Clinical assessment and endoscopic surgery in chronic sinusitis without nasal polyps of adult patients.

Objective To discuss the basic characteristics and effective treatment of chronic sinusitis without nasal polyps(CRSsNP)of adult patients in China.Methods 78 cases were scored by quantitative assessment:CT scans by Lund-Mackay scoring system,nasal endoscopy by Lund-Kennedy score,and symptoms severity score by visual analog scale(VAS scale).Combined with the chief complaint and objective score,we analyzed the abnormal anatomy of the nasal cavity which caused the disease and carried out individual endoscopic surgery.After surgery,patients were followed up for one year,and then were scored again and statistically analyzed.Results The ostiomeatal complex and maxillary sinus were completely involved.Pathological examination showed that plasma cells and lymphocytes were the main infiltrating cells.The total response rate was 100%:53 patients recovered and 25 patients improved.The average epithelization time was five weeks.The occurrence rate of the lesions was significantly higher in the front sinuses than in the back sinuses.In patients with 0-3 grades,there was no significant difference in the VAS score before and after surgery,while in patients with other grades there was a significant difference in the VAS score and the Lund-Kennedy score.Conclusion CRSsNP of adults in China has its own features:multi-local anatomical abnormalities may play animportant role in the pathogenesis and the ostiomeatal complex and the maxillary sinus are the target areas.Bacterial infection may be more important than allergy.The pathogenesis of unilateral and bilateral CRSsNP may be different.The EPOS2007 guide provides a more objective assessment method which can fully reflect the disease and its treatment.Surgical treatment of CRSsNP plays an important role and endoscopic individual rhinoplasty is an effective method.