Endoscopic Endonasal Sinus Surgery Research Articles

Sinonasal inverted papilloma and predictors of health-related quality of life after endonasal endoscopic surgery: A prospective cohort study.

Existing knowledge on health-related quality of life (HRQoL) after surgical removal of sinonasal inverted papilloma (IP) is limited. Moreover, predictors for a better or worse post-operative HRQoL outcome are not known. Our aim was to assess HRQoL in all three health domains (physical, psychological, and social), track its post-operative trajectory, investigate if pre-operative observations could predict distinct post-operative HRQoL outcomes, and evaluate whether physicians' interventions could contribute to improved post-operative HRQoL. Prospective cohort study. Tertiary referral hospital. Seventy-four patients who underwent surgery for an IP were included. They were asked to fill in the Endonasal Endoscopic Sinus and Skull-Base Surgery Questionnaire (EES-Q) pre-operatively, and then 2 weeks, 3 months, and 1 year post-operatively. Linear mixed models analyses were performed to evaluate the overall post-operative HRQoL and the separate health domains, as well as the impact of specific variables (sex, age, American Society of Anaesthesiologists [ASA] classification, smoker, Krouse staging, pre-operative EES-Q score, type of surgery, and post-operative antibiotics) on HRQoL improvement. The total EES-Q score (p < .001) as well as the physical (p < .001), psychological (p = .049), and the social (p = .002) domains significantly improved post-operatively. ASA classification (p = .049), pre-operative EES-Q score (p < .001) and post-operative antibiotics (p = .036) were significant variables. Overall HRQoL, as well as each of the three health domains, improved significantly. A higher ASA score, a higher pre-operative EES-Q score, and the administration of post-operative antibiotics were significant predictors for better HRQoL recovery post-operatively. Further research is necessary to confirm these results.

Local flap reconstruction techniques after frontal sinus drainage typeII andIII according to Draf

Extended endonasal endoscopic frontal sinus surgery is characterized by bone resection beyond the lamellae of the frontal sinus and is currently classified according to Draf as typeIIa, typeIIb, modified typeIII (also referred to as typeIIc), and typeIII. This approach is indicated when the surgical goal cannot be achieved through complete removal of the anterior ethmoidal cells. Numerous studies indicate restenosis rates ranging from 7to 36%, despite creation of maximal openings. Exposed bone, which tends to epithelize slowly with significant crusting and the risk of uncontrolled wound healing depending on the local environment and other factors, is considered acontributing factor. Covering the exposed bone with mucosa can significantly reduce the risk of restenosis. Avariety of flap techniques for frontal sinus drainage in DrafIII procedures are presented, including some variants that were part of presentations at the 2023 Congress of the European Rhinologic Society in Sofia, Bulgaria. These include combinations of free mucosal grafts, pedicled mucosal flaps, and hybrids combining both techniques. Additionally, the results of current studies are presented. The results and achieved opening areas in contemporary DrafIII surgeries are significantly improved and larger compared to the early stages of these procedures. Amultitude of published studies consistently demonstrate that outcomes are markedly improved with mucosal coverage. Depending on the prevailing anatomy, mucosal conditions, and the extent of the surgical intervention, the most suitable technique should be selected. Therefore, proficiency in various methods is crucial. The use of aflap technique (free, pedicled, or combinations thereof) should be defined as the standard when performing extended frontal sinus surgery (Draf IIb, IIc, III, or endonasal frontal sinus surgery [EFSS] 4-6).

