Cem SAKA, Gökhan KURAN, Erkan VURALKAN, Ayhan GÖKLER, İstemihan AKIN

Nazal polipoziste endoskopik sinüs cerrahisinin etkinliği

Amaç: Nazal polipozisli hastalarda uygulanan fonksiyonel endoskopik sinüs cerrahisinin etkinliği ve sonuçları değerlendirildi.Hastalar ve Yöntemler: Çalışmada nazal polipozisli 407 hasta değerlendirildi. Bu hastaların 102’sinde %25 astım, 25’inde %6.1 astım ve aspirin hipersensitivitesi, 142’sinde %34.8 anatomik varyasyon saptandı. Cerrahi tedavide Messerklinger ve Wigand teknikleri uygulandı. Fonksiyonel endoskopik sinüs cerrahisi tekniği iki taraflı uygulandı. Hastalar ameliyat öncesinde ve ameliyattan altı ay sonra endoskopik nazal muayene ve paranazal sinüs bilgisayarlı tomografisi Lund-Mackay skoru ile değerlendirildi. Ameliyat sonrasında nazal yıkama ve topikal steroid tedavisi uygulandı.Bulgular: Ameliyat öncesinde ortalama 17.0±4.3 olan bilgisayarlı tomografi puanı ameliyat sonrasında 8.5±4.7’ye geriledi. Bir hastada majör komplikasyon gelişti. Nazal mukozada yapışıklık en sık görülen komplikasyon %5.4 idi. Nazal polipozis 78 hastada %19.1 nüks etti. Nüks görülen hastaların 57’si yeniden ameliyat edildi.Sonuç: Çalışmamız, fonksiyonel endoskopik sinüs cerrahisinin ve sonrasında kortikosteroid uygulamasının nazal polipozis tedavisinde etkili olduğunu göstermektedir

Anahtar Kelimeler:

Endoskopi/yöntem, nazal polip/patoloji/cerrahi, paranazal sinüsler/cerrahi, steroid/terapötik kullanım

The effectiveness of endoscopic sinus surgery in nasal polyposis

Objectives: We evaluated the effectiveness and outcomes of functional endoscopic sinus surgery in the treatment of nasal polyposis. Patients and Methods: The study included 407 patients 262 males, 145 females; mean age 42±12 years; range 20 to 76 years with nasal polyposis. Of these, 102 patients 25% had asthma, 25 patients 6.1% had asthma and aspirin sensitivity, and 142 patients 34.8% had anatomic variations. The patients were operated on using the Messerklinger and Wigand techniques. Functional endoscopic sinus surgery was performed bilaterally. Evaluations were made preoperatively and at six months by endoscopic examination and paranasal sinus computed tomography LundMackay score . Postoperatively, the patients were treated with nasal irrigation and topical steroid spray. Results: Following surgery, the mean computed tomography score decreased from preoperative 17.0±4.3 to 8.5±4.7. Major complication occurred in one patient. Nasal mucosal adhesion was the most frequent minor complication 5.4% . Nasal polyposis recurred in 78 patients 19.1% , of whom 57 patients underwent revision surgery. Conclusion: Our data show that functional endoscopic sinus surgery combined with corticosteroid administration is effective in the treatment of nasal polyposis.

Keywords:

Endoscopy/methods, nasal polyps/pathology/ surgery, paranasal sinuses/surgery, steroids/therapeutic use,

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