Endoscopic Sinus Surgery for Type‐2 CRS wNP: An Endotype‐Based Retrospective Study

Alsharif, Saeed; Jonstam, Karin; Zele, Thibaut Van; Gevaert, Philippe; Holtappels, Gabriële; Bachert, Claus

doi:10.1002/lary.27815

Cited by 112 publications

(107 citation statements)

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“…Some studies have reported greater/faster symptoms reduction and less disease recurrence following surgeries compared with appropriate pharmaceutical managements alone in certain subgroups of chronic rhinosinusitis (Fokkens et al, 2019;Alsharif et al, 2019;Wang, Gullung & Schlosser, 2011). However, the appropriateness of primary EPLAs to treat lesions due to inflammation in rhinosinusitis has not been addressed.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcome of endonasal endoscopic prelacrimal approach in managing different maxillary pathologies

Lin

Chen

2020

PeerJ

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Background The aim of the study was to evaluate the treatment outcomes of endoscopic prelacrimal recess approaches (EPLAs) in managing different sinus pathologies, analyzing associated adverse events and post-treatment quality-of-life. Methods We enrolled 21 consecutive patients (22 lesions) who received endoscopic sinus surgical procedures with EPLAs in two tertiary medical institutes between 2015 and 2018. Quality-of-life and self-rated symptom severity data were collected using the 22-item Sino-Nasal Outcomes Test (SNOT-22) and 10-point visual analog scales (VAS), respectively. Results A total of 21 patients (mean age (standard deviation) 51.7 (14.5) years; 16(76.2%) male) were followed up for 12.7 months. The most common symptoms were nasal discharge and nasal airway obstructions. Nine lesions (40.9%) were sinonasal papilloma’s, seven lesions were other types of neoplasms (31.8%; five benign and two malignant), two were trauma-related (9.1%), and four inflammatory diseases (18.2%). Patients with non-papilloma lesions had higher presurgical SNOT-22 than those with papillomas (P-value = 0.021). After EPLAs, non-papilloma patients had significant improvements in SNOT-22 and VAS (P-values = 0.012 and 0.012, respectively), while those with papillomas had only marginally significant improvements in VAS (P-value = 0.061). The most common adverse events was temporary cheek/tooth numbness (n = 11), and patients with sinonasal papillomas were more likely to have post-treatment complications than those with other disease entities. Conclusions EPLAs were found to effectively manage various sinus diseases. Short-term life-quality improvements were promising. Future large-scale studies with longer follow-up periods are recommended.

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Section: Discussionmentioning

confidence: 99%

Clinical outcome of endonasal endoscopic prelacrimal approach in managing different maxillary pathologies

Lin

Chen

2020

PeerJ

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“…If necessary, this procedure is combined with a Draf type-III procedure. Reboot surgery shows significantly lower rates for polyp recurrence as well as a longer recurrence-free time and lower values in the SNOT-22 compared to conventional FESS [111].…”

Section: American Academy Of Otolaryngology-head and Neck Surgerymentioning

confidence: 90%

“…The extent of sinus surgery is usually adapted to the type and extent of disease as well as the individual anatomy. Surgical techniques range from polypectomy alone to partial uncinectomy, FESS and more extended surgical approaches like "nasalization", "reboot surgery" or "full-house FESS with Draf III" [110][111][112][113]. Individual terms such as MIST (minimally invasive sinus technique) are part of the spectrum of possible extents of surgery.…”

Section: Extent Of Surgerymentioning

confidence: 99%

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Qualität in der chirurgischen Therapie chronisch entzündlicher Erkrankungen der Nasennebenhöhlen