Determination of the effect of topical application of N-acetylcysteine on the recovery rate of patients with chronic rhinosinusitis after surgical treatment, based on SNOT-22 test scores

endonasal endoscopic sinus surgery ( FESS ) is the gold standard for the treatment of patients with chronic rhinosinusitis worldwide. The task of the otorhinolaryngologist is aimed at restoring the function of the osteomyetal complex . However, the tactics of the postoperative period, especially the topical form of treatment, remain an extremely important issue. The purpose of the study: Determination of the influence of the topical form of N-acetylcysteine on the speed of recovery of patients after FESS, compared to standardized topical treatment, based on the sino-nasal outcome test. The study was carried out at the Department of Otorhinolaryngology of Bogomolets National Medical University on the basis of the Oleksandriv Clinical Hospital of Kyiv together with the CNME "Kremenchuk City Hospital of Planned Treatment", Kremenchuk. A population of 96 patients aged 18 to 60 with a diagnosis of chronic rhinosinusitis after surgical treatment. The randomization method was two groups of patients were formed. 1st group (study) - 47 patients who received irrigation of the topical form of N-acetylcysteine. 2nd group (control) - 49 patients who received topical therapy using irrigation of 0.9% NaCl solution. The volume of surgical intervention of both groups of the study: Endonasal endoscopic maxillotomy, septoplasty , bilateral vasotomy of the lower nasal turbinates. To participate in the study, all participants had to sign an informed consent. All patients were surveyed using the SNOT22 test on the 1st day before surgery treatment and on the 3rd, 10th and 28th days after surgical treatment.According to the obtained results, the effectiveness of both methods of topical treatment was revealed (p=0.001). However, the use of topical N -acetylcysteine in patients of the study group has more effective dynamics of symptoms, according to the SNOT -22 questionnaire on the 3rd (p=0.034), 10th (p=0.002) and 28th day (p=0.001) after surgical treatment. Therefore, the topical form of N-acetylcysteine has an effective effect on the speed of recovery of the mucous membrane of the nasal cavity and paranasal sinuses and improves the quality of life in patients with chronic rhinosinusitis after FESS.

Nasolacrimal Duct Flap Technique in Endoscopic Endonasal Sinus Surgery for Postoperative Maxillary Mucoceles adjacent to the Nasolacrimal Duct

術後性上顎嚢胞に対する内視鏡下鼻内副鼻腔手術において, 嚢胞開窓部の骨性辺縁を鼻粘膜弁で覆う処置が再閉鎖の予防に寄与し, 下鼻道に接する嚢胞に対しては下鼻道粘膜弁を用いることが多い. しかし鼻涙管外側に位置する嚢胞に対する下鼻道粘膜弁の適用は困難であり, われわれは鼻涙管粘膜弁を作製し鼻涙管に隣接する嚢胞開窓部を覆っている. 代表症例を提示し鼻涙管粘膜弁作製の手術手技を示し, 鼻涙管粘膜弁を用い加療した4例の術後経過について報告する. 術後は全例で鼻涙管狭窄や閉塞症状を来さず嚢胞開存性は保たれ, 鼻涙管粘膜弁は嚢胞再閉鎖を予防し, かつ, 嚢胞から下鼻道へのドレナージルートになる有用な手術手技であると示唆された.

Temporal evolution of quality of life in patients endoscopically treated for sinonasal malignant tumors.

The aim of our study is to assess which factors may affect the quality of life (QoL) and its fluctuation over time in adult patients who received endonasal endoscopic oncologic sinus surgery (EOSS) for sinonasal malignancies (SNM) in our center. We analyzed EOSS cases for primary SNM from January 2015 to June 2020. For each patient, we have recorded the age at treatment, gender, smoking habits, use of psychotropic drugs for mood disorders, stage, histotype, type of surgical resection, need for skull-base reconstruction, development of postoperative major complications, and the use of adjuvant intensity-modulated radiotherapy (IMRT). We evaluated the patient's performance status pre-treatment using the ECOG scale. Quality of life was measured using three questionnaires (SNOT-22; ASK-9; EORTC QLQ-C30 version 3). Fifty-five patients were enrolled in our study, of whom thirty-two (58.18%) received adjuvant IMRT. Overall, a significant improvement in all QoL outcomes was observed at eighteen months, while, female sex, higher ECOG scores, advanced stage of disease, and adjuvant IMRT were associated with worse QoL. After 18 months the delta in QoL between women and men worsened (in SNOT-22 and EORTC QLQ-GLOBAL) while if only the most fragile patients according to ECOG are considered, this difference was reduced for both tools. Our analysis revealed that IMRT is the element that has the greatest impact on patient's quality of life, in association with the female sex, ECOG &gt;2, and advanced stage of the disease.

