Frontal Sinusitis Management: Intact Ethmoidal Bulla Technique Vs Ethmoidal Bullectomy
Introduction Conventional functional endoscopic sinus surgery (FESS) for frontal sinusitis treatment involves ethmoidal bullectomy, that is associated with damage to the surrounding structures. These complications can be overcome by minimally invasive FESS anterior to the ethmoidal bulla that all...
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| Format: | Article |
| Language: | English |
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The Association of Otolaryngologists of India, West Bengal
2021-09-01
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| Series: | Bengal Journal of Otolaryngology and Head Neck Surgery |
| Subjects: | |
| Online Access: | https://bjohns.in/journal3/index.php/bjohns/article/view/458 |
| _version_ | 1827334263408689152 |
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| author | Harshavardhan N. Reddy Evin Abraham Chandrakiran C Sanjay B Patil |
| author_facet | Harshavardhan N. Reddy Evin Abraham Chandrakiran C Sanjay B Patil |
| author_sort | Harshavardhan N. Reddy |
| collection | DOAJ |
| description | Introduction
Conventional functional endoscopic sinus surgery (FESS) for frontal sinusitis treatment involves ethmoidal bullectomy, that is associated with damage to the surrounding structures. These complications can be overcome by minimally invasive FESS anterior to the ethmoidal bulla that allows ease in locating the sinus ostium, eliminating risk of injury to anterior skull base and nearby structures. This study aims to compare the efficacy of ethmoidal bullectomy versus intact ethmoidal bulla technique as an adjunct to FESS in frontal sinusitis management.
Materials and Methods
Forty patients, clinically and radiologically diagnosed with frontal sinusitis, were randomly divided into 2 groups: Group A (n=20; treated with FESS keeping the ethmoidal bulla intact) and Group B (n=20; treated using FESS with ethmoidal bullectomy). After detailed history and clinico-radiological examinations, diagnostic nasal endoscopy was performed, followed by FESS. Pre- and post-operative endoscopic and clinical assessment was done using Modified Lund-Kennedy Endoscopy (MLKE) Score and Sino-Nasal Outcome Test-22 (SNOT-22) Questionnaire, respectively. Data was analyzed using software R version 3.6.3.
Results
Significant reductions in SNOT-22 (clinical improvement) and MLKE scores (endoscopic improvement) were seen within the groups from baseline to each follow-up visit and between the successive recall visits (p<0.001). The SNOT-22 and MLKE scores were insignificant at any visit between the groups, along with age distribution, gender and intra-operative complications (p>0.05). Complications were seen only in Group B.
Conclusion
Both, ethmoidal bullectomy and intact ethmoidal bulla technique, when used as adjuncts to FESS, showed similar improvements in frontal sinusitis patients. However, bullectomy was associated with greater risk of intra-operative complications. |
| first_indexed | 2024-03-07T17:50:53Z |
| format | Article |
| id | doaj.art-660a5ba638eb419681278901a4f5eb1f |
| institution | Directory Open Access Journal |
| issn | 2395-2407 |
| language | English |
| last_indexed | 2024-03-07T17:50:53Z |
| publishDate | 2021-09-01 |
| publisher | The Association of Otolaryngologists of India, West Bengal |
| record_format | Article |
| series | Bengal Journal of Otolaryngology and Head Neck Surgery |
| spelling | doaj.art-660a5ba638eb419681278901a4f5eb1f2024-03-02T14:04:56ZengThe Association of Otolaryngologists of India, West BengalBengal Journal of Otolaryngology and Head Neck Surgery2395-24072021-09-01292Frontal Sinusitis Management: Intact Ethmoidal Bulla Technique Vs Ethmoidal BullectomyHarshavardhan N. Reddy0Evin Abraham1Chandrakiran C2Sanjay B Patil3M. S. Ramaiah Medical College, M S Ramaiah Nagar, Mathikere, Bengaluru - 560054, Karnataka, IndiaM. S. Ramaiah Medical College, M S Ramaiah Nagar, Mathikere, Bengaluru - 560054, Karnataka, IndiaM. S. Ramaiah Medical College, M S Ramaiah Nagar, Mathikere, Bengaluru - 560054, Karnataka, IndiaM. S. Ramaiah Medical College, M S Ramaiah Nagar, Mathikere, Bengaluru - 560054, Karnataka, IndiaIntroduction Conventional functional endoscopic sinus surgery (FESS) for frontal sinusitis treatment involves ethmoidal bullectomy, that is associated with damage to the surrounding structures. These complications can be overcome by minimally invasive FESS anterior to the ethmoidal bulla that allows ease in locating the sinus ostium, eliminating risk of injury to anterior skull base and nearby structures. This study aims to compare the efficacy of ethmoidal bullectomy versus intact ethmoidal bulla technique as an adjunct to FESS in frontal sinusitis management. Materials and Methods Forty patients, clinically and radiologically diagnosed with frontal sinusitis, were randomly divided into 2 groups: Group A (n=20; treated with FESS keeping the ethmoidal bulla intact) and Group B (n=20; treated using FESS with ethmoidal bullectomy). After detailed history and clinico-radiological examinations, diagnostic nasal endoscopy was performed, followed by FESS. Pre- and post-operative endoscopic and clinical assessment was done using Modified Lund-Kennedy Endoscopy (MLKE) Score and Sino-Nasal Outcome Test-22 (SNOT-22) Questionnaire, respectively. Data was analyzed using software R version 3.6.3. Results Significant reductions in SNOT-22 (clinical improvement) and MLKE scores (endoscopic improvement) were seen within the groups from baseline to each follow-up visit and between the successive recall visits (p<0.001). The SNOT-22 and MLKE scores were insignificant at any visit between the groups, along with age distribution, gender and intra-operative complications (p>0.05). Complications were seen only in Group B. Conclusion Both, ethmoidal bullectomy and intact ethmoidal bulla technique, when used as adjuncts to FESS, showed similar improvements in frontal sinusitis patients. However, bullectomy was associated with greater risk of intra-operative complications.https://bjohns.in/journal3/index.php/bjohns/article/view/458Frontal SinusFrontal SinusitisEndoscopySino-Nasal Outcome TestEthmoid Bone |
| spellingShingle | Harshavardhan N. Reddy Evin Abraham Chandrakiran C Sanjay B Patil Frontal Sinusitis Management: Intact Ethmoidal Bulla Technique Vs Ethmoidal Bullectomy Bengal Journal of Otolaryngology and Head Neck Surgery Frontal Sinus Frontal Sinusitis Endoscopy Sino-Nasal Outcome Test Ethmoid Bone |
| title | Frontal Sinusitis Management: Intact Ethmoidal Bulla Technique Vs Ethmoidal Bullectomy |
| title_full | Frontal Sinusitis Management: Intact Ethmoidal Bulla Technique Vs Ethmoidal Bullectomy |
| title_fullStr | Frontal Sinusitis Management: Intact Ethmoidal Bulla Technique Vs Ethmoidal Bullectomy |
| title_full_unstemmed | Frontal Sinusitis Management: Intact Ethmoidal Bulla Technique Vs Ethmoidal Bullectomy |
| title_short | Frontal Sinusitis Management: Intact Ethmoidal Bulla Technique Vs Ethmoidal Bullectomy |
| title_sort | frontal sinusitis management intact ethmoidal bulla technique vs ethmoidal bullectomy |
| topic | Frontal Sinus Frontal Sinusitis Endoscopy Sino-Nasal Outcome Test Ethmoid Bone |
| url | https://bjohns.in/journal3/index.php/bjohns/article/view/458 |
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