Artikel
Treatment of the chronic rhinosinusitis with nasal polyposis
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Veröffentlicht: | 17. April 2009 |
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Gliederung
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Introduction: Chronic Rhinosinusitis with Nasal Polyps (CRS with NP)is estimated to affevt approximately 5–6% of the population. The managment of CRS with NP is undoubdetly a controversial subject. The aim of the present study is to compare the improvement of Symptoms assiciated to CRS with NP 1) After Functional Endoscopic sinus surgery (FESS) and 2) After topical nasal steroid therapy 3 months before and after FESS.
Materials and Methods: 147 patients with clinically diagnosed CRS with NP participated in this investigation. In all patients FESS (Polypectomy, uncinectomy, partial antero-interior middle turbinectomy, Antrostomy and complete ethmoidectomy) was performed under control wirh a 0, 30 and 70 grad endoscopes.
Symptoms were recorded on Visual analogs scals before and after three months later the day of surgery (77 patients) and after topical Fluticasone propionate nasal spray (FPNS) therapy (FPNS 200 mg. twice daily) for at least 3 months before and after FESS (70 patients).
Results: Nasal obstruction was major complaint at entry in the study. Following local steroid course the obstruction score improved significantly. Post-operative normalisation of nasal function was obtinaid in 64% of first group patients and of 72% of second group. Following surgery and local steorid therapy nasal symptoms (nasal obstruction, anosmia or hyposmia, anterior and/or posterior rhinorrhea, sneezing and itching and facial pain) were improved more significantly in second group patients, than first group (p'Y 0,05).
Conclusion: These data showed that functional Endoscopic sinus surgery is effective for patients with CRS with NP.
FESS is more effective when the patients receive local steroid therapy, FPNS 200 mg. twice daily, three months before and after surgery.