Assessment of outcome of functional endoscopic sinus surgery in patients with chronic sinusitis with or without sinonasal polyposis

Elizebeth Sunny, (2013) Assessment of outcome of functional endoscopic sinus surgery in patients with chronic sinusitis with or without sinonasal polyposis. Masters thesis, Christian Medical College, Vellore.

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Abstract

OBJECTIVES AND AIMS OF STUDY: To assess the outcome of functional endoscopic sinus surgery (FESS) in patients with chronic sinusitis with or without nasal polyposis using the quality of life assessment instrument SNOT 22 questionnaire and endoscopic scoring. METHOD OF STUDY: This prospective study was conducted in the Department of ENT at Christian Medical College Vellore. Pre and postoperative data was collected from patients undergoing functional endoscopic sinus surgery for chronic rhinosinusitis with or without polyposis. We used a quality of life instrument (SNOT 22) along with Lund Kennedy endoscopic scoring and Lund Mackay CT scan scoring. Patients were followed up for a minimum of 3 to 6 months postoperatively and at the same scoring instruments re‐administered. Descriptive data was analyzed and frequency distributions derived. Patients with and without sinonasal polyposis were compared in terms of demography as well as SNOT 22, endoscopic and CT scores using Student’s t- test. Pearson’s correlation was used to assess the correlation between endoscopic scores and CT scan scores. Changes in the SNOT 22 score, symptom specific frequency and endoscopic score after surgery were assessed using chi square test of proportions, to see if there was a significant difference in scores postoperatively. The frequency of complications following the procedures was also assessed. RESULTS: Of a total of 90 patients who were included in the study, 50 patients came for the follow up. There were 37 patients with polyps and 13 patients without polyps. On comparing the pre and post operative results of SNOT 22 score, we observed that there was a mean improvement of 19.8 points in the score overall. Out of 37 patients in the group with polyps, 31 patients (83.8%) improved at least by 9 points postoperatively, while 84% (11/13 patients) improved by at least 9 points in the group without polyps. The mean improvement of total SNOT 22 score was 20.8 in the group with polyps and this was statistically significant (p=0.00). The mean improvement of total SNOT 22 score was 17.0 in the group without polyposis and this was also statistically significant (p=0.01). Symptoms‐ specific assessment showed a significant improvement for all the major symptoms. There was a significant improvement in Lund Kennedy endoscopic scores (p=0.03) as well in both the groups of the patients. The improvement in SNOT22 scores and endoscopic scores was seen in both patients who underwent primary surgery (p=0.00) as well as those who underwent revision surgery (p=0.00). The complication rate was only 2.2%. CONCLUSIONS: Functional endoscopic sinus surgery provides a significant quality of life improvement as well as symptom specific improvement in patients with sinusitis with or without polyposis. The improvement in endoscopic appearances is also corroborated by improved endoscopic scores postoperatively. Functional endoscopic sinus surgery is equally effective in primary and revision cases. There are few complications and it is a safe procedure in experienced hands.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Chronic rhinosinusitis with polyps, Chronic rhinosinusitis without polyps SNOT22, Lund Kennedy score, Functional endoscopic sinus surgery outcome, Revision functional endoscopic sinus surgery.
Subjects: MEDICAL > Otolaryngology
Depositing User: Devi S
Date Deposited: 27 Mar 2020 06:12
Last Modified: 27 Mar 2020 06:12
URI: http://repository-tnmgrmu.ac.in/id/eprint/12479

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