Computed Tomographic Staging and the Fate of the Dependent Sinuses in Revision Endoscopic Sinus Surgery

Abstract

The Lund and Mackay system can be applied in the setting of revision endoscopic sinus surgery. Sinusotomies should be performed only in sinuses with radiographic disease, and not prophylactically to prevent disease. The standard functional approach may allow disease initially present in the sphenoid or frontal sinuses to normalize without formal sphenoidotomy or frontal sinusotomy.

Correlation of histopathology and symptoms in allergic and non-allergic patients with chronic rhinosinusitis

“…Our findings confirm previous findings in the literature, that correlations between severity of symptoms and objective extent of disease (CT or endoscopy) are usually not significant, although may have an impact on treatment outcome [4,8,9]. This means that a rhinosurgeon does not have a general predictive parameter after surgical specimen is analyzed, at least in non-allergic patients with CRS but has to analyze a single symptom and relate it to different parameters of inflammation, considering predisposing factors in an individual patient, in order to predict, to a limited extent, persistence of some bothersome symptoms after sinus surgery.…”

Correlations and Comparison between Repeat Computed Tomography Scores, Endoscopy Scores and Symptomatic Improvement before and after Endoscopic Sinus Surgery: A Pilot Study

“…It can also be used to assess response to surgery. 16 Objectivity can be further enhanced if a grading of the disease findings on CT is done. To this end, the American Academy of Otolaryngology Task Force on rhinosinusitis has recommended the Lund-Mackay system for radiographic staging.…”

Histopathologic Parameters as Predictors of Response to Endoscopic Sinus Surgery in Nonallergic Patients with Chronic Rhinosinusitis

“…Cellular infiltration and local cytokine activity in the sinus mucosa collected at surgery may have high prognostic value for long-term outcome, mostly indicating poorer prognosis in allergic and asthmatic patients, with increased local eosinophilia and IL-5 activity. 3,5,6 Prediction of treatment failure and detection of potential responders among candidates for surgical treatment would be of a great clinical value. However, no study on histopathologic prognostic parameters in a larger group of non-allergic, non-asthmatic, non-polyposis, non-revision patients, with CRS has been published in the literature.…”