Effect of Functional Endoscopic Sinus Surgery on Bronchial Asthma Outcomes

Goldstein, Michael S.; Grundfast, Steven K.; Dunsky, Eliot H.; Dvorin, Donald J.; Lesser, Ray

doi:10.1001/archotol.125.3.314

Cited by 58 publications

(36 citation statements)

References 17 publications

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“…These patients require intensive care during these attacks and these episodes are a marker of poor asthma control. Goldstein et al in a retrospective case study has shown reduction of these episodes after ESS [13]. We also had a marked reduction in visits to the emergency room/ casualty in our patients after surgery.…”

Section: Discussionsupporting

confidence: 67%

Effect of endoscopic sinus surgery on asthmatic patients with chronic rhinosinusitis

Nair

Bhadauria²,

Sharma³

2010

Indian J Otolaryngol Head Neck Surg

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Section: Discussionsupporting

confidence: 67%

Effect of endoscopic sinus surgery on asthmatic patients with chronic rhinosinusitis

Nair

Bhadauria²,

Sharma³

2010

Indian J Otolaryngol Head Neck Surg

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“…However, they did not use any objective assessments such as pulmonary function tests. By contrast, Goldstein et al [23] found that ESS did not reduce postoperative asthma symptoms or asthma medication use, or result in improved pulmonary function. They studied a small number of subjects who had severe nasal polyposis and allergy prior to surgery and they did not evaluate objective sinonasal outcomes after ESS.…”

Section: Discussionmentioning

confidence: 96%

A Clinical Study of Endoscopic Sinus Surgery for Sinusitis in Patients with Bronchial Asthma

Dejima

Hama²,

Miyazaki³

et al. 2005

Int Arch Allergy Immunol

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Background: An association between bronchial asthma and sinusitis has long been suspected. Our aim is to study the clinical features of chronic sinusitis associated with bronchial asthma as two manifestations of one airway disease. Methods: We conducted a prospective analysis of the outcome of 88 patients, with or without bronchial asthma, who underwent endoscopic sinus surgery (ESS) for chronic sinusitis. Patients were divided into two groups by the presence or absence of asthma and were evaluated. One surgeon performed the ESS, and the same postoperative treatment was given to both groups. The postoperative outcomes of symptoms and objective findings related to sinusitis were evaluated numerically, with a maximum score of 2 points for each examination item. Twenty-eight patients with asthma symptoms were assessed before and after surgery, using peak flow (liter/second) and medication scores (according to US Food and Drug Administration) to determine whether bronchial asthma was improved by first-time ESS. Results: The outcomes of ESS were signifi- cantly worse in the asthma group, especially the endonasal findings. Patients suffering from chronic sinusitis and bronchial asthma showed improvement following ESS in terms of their asthma symptoms, peak flow and medication score. Patients with a good ESS result tended to have the greatest improvement in their asthma. Conclusions: We conclude that sinusitis and asthma are closely related to each other, acting as two manifestations of one airway disease. We recommend treating cases of sinusitis complicated by asthma as a single disease of the entire respiratory tract.

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“…Radiological studies have shown abnormal sinus radiographs in 53% [2,3] and mucosal thickening on sinus computed tomography (CT) scans in 74% [4] of patients with asthma. Recently, .84% of CT scans were found to be abnormal in severe asthma, with a correlation between the extent of CT changes, sputum eosinophilia and pulmonary function [5].A number of authors have investigated the effect of surgical treatment of rhinosinusitis upon asthma, with improvement [6-8], worsening [9, 10] and equivocal effect [11,12] being reported. Only two studies of medical chronic rhinosinusitis (CRS) treatment exist, one included four medical patients [13], whereas the other considered CRS with polyposis alone and was nonrandomised [14].…”

mentioning

confidence: 99%

“…A number of authors have investigated the effect of surgical treatment of rhinosinusitis upon asthma, with improvement [6][7][8], worsening [9,10] and equivocal effect [11,12] being reported. Only two studies of medical chronic rhinosinusitis (CRS) treatment exist, one included four medical patients [13], whereas the other considered CRS with polyposis alone and was nonrandomised [14].…”

mentioning

confidence: 99%

Treatment of chronic rhinosinusitis and its effects on asthma

Ragab

Scadding²,

Lund³

et al. 2006

Eur Respir J

145

100

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The effects of rhinosinusitis treatment upon asthma are disputed.The first randomised prospective study of surgical compared with medical therapy of chronic rhinosinusitis in 90 patients with and without nasal polyps was previously reported. Asthma symptoms, control, forced expiratory volume in one second (FEV1), peak flow, exhaled nitric oxide, medication use and hospitalisation at 6 and 12 months from the start of the study were also monitored. This paper reports these results in 43 of those patients with concomitant asthma.Both medical and surgical treatment of chronic rhinosinusitis were associated with subjective and objective improvements in asthma. Overall asthma control improved significantly following both treatment modalities, but was better maintained after medical therapy, where improvement could also be demonstrated in the subgroup with nasal polyps. Medicine was superior to surgery with respect to a decrease in exhaled nitric oxide and increase in FEV1 in the polyp patients. Two patients noted worsening of asthma post-operatively.Improvement in upper airway symptoms, as assessed using a visual analogue scale, correlated with improvement in asthma symptoms and control. Treatment of chronic rhinosinusitis, medical or surgical, benefits concomitant asthma; that associated with nasal polyposis benefits more from medical therapy.KEYWORDS: Asthma, chronic rhinosinusitis, endoscopic sinus surgery, exhaled nitric oxide, forced expiratory volume in one second, nasal polyps R hinosinusitis coexisted with asthma in 34% of patients in one study [1]. Radiological studies have shown abnormal sinus radiographs in 53% [2,3] and mucosal thickening on sinus computed tomography (CT) scans in 74% [4] of patients with asthma. Recently, .84% of CT scans were found to be abnormal in severe asthma, with a correlation between the extent of CT changes, sputum eosinophilia and pulmonary function [5].A number of authors have investigated the effect of surgical treatment of rhinosinusitis upon asthma, with improvement [6-8], worsening [9, 10] and equivocal effect [11,12] being reported. Only two studies of medical chronic rhinosinusitis (CRS) treatment exist, one included four medical patients [13], whereas the other considered CRS with polyposis alone and was nonrandomised [14]. MATERIALS AND METHODSPatients were recruited over 2 yrs from the Rhinology Clinics of the Royal National Throat, Nose and Ear Hospital (London, UK). The study was approved by the Ethics Committee of the Royal Free Hospital (London, UK). After application of exclusion criteria, the study was discussed with 327 consecutive patients with a primary diagnosis of CRS. Of these, 90 patients who agreed to the process of randomisation were finally included and were randomised equally into the medical and surgical groups. The study design and flow chart showing the course of the study are presented in figures 1 and 2, respectively. Diagnosis of CRS was based on the criteria described by the Staging and Therapy Group [15]. The criteria for diagnosis of...

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Effect of Functional Endoscopic Sinus Surgery on Bronchial Asthma Outcomes

Cited by 58 publications

References 17 publications

Effect of endoscopic sinus surgery on asthmatic patients with chronic rhinosinusitis

Effect of endoscopic sinus surgery on asthmatic patients with chronic rhinosinusitis

A Clinical Study of Endoscopic Sinus Surgery for Sinusitis in Patients with Bronchial Asthma

Treatment of chronic rhinosinusitis and its effects on asthma

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