Prospective evaluation of multidimensional health-related quality of life after endoscopic endonasal surgery for pituitary adenomas using the endoscopic endonasal sinus and skull base surgery questionnaire.

Social functioning is an important factor in the evaluation of postoperative health-related quality of life (HRQoL) for pituitary adenoma patients. In a prospective cohort study multidimensional HRQoL of non-functioning (NFA) and functioning (FA) pituitary adenoma patients were evaluated following endoscopic endonasal surgery using the endoscopic endonasal sinus and skull base surgery questionnaire (EES-Q). Prospectively, 101 patients were included. The EES-Q was completed preoperatively and postoperatively (2 weeks, 3months, 1year). Sinonasal complaints were completed daily during the first week postoperatively. Preoperative and postoperative scores were compared. A generalized estimating equation (uni- and multivariate) analysis was performed to identify significant HRQoL changes related to selected covariates. Two weeks postoperatively, physical (p < .05) and social (p < .05) HRQoL are worse and psychological (p < .05) HRQoL improved compared with preoperatively. Three months postoperatively, psychological HRQoL (p=.01) trended back to baseline and no differences in physical or social HRQoL were reported. One year postoperatively, psychological (p=.02) and social (p=.04) HRQoL improved while physical HRQoL remained stable. FA patients report a worse HRQoL preoperatively (social, p < .05) and 3months postoperatively (social, p < .02 and psychological, p < .02). Sinonasal complaints peak in the first days postoperatively and gradually return to presurgical levels 3months postoperatively. The EES-Q provides meaningful information on multidimensional HRQoL to improve patient-centred health care. Social functioning remains the most difficult area in which to achieve improvements. Despite the relatively modest sample size, there is some indication that the FA group continues to show a downward trend (and thus improvement) even after 3months, when most other parameters reach stability. Level II-B.

Quality of life and olfactory outcomes following frontal sinus drill-out procedures

ObjectiveExtensive endoscopic frontal sinus surgery requires drilling of the bone close to the olfactory epithelium and exposing the first olfactory fiber. This study assesses long-term quality of life (QoL) and olfactory outcomes following endoscopic endonasal frontal sinus drill-out procedures. MethodsAll patients who underwent endoscopic endonasal frontal sinus surgery (Draf IIa or Draf III) for chronic rhinosinusitis (CRS) without nasal polyp in 2017 at a single tertiary center were included in the study. Pre- and postoperative scores of SNOT-22, odor identification, discrimination, and threshold were noted. ResultsOf the 31 patients included in this study, Draf IIa and Draf III were performed in 12 (38.7 %) and 19 (61.3 %) patients, respectively. A general assessment of QoL changes was carried out by evaluating pre- and postoperative SNOT-22 scores. A statistically significant difference was found between pre- and postoperative SNOT scores (p < 0.001): SNOT scores decreased by 9.13 units postoperatively. Comparing differences in SNOT-22 and olfactory test scores between Draf IIa and Draf III patients, we did not detect any statistically significant difference between the two procedures (p > 0.05). Draf IIa and Draf III did not display a statistically significant difference in SNOT-22 scores (p = 0.484) and did not have a significant effect on differences in pre- and postoperative identification (p = 0.675), discrimination (p = 0.535), and threshold (p = 0.141) scores. ConclusionsOur study demonstrated that extensive drill-out procedures have not a negative effect on olfactory functions, including threshold scores, in the long term. Patients who underwent frontal sinus procedures for persistent CRS have a better QoL postoperatively. However, more prospective double-blind studies are needed to support our results.

Extending the use of the Endoscopic Endonasal Sinus and Skull Base Surgery Questionnaire in a cross-sectional study: Patients with chronic rhinosinusitis versus healthy controls.

