Primer endoskopik sinüs cerrahisi sonrası polipozis olmayan kronik rinosinüzitin iyileşmesinde larengofarengeal reflünün etkisi

Amaç: Bu çalışmada endoskopik sinüs cerrahisi ESC geçirmiş hastalarda larengofarengeal reflünün kronik rinosinüzitin KRS iyileşmesi üzerindeki etkisi araştırıldı.Hastalar ve Yöntemler: Polipozis olmayan KRS’li toplam 48 hasta 28 erkek, 20 kadın; ort. yaş 41.6±15.1 yıl; dağılım 18-75 yıl primer ESC geçirmeden önce Reflü Semptom İndeksi RSİ ve Reflü Bulgu Skorları RBS ile gastrik reflü varlığı bakımından değerlendirildi. Reflü Semptom İndeksi >12 ve >7 olan hastalar reflü + , bu ayrımın altında skoru olanlar reflü – grubuna dahil edildi. İyileşme skorları ameliyat öncesi skorlar ve ameliyat sonrası altıncı ay Lund-Mackay Radyoloji Skorları, Lund-Kennedy Endoskopi Skorları LKES ve Sinüzit Semptom Skorları SSS arasındaki farklılık olarak kabul edildi.Bulgular: Reflü + ve reflü – gruplarının iyileşmeleri arasında radyoloji, endoskopi ve semptom skoları açısından anlamlı farklılık yoktu p>0.05 . Ancak ameliyat öncesi ve ameliyat sonrası altıncı ay radyoloji skorları reflü + hastalarda anlamlı olarak daha yüksekti p

Effect of laryngopharyngeal reflux on the improvement of chronic rhinosinusitis without polyposis after primary endoscopic sinus surgery

Objectives: This study aims to investigate the influence of laryngopharyngeal reflux on the improvement of chronic rhinosinusitis CRS in patients who underwent endoscopic sinus surgery ESS . Patients and Methods: A total of 48 patients 28 males, 20 females; mean age 41.6±15.1 years; range 18 to 75 years with CRS without polyposis were assessed for the presence of gastric reflux with Reflux Symptom Index RSI and Reflux Finding Scores RFS before undergoing primary ESS. Patients with a RSI >12 and RFS >7 were included in the reflux + and those with either score under these cutoffs in the reflux – group. Improvement scores were accepted as the difference between preoperative scores and postoperative sixth-month Lund-Mackay Radiology Scores, Lund-Kennedy Endoscopy Scores LKES , and Sinusitis Symptom Scores SSS . Results: There was no significant difference between improvements of the reflux + and reflux – groups in terms of radiology, endoscopy, and symptom scores p>0.05 . However, preoperative and postoperative six-month radiology scores were significantly higher in reflux + patients p

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  • Chambers DW, Davis WE, Cook PR, Nishioka GJ, Rudman DT. Long-term outcome analysis of functional endoscopic sinus surgery: correlation of symptoms with endoscopic examination findings and potential prognostic variables. Laryngoscope 1997;107:504-10.
  • Hanna BC, Wormald PJ. Gastroesophageal reflux and chronic rhinosinusitis. Curr Opin Otolaryngol Head Neck Surg 2012;20:15-8.
  • 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;129:1-32.
  • Belafsky PC, Postma GN, Koufman JA. Validity and reliability of the reflux symptom index (RSI). J Voice 2002;16:274-7.
  • Belafsky PC, Rees CJ. Laryngopharyngeal reflux: the value of otolaryngology examination. Curr Gastroenterol Rep 2008;10:278-82.
  • Lund VJ, Kennedy DW. Staging for rhinosinusitis. Otolaryngol Head Neck Surg 1997;117:35-40.
  • Belafsky PC, Postma GN, Koufman JA. The validity and reliability of the reflux finding score (RFS). Laryngoscope 2001;111:1313-7.
  • Kennedy DW. Functional endoscopic sinus surgery. Technique. Arch Otolaryngol 1985;111:643-9.
  • DelGaudio JM. Direct nasopharyngeal reflux of gastric acid is a contributing factor in refractory chronic rhinosinusitis. Laryngoscope 2005;115:946-57.
  • Dauer E, Thompson D, Zinsmeister AR, Dierkhising R, Harris A, Zais T, et al. Supraesophageal reflux: validation of a symptom questionnaire. Otolaryngol Head Neck Surg 2006;134:73-80.
  • Park KH, Choi SM, Kwon SU, Yoon SW, Kim SU. Diagnosis of laryngopharyngeal reflux among globus patients. Otolaryngol Head Neck Surg 2006;134:81-5.
  • Mesallam TA, Stemple JC, Sobeih TM, Elluru RG. Reflux symptom index versus reflux finding score. Ann Otol Rhinol Laryngol 2007;116:436-40.
  • Contencin P, Narcy P. Nasopharyngeal pH monitoring in infants and children with chronic rhinopharyngitis. Int J Pediatr Otorhinolaryngol 1991;22:249-56.
  • Halstead LA. Role of gastroesophageal reflux in pediatric upper airway disorders. Otolaryngol Head Neck Surg 1999;120:208-14.
  • Phipps CD, Wood WE, Gibson WS, Cochran WJ. Gastroesophageal reflux contributing to chronic sinus disease in children: a prospective analysis. Arch Otolaryngol Head Neck Surg 2000;126:831-6.
  • Ulualp SO, Toohill RJ, Hoffmann R, Shaker R. Possible relationship of gastroesophagopharyngeal acid reflux with pathogenesis of chronic sinusitis. Am J Rhinol 1999;13:197-202.
  • DiBaise JK, Huerter JV, Quigley EM. Sinusitis and gastroesophageal reflux disease. Ann Intern Med 1998;129:1078.
  • Harrell SP, Koopman J, Woosley S, Wo JM. Exclusion of pH artifacts is essential for hypopharyngeal pH monitoring. Laryngoscope 2007;117:470-4.
  • Joniau S, Bradshaw A, Esterman A, Carney AS. Reflux and laryngitis: a systematic review. Otolaryngol Head Neck Surg 2007;136:686-92.
  • DeConde AS, Mace JC, Smith TL. The impact of comorbid gastroesophageal reflux disease on endoscopic sinus surgery quality-of-life outcomes. Int Forum Allergy Rhinol 2014;4:663-9.
  • Bakshi SS. Chronic rhinosinusitis in gastroesophageal reflux disease. Am J Rhinol Allergy 2015;29:225.
  • Lupa M, DelGaudio JM. Evidence-based practice: reflux in sinusitis. Otolaryngol Clin North Am 2012 Oct;45:983-92.
  • Ali Mel-S. Laryngopharyngeal reflux: diagnosis and treatment of a controversial disease. Curr Opin Allergy Clin Immunol 2008;8:28-33.