Metin YILDIRIM, Seyda BELLİ, Cemal ÖZYILMAZ, Özcan OĞURLU

The Effect Of Functional Endoscopic Sinus Surgery On Lung Function In Patients With Chronic Sinusitis And Nasal Polyps Without Asthma

Objectives: The aim of this study was to look into how functional endoscopic sinus surgery (FESS) for CRSwNP without asthma affects lung function. The investigators aimed to determine any correlation between Lund-Kennedy scores, Lund-Mackay scores and pulmonary function. Methods: All participants underwent nasal endoscopic examination and CT scanning paranasally. Lund-Kennedy endoscopy and Lund-Mackay CT scores were calculated and compared with postoperative findings. Statistical analysis was performed to compare preoperative and postoperative spirometry findings to assess efficacy of surgery on pulmonary function. Results: There were no statistically significant differences between the Lund-Mackay scores for primary FESS and revision. Nevertheless, Lund-Kennedy scores did show evidence of greater statistical significance when comparing revision FESS and primary FESS (p=0.04) With respect to both primary and revision FESS patients there was no statistical significance between the preoperative values of FEV1, FEV1/FVC, FVC, and FEF25-75 and the same parameters measured one month postoperatively (p>0.05). Conclusion: Our results reveal that FVC improves following FESS in cases of CRSwNP that are not also asthmatic. No relationship was demonstrable between how severe the disease is and how the lung functions. Further research that looks at FESS in asymptomatic cases of airway obstruction over more prolonged follow-up needs to be undertaken.

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1) Rosenfeld RM, Andes D, Bhattacharyya N, Cheung D, Eisenberg S, Ganiats TG, et al. Clinical practice guideline: adult sinusitis. Otolaryngol Head Neck Surg 2007;137(3 Suppl):S1-31

2) Zhang L, Zhang L, Zhang CH, Fang XB, Huang ZX, Shi QY, et al. The Lung Function Impairment in Non-Atopic Patients With Chronic Rhinosinusitis and Its Correlation Analysis. Clin Exp Otorhinolaryngol. 2016 Dec; 9(4): 339–345

3) Cherry DK, Woodwell DA. National Ambulatory Medical Care Survey: 2000 summary. Adv Data 2002;(328):1-32

4) Anon JB, Jacobs MR, Poole MD, Ambrose PG, Benninger MS, Hadley JA, et al. Antimicrobial treatment guidelines for acute bacterial rhinosinusitis. Otolaryngol Head Neck Surg 2004;130(1 Suppl):1-45

5) Fokkens W, Lund V, Mullol J. EP3OS 2007: European position paper on rhinosinusitis and nasal polyps 2007. A summary for otorhinolaryngologists. Rhinology 2007;45:97–101

6) Mygind N, Lund V. Intranasal corticosteroids for nasal polyposis : biological rationale, efficacy, and safety. Treat Respir Med 2006;5: 93–102

7) de Leng WW, Jansen M, Keller J, de Gijsel M, Milne A, Morsink F et al. Peutz-Jeghers syndrome polyps are polyclonal with expanded progenitor cell compartment. Gut 2007;56:1475–1476

8) Hedman J, Kaprio J, Poussa T, Nieminen MM. Prevalence of asthma, aspirin intolerance, nasal polyposis and chronic obstructive References pulmonary disease in a populationbased study. Int J Epidemiol 1999;28:717–722

9) Johansson L, Akerlund A, Holmberg K, Melen I, Bende M. Prevalence of nasal polyps in adults: the Skovde population-based study. Ann Otol Rhinol Laryngol 2003;112: 625–629

10) Klossek JM, Neukirch F, Pribil C, Jankowski R, Serrano E, Chanal I et al. Prevalence of nasal polyposis in France: a cross-sectional, case-control study. Allergy 2005;60: 233–237

11) Benninger MS, Ferguson BJ, Hadley JA, Hamilos DL, Jacobs M, Kennedy DW et al. Adult chronic rhinosinusitis: definitions, diagnosis, epidemiology, and pathophysiology. Otolaryngol Head Neck Surg 2003; 129(3 Suppl.): S1–S32

12) Uri N, Cohen-Kerem R, Barzilai G, Greenberg E, Doweck I, Weiler-Ravell D. Functional endoscopic sinus surgery in the treatment of massive polyposis in asthmatic patients. J Laryngol Otol 2002;116:185–189