There are several instruments to assess health-related quality of life (HRQoL) in chronic rhinosinusitis (CRS). Unfortunately, none of them evaluates all three health domains (physical, social and psychological) important to assess the overall well-being of the patient. The Endoscopic Endonasal Sinus and Skull Base Surgery Questionnaire (EES-Q) does assess all these elements. Initially, the EES-Q is validated to evaluate the impact of endoscopic endonasal surgery (EES) on HRQoL. The aim of this study is to assess whether EES-Q outcomes differ in patients with CRS compared with healthy individuals. Therefore, extending the use of the EES-Q for all CRS patients. Cross-sectional study. Tertiary referral hospital. One hundred patients with uncontrolled CRS (50% with nasal polyps) scheduled to receive EES. The questionnaire was completed preoperatively. Healthy control subjects (n= 100) without any history of sinusitis or a known current medical treatment at a hospital were included. Mann-Whitney U test was performed to identify differences in EES-Q scores (domain scores and EES-Q score). The median EES-Q score in CRS patients (33.8) was significantly higher (p< 0.001) than in the control group (10.4). As well as the physical (52.5 vs. 16.4, p< 0.001), psychological (13.8 vs. 5.0, p< 0.001) and social (37.5 vs. 2.5, p< 0.001) domain scores. With this study, we are extending the use of the EES-Q. It indicates that the EES-Q can be a valuable clinical tool to assess multidimensional HRQoL in all patients with CRS.

Adjunctive Middle Turbinectomy for Endoscopic Medial Orbital Wall - Thyroid Eye Disease Decompression.

Introduction Middle turbinate resection (MTR) is commonly performed during endonasal endoscopic sinus and skull base surgery. Objective The purpose of this study was to characterize the additional orbital soft-tissue volume expansion during endoscopic medial orbital wall decompression with adjunctive MTR. Methods A retrospective review of patients who underwent endoscopic medial wall decompression with MTR was performed. The imaging software AW (GE Healthcare, Chicago, IL, USA) was used to overlay pre and postoperative orbital computed tomography (CT) images to visualize the preoperative position of the middle turbinate and the postoperative orbital soft tissue in the ethmoid bed. The imaging software Vitrea (Vital Images Inc., Minnetonka, MN, USA) was used to manually segment postoperative scans to determine the volume of orbital tissue which had filled the space previously occupied by the middle turbinate or medial to it. Results Nine orbits from 5 patients were included in this study; all patients were female with a history of hyperthyroidism. The average age was 55.6 years (range 32-74). Of the 9 orbits, 7 (78%) had orbital soft tissue within the space of the resected middle turbinate postoperatively. The average volume of orbital tissue within or medial to this space was 0.83 +/- 0.67 cc. No patients had any postoperative complications. Conclusions In this patient cohort, adjunctive middle turbinate resection for endoscopic medial orbital wall decompression added ∼ 0.83 cc of volume for orbital soft tissue after medial wall decompression. Middle turbinate resection is a useful adjunct to the orbital surgeon's armamentarium to augment the results of a medial orbital decompression for select patients.

A review of the revisions and complications management procedure in sinus surgery

One of the most standard and least invasive surgical procedures that could be applied mostly for the treatment of inflammation of the paranasal sinuses is endonasal endoscopic sinus surgery. The main objective of this study is to assess the available strategies for avoiding, diagnosis and also dealing with various kinds of potential complications of sinus disorders as well as the symptoms which specify the need for revision endoscopic sinus surgery mainly for the treatment of chronic rhinosinusitis. Based on the objectives of this study, the studies were categorized within four main groups; sinus disorders, diagnosis, management, and treatment. In this regard, wide research has been done in various scientific databases of PubMed, EMBASE, Europe PMC, HubMed, MEDLINE, Scientific Information Database (SID) and Google Scholar. From a total of 315 founded records, the final number of 91 records were reviewed. The rate of complication associated with endoscopic sinus surgery is not much and the improvement of surgical technology and experience could decrease its side effects. Performing immediate extensive surgery among patients who have inflammatory sinonasal disease could modify long-term consequences. Applying endoscopic sinus surgery could yield the most appropriate positive outcomes. For achieving the most suitable surgical consequences, the surgeon should be adequately qualified in diagnosis and facing with any possible complications during the operation in addition to cases with complex and revision problems.

