohort with frontal 
CRS(22 CRSwNP and 24 CRSsNP) was prospectively evaluated 
using the SNOT-22, CT imaging, and endoscopic examination. 
Six months at least post-FESS, patients were reassessed with 
SNOT-22 and endoscopic assessment for the frontal sinus osteam 
patency.
Results: Within included 46 patients (22 CRSwNP and 24 
CRSsNP) underwent EFSS, a significant improvement (p< 
0.0001) in the SNOT-22 symptom scores was achieved 
postoperatively in both patients with CRSwNP and 
CRSsNP.Inaddition to each of its mean; rhinological, ear and 
facial, sleep function, psychological, cough, and waking up tired 
subscale scores were also signifacntly improved in both 
CRSwNP and CRSsNP. Moreover, the 6 months postoperative 
examination, revealed 85% overall patent frontal sinus 
ostia;86.4% in CRSwNP and 83.3% in CRSsNP..
Conclusion: Endoscopic frontal sinus surgery could significantly 
improve the quality of life of patients with CRS with and without 
nasal polyps with high frontal sinus ostia patency rate.

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