Indian Journal of Physiotherapy & Occupational Therapy-An International Journal

Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

A Prospective Study of Role of Fess in Management of Recurrent Nasal Polyposis


Affiliations
1 Vydehi Institute of Medical Sciences, Bangalore, India
2 Dept. of Pathology, Navodaya Medical College, Raichur, India
3 Chirag Hospital, Bangalore, India
     

   Subscribe/Renew Journal


Background and objectives: Nasal Polyps are the most frequent and very prevalent nasal masses, which the otorhinolaryngologists come across. The uncertain etiologies of this condition have contributed greatly to a wide range of treatment, none of which has been uniformly successful or universally accepted. Hence, this literature looks at the various causes of recurrence of nasal polyposis and also compares the efficacy of conventional and endoscopic endonasal polypectomy in terms of safety, recurrence and postoperative morbidity.

Materials and methods: The present study was conducted in the Department of Otorhinolaryngology in Vydehi Institute of Medical Sciences and Research Centre from April 2009 to March 2011.

Data for this study was collected. All clinically confirmed cases of recurrent nasal polyposis Cases selected were subjected to a complete examination according to the defined proforma.Detailed history was taken and clinical examination done. Acute infections were treated on medical line and then taken up for surgery. All patients received a course of antibiotics starting one day prior to surgery. The patients were treated either by conventional polypectomy or Functional Endoscopic Sinus Surgery (FESS).The patients were discharged when fit and were strictly called for follow-up on the first week, third week, 2nd month, 4th month, 6th month and 1 year from date of surgery.

Results: Fifty cases having nasal polyposis were selected and subjected to surgical management. The cases were divided into 2 groups. The first 25 cases were identified as Group-1 and were subjected to surgical management using conventional polypectomy. Similarly, the next 25 cases were identified as Group-2 and were subjected to surgical management using Functional Endoscopic Sinus Surgery (FESS).

The salient observations of this study are as follows:

1. Age: The age of the patients ranged from 6-65 years with a mean age of 31.5 years. In case of antrochoanal polyp, the average age was 20 years.

2. Sex: A male preponderance is seen with a male: female ratio of 2.57:1.

3. Complaints: Majority of the patients presented with complaints of nasal obstruction and nasal discharge, followed by headache, sneezing, anosmia and postnasal drip.

4. Diagnosis: Out of 50 cases, 31 patients presented with Ethmoidal polyp and 19 patients presented Antrochoanal polyp.

5. Complications: Bleeding (<50 ml), was the most common intraoperative and postoperative complication.

6. Recurrence: Recurrence was seen in 36% cases with conventional polypectomy and 12% cases with functional endoscopic sinus surgery (FESS), which indicates low recurrence in case of patients who underwent FESS.

Conclusion: Nasal polyposis is a prevalent disease and is known for its recurrence. Functional ndoscopic sinus surgery is a minimally invasive technique used to restore sinus ventilation and normal function. Functional endoscopic sinus surgery revolutionized the management of chronic inflammatory sinus diseases. In nasal polyposis, there is no doubt that the polypoidal mucosa needs to be completely removed to prevent recurrence. Endoscopic technique can help achieve this goal and also preserve the healthy mucosa and its physiological function of mucociliary mechanism. Also, patients usually experience only minimal discomfort. Functional endoscopic sinus surgery has better success rates than conventional polypectomy and is less traumatic to the patients. The complication rate for this procedure is lower than that for conventional sinus surgery.


Keywords

Nasal Polyps, Polypectomy, FESS
Subscription Login to verify subscription
User
Notifications
Font Size


  • Martin E. Vancil. A historical survey of treatments for nasal polyposis. The Laryngoscope 1968; 435-445.

  • Ramesh C. Deka. Antrochoanal polyps: Its pathogenesis, origin and management by FESS. Ind J Otology Head Neck Surg 1999; 51:33-35.

  • Stammberger Heinz. FESS – The Messerklinger Technique. Mosby Yearbook 1991. Pg. xii.

  • Wigand ME. Transnasal Ethmoidectomy under Endoscopic Control. Rhinology 1981; 19: 7-10

  • Wigand ME, Steiner W, Jaumann MP. Endonasal sinus surgery with endoscopic control from radical operation to rehabilitation of the mucosa. Endoscopy 1978; 10: 255-260.

  • Levine HL. Functional Endoscopic Sinus Surgery: Evaluation, Surgery and follow up of 250 patients. Laryngoscope 1990; 100: 79-84.

  • Wynn and Has EL. Recurrence rates after Endoscopic Sinus Surgery. Laryngoscope 2004; 114: 118-120.

  • Drake Lee AB. Nasal Polyps, Scott Brown’s Otolaryngology, Vol. 4, 6th edition, Butterworth-Heinemann 1997; Chapter 4/10/1-15.

  • Duncavage JA. Nasal Polyposis. Current Therapy in Otolaryngology and Head and Neck Surgery 1994; 6th edition, Mosby Inc. 366-369.

  • Gindy AE, Mansour MH. The role of transcanine surgery in Antrochoanal Polyps. J Laryngol Otol 1994; 108: 1055-1057.

  • Mayers D, Myers EN. The medical and surgical treatments of nasal polyps. Laryngoscope 1994; 84: 833-847.

  • Stammberger H. Functional Endoscopic Sinus Surgery. Ed Decker BC, Philadelphia 1991; 17-87 / 145-268.

  • Jean Michel Klossek. Diffused nasal polyposis: Postoperative long-term results after endoscopic sinus surgery and frontal irrigation. Otolaryngology Head and neck surgery 1997; 117(4): 355-361.

  • Neena Chowdhary, Rajeev Kapoor, Gul Motwani, Gandotra SC. FESS results in 69 patients. Ind J Otolaryngol and Head and Neck Surg 1999; 52(1): 5-8.