Protrusion of the carotid canal into the sphenoid sinuses: evaluation before endonasal endoscopic sinus surgery.

Many reports have previously indicated the vast number of anatomical variations of the sphenoid sinuses, e.g. presence of the recesses. Notwithstanding, there are a few crucial neurovascular structures directly neighbouring with the sinuses. The following research aimed to evaluate frequency prevalence of the carotid canal's protrusion into the sphenoid sinuses in adult population. Computed tomography (CT) scans of the paranasal sinuses of 296 patients (147 females, 149 males) were analysed in this retrospective study. The patients did not present any pathology in the sinuses. Spiral CT scanner Siemens Somatom Sensation 16 was used in the standard procedure in the option Siemens CARE Dose 4D. Protrusion of the carotid canal was found in the majority of the patients - 55.74%, more frequently in males (65.1% of the patients) than in females (46.26% of the patients). The said variant - regardless of gender - was noted more often bilaterally (41.55% of the cases: 29.93% females, 53.02% males) than unilaterally (14.19% of the cases: 16.33% females, 12.08% males). In the unilateral type (regardless of gender), the protrusion was more common for the left sphenoid sinus - 10.81% of the patients (12.24% females, 9.4% males) than for the right - 3.38% of the patients (4.08% females, 2.68% males). Complicated structure of the paranasal sinuses, derived from the high prevalence of their anatomical variations, may perplex routine surgical interventions. Henceforth, referral for a CT scan is imperative in order to abate the risks associated with an invasive procedure in the said region.

Endoscope Assisted Combined Drainage of Sino-Orbital Abscess: Technique Revisited.

Orbital complications of acute rhinosinusitis may present with painful proptosis and ophthalmoplegia. Surgical management, when required comprises of endonasal endoscopic sinus clearance with or without external orbital abscess drainage. External drainage involves blind dissection and carries a risk of iatrogenic injury to periorbital structures. We describe a novel technique of endoscope guided orbital abscess drainage under direct visualisation via the external incision site. Patients with orbital cellulitis secondary to rhinosinusitis and planned for surgical intervention were recruited. After endonasal endoscopic sinus surgery, the orbital abscess cavity was opened and an endoscope was inserted externally. The cavity was examined; loculi were opened under direct visualisation till drainage was complete. This procedure was performed in seven patients with a successful outcome. The mean time to resolution was 1.5months (36.4 ± 18.2days). None of the patients had any recurrence or residual disease on follow up. In addition, in two cases with obstructed sinus drainage and "walling off" of frontal sinus, visualisation of the instrument placed in the drained abscess cavity via endo-nasally inserted endoscope confirmed the re-establishment of continuity of sinus opening. This approach may allow the surgeon to drain multiloculated abscess completely under direct visualization while minimising iatrogenic damage to periorbital structures. Real time display using endoscopic camera on the monitor screen also serves as a teaching and training tool during the procedure. Technique utilises the existing endoscopic set-up without the need for additional instrumentation.

Treatment of sinusitis associate with filling material of the maxillary sinus by endonasal endoscopic sinus surgery simultaneous sinus-lifting and dental implantation

Optimization of the sinus-lifting in patients with filling material in maxillary sinus cavity by a one-stage endonasal endoscopic elimination of the sinus pathology and carrying out a sinus-lifting.

