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4 results

  • Frontal sinus stenting in endoscopic sinus surgery: the 10-year Oxford experience

  • F Bandino, AL Pendolino, J Bates, A Qureishi, P Martinez-Devesa
  • Journal:
    The Journal of Laryngology & Otology / Volume 138 / Issue 1 / January 2024
    Published online by Cambridge University Press:
    05 April 2023, pp. 60-66
    Print publication:
    January 2024
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  • Background

    Frontal sinus stents have been introduced to reduce frontal sinus re-stenosis after surgery and to improve outcomes.

    Method

    This study was a retrospective analysis of 19 patients who had endoscopic sinus surgery with approach to the frontal sinus and insertion of a soft sinus stent.

    Results

    The frontal recess was patent in 78.9 per cent and stenosed in 21.1 per cent of patients; no completely closed recesses were observed. Mean follow up was 20.7 months, and time period of stenting was 9.8 months on average; complications were observed in 47.4 per cent of the patients, with post-operative sinonasal infection being the most common.

    Conclusion

    In the authors’ experience, indications for frontal sinus stenting include recalcitrant chronic rhinosinusitis after multiple functional endoscopic sinus surgeries (especially in chronic rhinosinusitis with nasal polyps), patients with history of important craniofacial surgery or trauma, and recurrent mucoceles. The stent was overall well tolerated as only minor complications were observed. Close clinical follow up is mandatory.

  • Negative predictive value of normal nasal endoscopy for sinus disease as a cause of isolated facial pain

  • D A Kieff, N Y BuSaba
  • Journal:
    The Journal of Laryngology & Otology / Volume 125 / Issue 10 / October 2011
    Published online by Cambridge University Press:
    27 July 2011, pp. 1038-1041
    Print publication:
    October 2011
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  • Objective:

    To determine the negative predictive value of normal nasal endoscopy in assessing paranasal sinus disease as the cause of isolated facial pain in the sinus regions.

    Subjects and methods:

    The study group comprised 42 consecutive adult patients presenting with the isolated symptom of facial pain, and a negative nasal endoscopy. Patients underwent sinus computed tomography to determine whether radiographic findings indicated a sinugenic aetiology.

    Results:

    Patients comprised 27 women and 15 men, with a median age of 38 years. Twenty patients had unilateral pain, 33 per cent had sinus radiographic findings that might explain their facial pain, and 10 per cent had imaging demonstrating mucosal disease in one or more sinuses correlating with the location of the facial pain. Thirty-one per cent had anatomical radiographic findings that could potentially obstruct the osteomeatal unit.

    Conclusion:

    Normal nasal endoscopy had a negative predictive value of 67 per cent in excluding a sinugenic cause of isolated facial pain, if radiographically determined anatomical factors and mucosal disease were both included as positive findings; this rose to more than 90 per cent if only those patients with mucosal sinus disease were considered as true positive patients.

  • Adenoids: comparison of radiological assessment methods with clinical and endoscopic findings

  • P. J. Wormald, C. A. J. Prescott
  • Journal:
    The Journal of Laryngology & Otology / Volume 106 / Issue 4 / April 1992
    Published online by Cambridge University Press:
    29 June 2007, pp. 342-344
    Print publication:
    April 1992
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  • Methods of evaluating adenoidal size pre-operatively are controversial. Symptoms and clinical evaluation have been both advocated and condemned. Depending on the methodology, measurement of the radiological adenoidal shadow has been difficult to correlate with the clinical patency of the nasopharyngeal airway and to the actual size of the removed adenoid.

    Four different methods were used to measure the adenoidal size on 74 radiographs. The methods were evaluated against the degree to which the adenoids obstructed the nasopharynx on flexible endoscopy of the postnasal space. Obstructive symptomatology was also evaluated against the degree of obstruction.

    The radiological method that best correlated to the endoscopic findings was that of Cohen and Konak (1985). However, obstructive symptomatology had the overall highest correlation to endoscopic findings.