  • Deka Ramesh. Antrochoanal polyp: Its pathogenesis, origin and management by FESS. Indian journal of otorhinolaryngology and head and neck surgery 1999; 51(1): 33-35.

  • Freitas MR, Giesta RP, Pinheiro D, Sitva VC. Antrochoanal polyp review of 16 cases. Rev Bras Otrorhinolaryngology (Engl Ed) 2006; 72(6): 831-5.

  • Yuca K, Bayran I., Kiroglu A.F, Etlik O, Cankaya H., Silcin F, Kiris M. Evaluation and treatment of antrochoanal polyp. J Otolaryngol 2006; 34 (6): 420-423.

  • Wang H, Zhang L, Zhou B, Zhang W, Liu HC, Liu M. Huang Q. Relationship between allergic factors and chronic sinusitis with or without nasal polyposis. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2005; 40 (3): 168-71.

  • Jovicevic J, Kljajic V. Nasal polyposis and allergic rhinitis. Srp Arh Celok Lek 2005; 133 (supplement 2): 105-7.

  • Hemanth Chopra AS, Khurana, Manish Munjal, Kapil Due. Indian journal of Otorhinolaryngology and head and neck surgery 2006; 58(2).

  • Dalsiel K, Stein K, Round A, Garside R, Royke P. Systematic review of endoscopic Sinus surgery for nasal polyp. Health Technol Assess 2003; 7(17): 1-159.

  • Venkatachalam et al. Comparative evaluation of endoscopic and conventional Surgical techniques in the management of nasal polyposis. J K Practitioner 1998; 5(4): 295-299.

  • Bussaba et al. Endoscopic sinus surgery for inflammatory maxillary sinus disease. Laryngoscope 2002; 112: 1378-1383.

  • Zhang et al. The clinical application of FESS and conventional technique in sinus Surgery. Zhongua Er Bi Yan Hou Ke Za Zhi 1998; 33(6): 354-355.


Abstract Views: 373

PDF Views: 0




  • A Prospective Study of Role of Fess in Management of Recurrent Nasal Polyposis

Abstract Views: 373  |  PDF Views: 0

Authors

Santosh Nagalikar
Vydehi Institute of Medical Sciences, Bangalore, India
Chandrakanth V. Rathod
Dept. of Pathology, Navodaya Medical College, Raichur, India
Meera
Chirag Hospital, Bangalore, India
G. Mohan
Vydehi Institute of Medical Sciences, Bangalore, India
Satish Kumar
Vydehi Institute of Medical Sciences, Bangalore, India
S. Manjunath
Vydehi Institute of Medical Sciences, Bangalore, India

Abstract


Background and objectives: Nasal Polyps are the most frequent and very prevalent nasal masses, which the otorhinolaryngologists come across. The uncertain etiologies of this condition have contributed greatly to a wide range of treatment, none of which has been uniformly successful or universally accepted. Hence, this literature looks at the various causes of recurrence of nasal polyposis and also compares the efficacy of conventional and endoscopic endonasal polypectomy in terms of safety, recurrence and postoperative morbidity.

Materials and methods: The present study was conducted in the Department of Otorhinolaryngology in Vydehi Institute of Medical Sciences and Research Centre from April 2009 to March 2011.

Data for this study was collected. All clinically confirmed cases of recurrent nasal polyposis Cases selected were subjected to a complete examination according to the defined proforma.Detailed history was taken and clinical examination done. Acute infections were treated on medical line and then taken up for surgery. All patients received a course of antibiotics starting one day prior to surgery. The patients were treated either by conventional polypectomy or Functional Endoscopic Sinus Surgery (FESS).The patients were discharged when fit and were strictly called for follow-up on the first week, third week, 2nd month, 4th month, 6th month and 1 year from date of surgery.

Results: Fifty cases having nasal polyposis were selected and subjected to surgical management. The cases were divided into 2 groups. The first 25 cases were identified as Group-1 and were subjected to surgical management using conventional polypectomy. Similarly, the next 25 cases were identified as Group-2 and were subjected to surgical management using Functional Endoscopic Sinus Surgery (FESS).

The salient observations of this study are as follows:

1. Age: The age of the patients ranged from 6-65 years with a mean age of 31.5 years. In case of antrochoanal polyp, the average age was 20 years.

2. Sex: A male preponderance is seen with a male: female ratio of 2.57:1.

3. Complaints: Majority of the patients presented with complaints of nasal obstruction and nasal discharge, followed by headache, sneezing, anosmia and postnasal drip.

4. Diagnosis: Out of 50 cases, 31 patients presented with Ethmoidal polyp and 19 patients presented Antrochoanal polyp.

5. Complications: Bleeding (<50 ml), was the most common intraoperative and postoperative complication.

6. Recurrence: Recurrence was seen in 36% cases with conventional polypectomy and 12% cases with functional endoscopic sinus surgery (FESS), which indicates low recurrence in case of patients who underwent FESS.

Conclusion: Nasal polyposis is a prevalent disease and is known for its recurrence. Functional ndoscopic sinus surgery is a minimally invasive technique used to restore sinus ventilation and normal function. Functional endoscopic sinus surgery revolutionized the management of chronic inflammatory sinus diseases. In nasal polyposis, there is no doubt that the polypoidal mucosa needs to be completely removed to prevent recurrence. Endoscopic technique can help achieve this goal and also preserve the healthy mucosa and its physiological function of mucociliary mechanism. Also, patients usually experience only minimal discomfort. Functional endoscopic sinus surgery has better success rates than conventional polypectomy and is less traumatic to the patients. The complication rate for this procedure is lower than that for conventional sinus surgery.


Keywords


Nasal Polyps, Polypectomy, FESS

References