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80th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

20.05. - 24.05.2009, Rostock

Medical versus surgical treatment of chronic rhinosinusitis without nasal polyposis – preliminary results

Meeting Abstract

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  • corresponding author Theodoros Skevas - Universitäts-HNO-Klinik Heidelberg, Heidelberg, Germany
  • Peter Karl Plinkert - Universitäts-HNO-Klinik Heidelberg, Heidelberg, Germany
  • Ingo Baumann - Universitäts-HNO-Klinik Heidelberg, Heidelberg, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 80th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Rostock, 20.-24.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. Doc09hno092

DOI: 10.3205/09hno092, URN: urn:nbn:de:0183-09hno0923

Published: July 22, 2009

© 2009 Skevas et al.
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Outline

Text

Background: Thus far it is unclear to what extent patients with chronic rhinosinusitis without nasal polyposis (CRSwoNP) benefit from medical treatment and to what extent, if at all, the endonasal sinus surgery (ESS) can be averted.

Material und methods: A randomised, open, monocentric, prospective study in parallel design was conducted. Enclosed were adult patients with a CRSwoNP without prior ESS. Patients of the medical, as well as of the surgical treatment limb received a clindamycin-therapy for 10 days, a systemic corticoid-therapy for 3 weeks and a topical corticoid-therapy for 12 weeks. In the surgical treatment limb the ESS was performed before beginning drug administration. The examinations were conducted preoperative as well as 3 and 12 months after beginning therapy. In all of the three follow-up visits, beside the clinical examination, a rhinomanometric test, a saccharine-test and quality of life measurements with the SF-36 and the Sino-Nasal Outcome Test 20 German Adapted Version (SNOT-20 GAV) were conducted.

Results: At present, results are available for 45 patients, therefrom 24 in the surgical and 21 in the medical limb, for a follow up period of three months.

The saccharine clearance time, as well as the rhinomanometric values before decongestion did not alter in either treatment limb. The rhinomanometric values after decongestion showed a statistic significant improvement on the operated patients. The quality of life measurements showed a significant improvement, whereas the degree of improvement in the surgically treated patients was clearly greater.

Synopsis: Both treatment modalities led to an improvement of the health related quality of life, whereas the surgically treated patients gained a stronger benefit after three months. The long-term results of this study have to be awaited.