Endoscopic sinus surgery and its effects on pulmonary function test in patients of chronic rhinosinusitis with nasal polyposis

Authors

  • Dameshwa S. Lyngdoh Department of ENT and HNS, SCB Medical College and Hospital, Cuttack, Odisha, India
  • Subrat Kumar Behera Department of ENT and HNS, SCB Medical College and Hospital, Cuttack, Odisha, India
  • Smruti Swain Department of ENT and HNS, SCB Medical College and Hospital, Cuttack, Odisha, India
  • Manoranjan Pattnaik Department of Pulmonary Medicine, SCB Medical College and Hospital, Cuttack, Odisha, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20203200

Keywords:

CRSwNP, Endoscopic sinus surgery, FEV1, FVC, Pulmonary function test

Abstract

Background: The human upper and lower respiratory tract share a close relationship in respect to existence of diseases. The objectives of this study were to evaluate the outcome of endoscopic sinus surgery with the Lund- Mackay staging system and to find any objective changes between the pre and post-operative pulmonary function test values in patients with chronic rhinosinusitis undergoing endoscopic sinus surgery.

Methods: A total of 50 patients of CRSwNP refractory to maximal medical treatment (for 1 month) planned for endoscopic sinus surgery were included in the study. Results were assessed on the basis of pre and post-operative endoscopic and CT scores and PFT (FEV1, FVC and FEV1/FVC) values.  

Results: Postoperatively, Lund Mackay endoscopic and CT scores improved from the preoperative values, which were statistically significant with p values<0.05. Comparing FEV1/FVC, FVC and FEV1 values in three situations- preoperative versus postoperative 1 month, preoperative versus postoperative 3rd month and post-operative 1st month versus postoperative 3rd month, the difference between the means were found to be statistically significant (p=0.000), except for FVC between postoperative 3rd month and 1st month.

Conclusions: This study provides objective evidence that patients with CRSwNP may have non clinical lower airway disease detected by PFT and ESS is effective in improvement of both nasal and lower airway disease as evident from the improvements in PFT values.

Author Biography

Dameshwa S. Lyngdoh, Department of ENT and HNS, SCB Medical College and Hospital, Cuttack, Odisha, India

Final year Post graduate in Department of ENT & HNS, SCB Medical College & Hospital

References

Karuthedath S, Singh I, Chadha S. Impact of functional endoscopic sinus surgery on the pulmonary function of patients with chronic rhinosinusitis: a prospective study. Indian J Otolaryngol Head Neck Surg. 2014;66(4):441-8.

Zachary M Soler. Results of medical and surgical treatment of chronic rhinsinusitis with and without nasal polyposis. In: Flint P, Haughey B, Lund V, Niparko J, Robbins K, Thomas JR, et al, eds. Cummings Otolaryngology Head and Neck surgery 6th edition. Saunders, Elsevier; 2015: 703.

Hastan D, Fokkens WJ, Bachert C, Newson RB, Bislimovska J, Bockelbrink A, et al. Chronic rhinosinusitis in Europe- an underestimated disease. A GA(2) LEN study. Allergy. 2011;66(9):1216-23.

Stammberger H. Functional endoscopic sinus surgery: the Messerklinger technique. Philadelphia: Decker; 1991: 283.

Wigand ME. Endoscopic surgery of the paranasal sinuses and anterior skull base. New York: Thieme Medical Publishers; 1990: 1-2.

Kennedy DW, Zinreich SJ, Rosenbaum AE, Johns ME. Functional endoscopic sinus surgery. Theory and diagnostic evaluation. Arch Otolaryngol. 1985;111:576-82.

Kennedy DW. Functional endoscopic sinus surgery. Technique. Arch Otolaryngol. 1985;111:643-9.

Fokkens WJ, Lund VJ, Mullol J, Bachert C, Alobid I, Baroody F, et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2012. Rhinology. 2012;2012(23):1-298.

Hansen JE, Sun XG, Wasserman K. Spirometric criteria for airway obstruction: use percentage of FEV1/FVC ratio below the fifth percentile, not <70%. Chest. 2007;131(2):349-55.

Barreiro TJ, Perillo I. An approach to interpreting spirometry. Am Fam Phys. 2004;69(5):1107-14.

Stammberger H. Endoscopic endonasal surgery- New concepts in the treatment of recurring sinusitis. Part II. Surgical technique. Otolaryngol Head Neck Surg. 1985;94:143-7.

Lund VJ, Kennedy DW. Quantification for staging sinusitis. Ann Otol Rhinol Laryngol. 1995;104(10):17-21.

Benninger MS, Ferguson B, Hadley J. Adult chronic rhinosinusitis: definitions, diagnosis, epidemiology, and pathophysiology. Otolaryngol Head Neck Surg. 2003;129:1-32.

Ragab A, Clement P, Vincken W. Objective assessment of lower airway involvement in chronic rhinosinusitis. Am J Rhinol. 2004;18:16-21.

Abdalla S, Alreefy H, Hopkins C. Prevalence of sinonasal outcome test (SNOT-22) symptoms in patients undergoing surgery for chronic rhinosinusitis in the England and Wales National prospective audit. Clin Otolaryngol. 2012;37(4):276-82.

Sing I, Shrestha A, Gautam D. Chronic rhinosinusitis and nasal polyposis in Nepal. Clin Rhinol. 2010;3(2):87-91.

Yousef M, Awad OGAN, Taha M. Pulmonary function of patients with chronic rhinosinusitis and the impact of endoscopic sinus surgery. OTO Open. 2017;1(4):1-31

Wang PC, Chu CC, Liang SC, Tai CJ. Outcome predictors for endoscopic sinus surgery. Otolaryngol Head Neck Surg. 2002;126:154-9.

Bhattacharyya N, Fried MP. The accuracy of computed tomography in the diagnosis of chronic rhinosinusitis. Laryngoscope. 2003;113:125-9

Kariya S, Okano M, Higaki T. Chronic rhinosinusitis patients have decreased lung function. Int Forum Allerg Rhinol. 2014;44:828-33.

Tanaka S, Hirota T, Kamijo A. Lung functions of Japanese patients with chronic rhinosinusitis who underwent endoscopic sinus surgery. Allergol Int. 2014;63:27-35.

Nakamura H, Kawasaki M, Higuchi Y, Takahashi S. Effects of sinus surgery on asthma in aspirin triad patients. Acta Otolaryngol. 1999;119(5):592-8.

Togias A. Mechanisms of nose-lung interaction. Allergy. 1999;57:94-105.

Maniscalco M, Sofia M, Pelaia G. Nitric oxide in upper airways inflammatory diseases. Inflamm Res. 2007;56:58-69.

Shturman-Ellstein R, Zeballos R, Buckley JM, Souhrada JF. The beneficial effect of nasal breathing on exercise induced bronchoconstriction. Am Rev Respir Dis. 1978;118:65-73.

Rix I, Ha¢ªkansson K, Larsen CG, Frend M, von Buchwald C. Management of chronic rhinosinusitis with nasal polyps and coexisting asthma: a systematic review. Am J Rhinol Allerg. 2015;29:193-201.

Jung T, Juhn S, Hwang D, Stewart R. Prostaglandins, leukotrienes, and other arachidonic acid metabolites in nasal polyps and nasal mucosa. Laryngoscope. 1987;97:184-9.

Wood R, Eggleston P. The effect of intranasal steroids on nasal and pulmonary responses to cat exposure. Am J Respir Crit Care Med. 1995;151:315-20

Downloads

Published

2020-07-22

Issue

Section

Original Research Articles