engleski

Endosinusal treatment of chronic maxillary sinusitis

Chronic rhinosinusitis (CRS) is one of the most common chronic disorders with significant impact on health-related quality of life (HRQL). The maxillary antrostomy through the inferior meatus is a minor but common otolaryngological procedure, usually followed by the irrigation and topical aplication of the drug into the maxillary sinus. The aim of the study was to evaluate inflammatory response by celular marker level (ECP, MPO and tryptase) in sinus lavage and by histopathologic parameters of the sinus mucosa, and to evaluate subjective outcomes in patients with chronic rhinosinusitis after endosinusal steroid/ antibiotic treatment. 30 patients with symptoms of CRS were recruited for the study. Inclusion criteria were sinusitis symptoms lasting more than three months and mucosal thickening of the maxillary sinuse mucosa more than 6 mm. During the study, patients were treated with 2 mg Dexamethasone and 40 mg Gentamycine per maxillary sinus/day, applied through a polyethylene anstrostomy tube inserted by antral sinusoscopy through inferior meatus in local anaesthesia. Patients rated CRS disease-specific symptoms and completed a self-administered questionnaire concerning sinusitis symptoms, before intervention and at one month follow-up. Outcome was assessed in each patient by a questionnaire in which the patient rated different symptoms 0 - 3 for intensity and frequency of each symptom. Sinusitis symptoms scores are presented as the mean value of 10 symptoms scores. Significant improvement was noted for overall sinusitis symptoms score (p<0.01) and for obstruction, postnasal drip, headache, sneezing and cough (p< 0.05) in the study group as a whole. There is positive correlation (p< 0.05) of celular marker concentration in sinus lavage for ECP, MPO and tryptase. There is no statisticaly significant change in sinus lavage concentration of these celular markers at the inclusion and after the endosinusal treatment. Though there is no statisticaly significant change in concentration level of ECP, MPO and tryptase in sinus lavage at inclusion and after the endosinusal treatment, endosinusal steroid/antibiotic treatment in patients with CRS was proven effective in reducing subjective sinusitis symptom

chronic rhinosinusitis; endosinusal treatment; subjective outcomes

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