Abstract:
Objective To observe the efficacy of modified endoscopic sinus surgery (ESS) in treatment of chronic rhinosinusitis with nasal polyps (CRSwNP) complicated by allergic rhinitis (AR).
Methods Forty patients with CRSwNP and perennial AR who were scheduled for ESS were divided into study group and control group, with 20 cases in each group. The control group was treated with conventional ESS, while the study group underwent resection of a large part of the middle turbinate on the basis of ESS to enhance middle meatal drainage. The postoperative mucosal outcomes, complications, as well as the Visual Analog Scale (VAS), sino-nasal outcome test-20 (SNOT-20), and nasal endoscopic Lund-Kennedy scores before surgery, at 3 months after surgery, and at 1 year after surgery were compared between the two groups.
Results In the control group, there were 3 cases of local adhesion between the displaced middle turbinate and the lateral nasal wall at 3 months after surgery, and 10 cases of middle turbinate edema at 1 year after surgery, including 4 cases with local polypoid changes in the middle turbinate and polypoid hyperplasia in the ethmoid sinus and frontal recess regions. No complications were observed in the study group, and the epithelialization of the surgical area was good. Moreover, the nasal congestion score, olfactory score, and Lund-Kennedy score at 1 year after surgery in the study group were lower than those in the control group, with statistically significant differences (P < 0.05).
Conclusion Modified ESS can significantly improve nasal congestion and olfactory symptoms in patients with CRSwNP complicated by perennial AR and effectively enhance their quality of life.