Pre and post functional endoscopic sinus surgery nasal cavity volume assessment by acoustic rhinometry

Rodrigo De Paula Santos,Walter Habermann,Thiemo Hofmann,Heinz Stammberger

doi:10.1016/s1808-8694(15)31003-x

Rodrigo De Paula Santos, Walter Habermann + Show 2 more

Open Access

https://doi.org/10.1016/s1808-8694(15)31003-x

Copy DOI

Abstract

SummaryAcoustic rhinometry is an objective method to determine nasal cavity geometry. The technique is based on sound wave reflexion analysis in the nasal cavity, and determines crossectional areas as a function of distance as well as volume.AimThe purpose of this study is to analyse nasal cavity volume changes caused by functional endoscopic sinus surgery (FESS) in adults with chronic rhinosinusitis by acoustic rhinometry, and to correlate these changes with improvements in the sensation of nasal obstruction.Material and MethodForty patients aged from 18 to 73 years were prospectively evaluated between August and October 1999 at the Graz University Hospital, Austria. All patients were diagnosed with chronic rhinosinusitis, and undertook acoustic rhinometry before and after FESS.Scientific designA clinical prospective study.ResultsThe nasal cavity total volume increased significantly after surgery. Nasal obstruction was improved in 88% of the patients, 20% with partial improvement and 68% with total improvement. There was no correlation between volume increase and improvement of the sensation of nasal obstruction.ConclusionTotal nasal cavity volume significantly increased after surgery; however, there was no correlation between volume increase and improvements of nasal obstruction. No significant pre or postoperative increase in total nasal cavity volume after decongestion were observed.

Highlights

Functional endoscopic sinus surgery (FESS) was developed based on the pathophysiology theory of chronic rhinosinusitis proposed by Messerklinger, published in the 50s and 60s
FESS involves the opening of paranasal sinus prechambers aiming to restore drainage and ventilation
The aim of this paper is to study volume changes in the nasal cavity caused by FESS in adults with chronic rhinosinusitis with or without nasal polyposis using Acoustic rhinometry (AR), and to correlate these alterations with clinical improvements and the sensation of nasal obstruction

Summary

Introduction

Functional endoscopic sinus surgery (FESS) was developed based on the pathophysiology theory of chronic rhinosinusitis proposed by Messerklinger, published in the 50s and 60s. He described the physiological pathways of paranasal sinus secretions Based on these observations and correlations with findings in surgery on changes in mucociliary transport, Messerklinger was able to establish that the maxillary and frontal sinuses depend on their prechambers in the ethmoid and lateral nasal wall. Messerklinger[2] observed that eradication of the primary disease in the anterior ethmoid sinus through a limited endoscopic surgical procedure resulted in recovery of the mucosa of adjacent paranasal sinuses (frontal and maxillary) with no direct surgical manipulation of these areas. This is a conservative approach to surgical procedures on the nasal septum and turbinates

Objectives

Methods

Discussion

Conclusion