Hildenbrand

Ketterer

2020

Laryngo-Rhino-Otol

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Hildenbrand T et al. Qualität in der chirurgischen … Laryngo-Rhino-Otol 2020; 99: S5-S33 ZusaMMenfassung Die endonasale endoskopische Nasennebenhöhlenchirurgie hat sich als Standard der operativen Therapie bei chronisch entzündlichen Erkrankungen der Nasennebenhöhlen etabliert. Eine Verbesserung der subjektiven Beschwerden und objektiven Befunde konnte in zahlreichen Studien nachgewiesen werden. Aufgrund der häufig beobachteten Diskrepanz zwischen objektiven und subjektiven Ergebnissen nach Nasennebenhöhlenchirurgie kommt der Messung des sog. patient reported outcome eine zunehmende Bedeutung zu. Qualität und Effizienz in der Medizin haben in den letzten Jahren zunehmend an Bedeutung gewonnen. In vielen Ländern und auch länderübergreifend wurden bereits durch Zusammenschluss von Experten, z.T unter Federführung verschiedener Fachgesellschaften, Initiativen zur Verbesserung der Qualität in der chirurgischen Versorgung gegründet.Die vorliegende Arbeit stellt eine Übersicht qualitätsrelevanter Faktoren in der chirurgischen Therapie chronisch entzündlicher Erkrankungen der Nasennebenhöhlen anhand der vorhandenen Literatur, v.a. der Prozess-und Ergebnisqualität, dar. Ein besonderes Augenmerk liegt auf der subjektiven Bewertung der Ergebnisqualität durch den Patienten.absTraCT Endonasal endoscopic surgery of the paranasal sinuses is the gold standard in surgical treatment of chronic inflammatory diseases of the paranasal sinuses. Improvement of subjective complaints and objective findings has been confirmed in numerous studies. Due to the discrepancy between objective and subjective results after paranasal sinus surgery, the assessment of patient reported outcomes has gained importance.Quality and efficiency in medicine became increasingly important during the last years. In many countries and transnationally, the association of experts, partly coordinated by different medical societies, led to initiatives focusing on improvement of the quality of surgical care. The present article represents an overview of quality-related factors in surgical treatment of chronic inflammatory diseases of the paranasal sinuses, summarizing the existing literature and focusing particularly on process and outcomes quality. Particular attention will be paid to the outcome quality individually assessed by the patients. S5Online publiziert: 16.03.2020 Hildenbrand T et al. Qualität in der chirurgischen … Laryngo-Rhino-Otol 2020; 99: S5-S33 Referat < 200 200 -400 Anzahl der Operationen Anzahl der Kliniken in % > 400 57,6 % 38,3 % 36,4 % 12,8 % städtisch/kirchlich/privat Uniklinik Krankenhaus S7 Hildenbrand T et al. Qualität in der chirurgischen … Laryngo-Rhino-Otol 2020; 99: S5-S33 Referat ren < 20 Operationen pro Jahr durch. Zwischen 20 und 50 Operationen werden von 38,4 % der Kliniken durchgeführt und mehr als 50 Operationen geben lediglich 2 % der Kliniken an (▶abb. 2). 83,1 % aller Kliniken gaben an, an einem interdisziplinären Tumorboard teilzunehmen und 68,4 % führen interdisziplinäre Tumoroperationen bei Erkrankungen der Nasennebenhöhle...

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“…24 To completely remove not only the sinus mucosa, including the polyps, but also the thickened and equally diseased mucosa next to them (Jonstam et al 2020, submitted for publication) prepared to develop polyps also, which may be a valid approach to a severe case of type 2 mucosal disease involving all the sinuses. 25 This approach, which has been termed reboot, may also involve the frontal sinuses and builds on the observation that the new mucosa growing into the sinuses from the nasal cavity shows less polyp formation. Nasal mucosa may also show type 2 bias, but it very rarely forms polyps, and thus overgrows the sinuses as a thin but functional mucosa within a few weeks after surgery.…”

Section: Phenotypes Versus Endotypes: Decisive For Treatment Optimizamentioning

confidence: 99%

Endotypes of chronic rhinosinusitis: Impact on management

Cardell

Stjärne

Jonstam

et al. 2020

Journal of Allergy and Clinical Immunology

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Following the trend in asthma, endotypes for chronic rhinosinusitis with nasal polyps have been established, with type 2 immune reactions representing >80% of nasal polyp cases in Europe and the United States. Endotyping is without doubt useful to predict the natural course of disease, to determine pharmacotherapy and the extent of surgery, and lately also to select patients for treatment with type 2 biologics. However, with the opening of this new era of treatment, limitations of the current possibilities in subgrouping patients also became apparent, as (1) mixed endotypes often can be found and (2) predictions as to the best biologic to be used in an individual patient are not yet possible. Some of the questions to address in the near future are discussed. (J Allergy Clin Immunol 2020;145:752-6.)

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Endoscopic Sinus Surgery for Type‐2 CRS wNP: An Endotype‐Based Retrospective Study

Cited by 112 publications

References 35 publications

Clinical outcome of endonasal endoscopic prelacrimal approach in managing different maxillary pathologies

Clinical outcome of endonasal endoscopic prelacrimal approach in managing different maxillary pathologies

Qualität in der chirurgischen Therapie chronisch entzündlicher Erkrankungen der Nasennebenhöhlen

Endotypes of chronic rhinosinusitis: Impact on management

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