ENDOSCOPIC TREATMENT OF CHRONIC RHINOSINUSITIS – A CLINICAL STUDY
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OBJECTIVE: To assess the role of endoscopic treatment in patients of chronic rhinosinusitis.DESIGN: Prospective study; interventional type; randomised design.METHOD: 32 patients with chronic rhinosinusitis treated by Endoscopic Sinus Surgery (ESS) were analyzed.They were studied from July 2012 to May 2013.Surgery was performed under general anaesthesia and various procedures were performed depending upon the pathology detected in the clinical and radiological examinations.Patients were followed post operatively regularly with nasal endoscopy and their improvement of symptoms noted at 3 months and 6 months and complication if any taken care of in between.RESULTS: Facial pain was subsided in 14 out of 17 patients, showing improvement in 82% of patients.Nasal obstruction was relieved in 24/27 patients which is improvement in 88%.Nasal discharge was subsided in 16/18 patients.Hyposmia and Anosmia were improved in 81% (09/11) of the patients.83% (15/18) improvement was seen in patients complaining of headache.Overall improvement of symptoms was observed in 27 out of 32 patients that is 84.4 % of patients at 6 months of follow up.CONCLUSION: Endoscopic sinus surgery succeeds in providing above 80% symptom relief to the patients.Complications in sinus surgery are minimal in experienced hand.Endoscopic surgery is the definitive treatment of chronic rhinosinusitis in patients not responding to medical therapy. INTRODUCTION:Chronic rhinosinusitis is one of the most frequent otolaryngologic disease encountered.(Black well DL et al) 1 A general histopathological definition of sinusitis is inflammation of the nasal and the paranasal sinus mucosa.In addition osteitis of the underlying bone can occur.(Giacchi RT et al) 2 Previously a distinction was made between rhinitis (symptoms centered on nasal cavity) and sinusitis (symptoms centered on the paranasal sinus).Clinical experience has taught that the contiguous lining of the nose and the sinuses are affected.Therefore, the term sinusitis was expanded to rhinosinusitis.(Lanza DC et al, Lund VJ et al) 3,4 Children less than 15 years and adult between the age of 25 and 64 years are more frequently affected.(Annon J, Glikich R 1995, Kaliner M 1997) 5,6 The location and extent of different rhinosinusitis pathological condition implies a detailed knowledge of the anatomic organization of the paranasal sinuses and first and foremost of the ethmoid sinuses.The structures of the lateral nasal wall and paranasal sinuses fall into two anatomically and physiologically distinct categories: the anterior and the posterior ethmoid complex.The basal lamella of the middle turbinate is the clear and distinct separation between the two ethmoid complexes, according to definition, patterns of mucociliary transports and embryological development.The ostiomeatal complex is a functional entity of the anterior ethmoid complex that represent the final common pathway for drainage and ventilation of the frontal, maxillary and the anterior ethmoid cells.(Kennedy DW 1995) 7Keywords:
Chronic Rhinosinusitis
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