13) Ikeda K, Tanno N, Tamura G, Suzuki H, Oshima T, Shimomura A et al. Endoscopic sinus surgery improves pulmanary function in patients with asthma associated with chronic sinusitis. Ann Otol Rhinol Laryngol 1999 Apr;108(4):355-9

14) Williamson PA, Vaidyanathan S, Clearie K, Barnes M, Lipworth BJ. Airway dysfunction in nasal polyposis: a spectrum of asthmatic disease? Clin Exp Allergy 2011;41(10):1379-85

15) Ciprandi G, Cirillo I, Vizzaccaro A, Monardo M, Tosca MA. Early bronchial airflow impairment in patients with persistent allergic rhinitis and bronchial hyperreactivity. Respir Med 2005;99(12):1606- 12

16) Ehnhage A, Olsson P, Kölbeck KG, Skedinger M, Dahlén B, Alenius M et al. Functional endoscopic sinus surgery improved asthma symptoms as well as PEFR and olfaction in patients with nasal polyposis Allergy 2009; 64: 762–769

17) Holmström M. Clinical performance of fluticasone propionate nasal drops. Allergy 1999;54(Suppl. 53):21–25

18) Stjarne P, Blomgren K, Caye´-Thomasen P, Salo S, Söderström T. The efficacy and safety of once-daily mometasone furoate nasal spray in nasal polyposis: a randomized, double-blind, placebo-controlled study. Acta Otolaryngol 2006;126:606–612

19) Brozek JL, Bousquet J, Baena-Cagnani CE, Bonini S, Canonica GW, Casale TB et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2010 revision. J Allergy Clin Immunol 2010;126:466–76

20) Kariya S, Okano M, Oto T, Higaki T, Makihara S, Haruna T et al. Pulmonary function in patients with chronic rhinosinusitis and allergic rhinitis. J Laryngol Otol 2014;128:255–62

21) Kariya S, Okano M, Higaki T, Noyama Y, Haruna T, Ishihara H et al. Chronic rhinosinusitis patients have decreased lung function. Int Forum Allergy Rhinol 2014;4:828–33

22) Yang MS, Lee HS, Kim MH, Song WJ, Kim TW, Kwon JW et al. Rhinitis patients with sputum eosinophilia show decreased lung function in the absence of airway hyperresponsiveness. Allergy Asthma Immunol Res 2013;5:232–8

23) Tanaka S, Hirota T, Kamijo A, Ishii H, Hatsushika K, Fujieda S et al. Lung Functions of Japanese Patientswith Chronic Rhinosinusitis Who Underwent Endoscopic Sinus Surgery. Allergology International 2014;63:27-35

24) Lee SY, Yoon SH, Song WJ, Lee SH, Kang HR, Kim SS, et al. Influence of chronic sinusitis and nasal polyp on the lower airway of subjects without lower airway diseases. Allergy Asthma Immunol Res 2014;6(4):310-5

25) Bachert C, Vignola AM, Gevaert P, Leynaert B, Van Cauwenberge P, Bousquet J. Allergic rhinitis, rhinosinusitis, and asthma: one airway disease. Immunol Allergy Clin North Am 2004;24(1):19-43

26) Jani AL, Hamilos DL. Current thinking on the relationship between rhinosinusitis and asthma. J Asthma 2005;42(1):1-7

27) Vizzaccaro A, Cirillo I, Pallestrini E, Ciprandi G. Allergic rhinitis frequently impairs bronchial function. Recenti Prog Med 2004;95(5):251-3

28) McCusker CT. Use of mouse models of allergic rhinitis to study the upper and lower airway link. Curr Opin Allergy Clin Immunol 2004;4(1):11-6

29) Ragab SM, Lund VJ, Scadding G. Evaluation of the medical and surgical treatment of chronic rhinosinusitis: a prospective, randomised, controlled trial. Laryngoscope 2004;114: 923–930

30) Vleming M, Middelweerd MJ, de Vries N. Results of endoscopic sinus surgery for nasal polyps . Am J Rhinol 1991;5:173-176

31) Lamblin C, Brichet A, Perez T, Darras J, Tonnel AB, Wallaert B. Long-term Follow-up of Pulmonary Function in Patients with Nasal Polyposis. Am J Respir Crit Care Med 2000;161:406–413