Prevention of frontal pocket stenosis after endoscopic transnazal surgery on the frontal sinus and endoscopic septoplasty in acute and chronic pathology of frontal sinuses

To offer an effective method to prevent postoperative frontal recess stenosis after endoscopic endonasal frontal sinus surgery and surgical correction of intra-nasal structures. In our manuscript we analyzed 274 cases of endoscopic endonasal frontal sinus surgery: postoperative treatment (local and systemic). All of them were operated by endoscopic endonasal approach both initially and repeatedly for acute and chronic frontal sinusities in the ENT department Pavlov First state medical university of Saint Petersburg from 2013 to 2019. In 10 cases, patients with previous endoscopic endonasal frontal sinus surgery underwent revision endoscopic procedure due to frontal recess obstruction, in 4 cases - due to a recurrence of the polypous process involving the frontal sinus, in 6 cases - without visible provoking factors contributing to restenosis of the frontal recess. First step in all cases was a correction of the nasal septum. It is necessary to assess the factors that contribute to restenosis of the frontal recess. Careful endoscopic care of the nasal cavity and the frontal recess in the postoperative period can reduce the risk of restenosis of the latter. Local antibacterial nasal therapy is recommended for the prevention of purulent processes in the nasal cavity in the early postoperative period.

Treatment of Sinusitis Associate with Filling Material of the Maxillary Sinus by Endonasal Endoscopic Sinus Surgery Simultaneous Sinus-Lifting and Dental Implantation

Treatment of Sinusitis Associate with Filling Material of the Maxillary Sinus by Endonasal Endoscopic Sinus Surgery Simultaneous Sinus-Lifting and Dental Implantation

Expression of COX-1, COX-2, 5-LOX and hbox {CysLT}_2 in nasal polyps and bronchial tissue of patients with aspirin exacerbated airway disease

BackgroundAspirin exacerbated respiratory disease (AERD) is a disease of the upper and lower airways. It is characterized by severe asthma, chronic sinusitis with nasal polyps (CRSwNP) and intolerance towards nonsteroidal analgesics (NSAR). Arachidonic acid (AA) metabolites play an important role in the pathogenesis of AERD. It is still unknown, whether metabolism of AA is comparable between the upper and lower airways as well as between patients with and without NSAR intolerance.ObjectiveWe sought to analyze differences in the expression of cyclooxygenases type 1 and 2 (COX-1, COX-2), arachidonate 5-lipoxygenase (5-LOX) and cysteinyl leukotriene receptor type 2 (hbox {CysLT}_2) in nasal polyps and the bronchial mucosa of patients with aspirin intolerant asthma (AIA, n=23) as compared to patients with aspirin tolerant asthma (ATA, n=17) and a control group with nasal polyps, but without asthma (NPwA, n=15).MethodsTissue biopsies from nasal polyps and bronchial mucosa were obtained during surgical treatment of nasal polyps by endonasal functional endoscopic sinus surgery (FESS) under general anesthesia from intubated patients. Immunohistochemistry was used to analyze the expression of COX-1, COX-2, 5-LOX and hbox {CysLT}_2 in nasal and bronchial mucosa. Categorization into the different patient groups was performed according to the patient history, clinical and laboratory data, pulmonary function and provocation tests, as well as allergy testing.ResultsWe observed a stronger expression of 5-LOX and hbox {CysLT}_2 in submucosal glands of nasal and bronchial tissue compared to epithelial expression. The expression of COX-1 and COX-2 was stronger in epithelia compared to submucosal glands. There was a similar expression of the enzymes and hbox {CysLT}_2 between upper and lower airways in all patient groups. We did not detect any significant differences between the patient groups.ConclusionsThe AA-metabolizing enzymes and the hbox {CysLT}_2 were expressed in a very similar way in different microscopic structures in samples of the upper and lower airways of individual patients. We did not detect differences between the patient groups indicating the pathogenetic role of AA metabolism in these disorders is independent of the presence of NSAR-intolerance.

