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Evaluation of a new and simple classification for endoscopic sinus surgery
Kengo Kanai1, Mitsuhiro Okano1, Takenori Haruna1
1From the Department of Otolaryngology-Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Allergy & Rhinology (Providence, R.I.)
|October 27, 2017
Summary
A new endoscopic sinus surgery (ESS) classification helps predict surgical burden. This system effectively correlates with operative time, bleeding, and patient outcomes in chronic rhinosinusitis and sinus cyst cases.
Area of Science:
- Otolaryngology
- Surgical Classification Systems
- Rhinology
Background:
- A 2013 classification for endoscopic sinus surgery (ESS) was proposed by the Japanese Rhinologic Society.
- This classification categorizes ESS into five types based on surgical extent: Type I (ostiomeatal complex), Type II (single sinus), Type III (polysinusal), Type IV (pansinus), and Type V (extended).
Purpose of the Study:
- To evaluate the clinical relevance of the Japanese ESS classification.
- To assess the classification's utility in managing chronic rhinosinusitis (CRS) and paranasal sinus cysts.
Main Methods:
- A retrospective study involving 122 patients (195 sinuses) who underwent ESS.
- Analysis of the relationship between ESS classification types and clinical parameters: operation time, bleeding, postoperative olfaction, CT scores, and nasal airway resistance.
Main Results:
- 195 ESS procedures were classified: Type I (3), Type II (17), Type III (91), Type IV (82), Type V (2).
- Significant associations were found between ESS types and disease phenotypes: Type II (sinus cyst), Type III (CRS without polyps), Type IV (CRS with polyps).
- ESS classification positively correlated with operation time and bleeding; olfaction, CT score, and nasal airway resistance improved post-surgery, with similar improvements for Type III and IV.
Conclusions:
- The proposed ESS classification system is clinically relevant.
- This simple classification effectively reflects the perioperative burden associated with ESS for various sinonasal conditions.