Simultaneous endoscopic endonasal sinus surgery and sinus augmentation with immediate implant placement: A retrospective clinical study of 23 patients

ObjectiveThe aim of this study was to evaluate the efficacy of simultaneous endoscopic endonasal sinus surgery and sinus augmentation with immediate implant placement. Patients and methodsThe study patients (n = 23) were partially or completely edentulous in the posterior maxilla and required maxillary sinus augmentation. All included patients had a sinus pathology confirmed clinically and radiographically. The technique of simultaneous endoscopic endonasal sinus surgery and sinus augmentation was used in 15 patients, with eight endonasal sinus surgery procedures being performed 2–3 months before sinus augmentation. Where possible, implants were placed during the same surgical procedure (with a ridge bone height of at least 4 mm). ResultsThere were no any major intraoperative complications. Implants placed in the reconstructed areas were shown to integrate normally, and postoperative occlusal function and aesthetics were favorable. Of the 95 implants placed in these 23 patients, two failed to osseointegrate. ConclusionThe method of simultaneous endoscopic endonasal sinus surgery and sinus augmentation with immediate implant placement leads to a reduction in postoperative complications, significantly shortening the rehabilitation period for patients with maxillary sinus diseases and insufficient bone tissue.

Endonasal endoscopic sinus surgery with rhinobasis resection due to esthesioneuroblastoma: case report.

Aim: Esthesionevroblastoma is a rare malignant neuroectodermal tumor that begins development of neuroepithelial cells of the olfactory membrane. Therefore the biology of the tumor, surgery is a method of choice. Endoscopic transnasal method with craniobasal resection is favorable alternative to more invasive surgical methods in a rigorous assessment of patients. Our aim is to describe the first case in the country operated endonasal with typical clinical and histopathological findings of olfactory neuroblastoma, and to discuss opportunities for radical surgery by endoscopic endonasal sinus surgery. Material and methods: We present a patient with nasal obstruction, epistaxis, smell disturbance, headache and eye symptoms. Results: Single step transnasal endoscopic resection with craniektomia, then undergoes postoperative radiotherapy is made on the patient. One year after surgery, no clinical, endoscopic and radiologic evidence of disease recurrence. Conclusion: Esthesionevroblastoma is a rare malignant tumor that untypical because its initial symptoms are often diagnosed at later stages. Early detection and timely performed treatment is important moment for the prognosis.

Development and evaluation of systems for detecting risk of endoscopic endonasal sinus surgery by measuring eyeball vibration

Development and evaluation of systems for detecting risk of endoscopic endonasal sinus surgery by measuring eyeball vibration

Effects of endoscopic endonasal sinus surgery on nasal flora in patients with chronic rhinosinusitis with nasal polyps

Aim: This study aimed to evaluate the alterations in the nasal flora in patients who underwent endoscopic endonasal surgery for chronic rhinosinusitis with nasal polyps (CRSwNP). Material and Methods: This prospective study included 30 patients diagnosed with CRSwNP who were resistant to medical treatment and recommended for surgery. The nasal cavity was sampled two times, first preoperatively on the day of operation and postoperatively in the 4th week. Patients were divided into two groups according to their culture results, including normal flora bacteria and potential pathogen production. Results: In the preoperative swab samples, 3 (11.1%) patients had no bacterial growth, 16 (59.3%) patients had a normal flora, and potential pathogens were detected in 8 (29.6%) patients. However, postoperatively, 3 (11.1%) patients had no bacterial growth, 13 (48.1%) patients had a normal flora, and potential pathogens were detected in 11 (40.7%) patients during the postoperative period. No significant difference was found between preoperative and postoperative culture results in terms of the number of patients with normal flora, potential pathogens, and no bacterial growth (p=0.676). The most common microorganism in the normal flora group preoperative and postoperative period was coagulase-negative Staphylococcus (77.8%, 51.9%, respectively), and the most common microorganism in the potential pathogen group was Staphylococcus aureus (18.5% and 25.9%, respectively). Comparing preoperative and postoperative culture results according to isolated potential pathogen microorganism types, no statistically significant difference was observed for any microorganism in the potential pathogen group (p>0.05).Conclusion: As a result, no correlation between nasal polyps’ surgery and potential pathogens was detected. Keywords: Chronic rhinosinusitis; culture; nasal polyps; flora; potential pathogens; bacteria; Staphylococcus aureus; coagulase; transnasal endoscopic surgery; pseodomanas.