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Related Experiment Videos

Immunotherapy in patients undergoing functional endoscopic sinus surgery

G J Nishioka1, P R Cook, W E Davis

  • 1Department of Surgery, University of Missouri-Columbia 65212.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|April 1, 1994
PubMed
Summary

Immunotherapy does not statistically impact outcomes after functional endoscopic sinus surgery for chronic sinusitis. However, allergic patients receiving immunotherapy show improved results compared to those not receiving it.

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Area of Science:

  • Otolaryngology
  • Allergy Immunology

Background:

  • Chronic sinusitis is a prevalent condition often managed with functional endoscopic sinus surgery (FESS).
  • Allergic rhinitis frequently coexists with chronic sinusitis, potentially influencing surgical outcomes.
  • The role of immunotherapy in managing allergic chronic sinusitis remains an area of investigation.

Purpose of the Study:

  • To evaluate the impact of immunotherapy on surgical outcomes in patients with chronic sinusitis, specifically focusing on allergic individuals.
  • To compare outcomes between allergic and nonallergic patients undergoing FESS.
  • To assess the effect of immunotherapy timing (pre- or post-operative) on middle meatotomy patency, synechiae formation, and recurrent polyp development.

Main Methods:

  • A retrospective analysis of 283 consecutive patients with chronic sinusitis who underwent FESS.

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  • Patients were categorized into allergic (n=72) and nonallergic (n=211) groups.
  • Data on middle meatotomy patency, synechiae formation, and recurrent polyps were collected and analyzed in relation to immunotherapy use in allergic patients.

    • Main Results:

    • Immunotherapy did not significantly alter middle meatotomy patency, synechiae formation, or polyp recurrence rates post-FESS.
    • Allergic patients undergoing immunotherapy demonstrated better outcomes for all three parameters compared to allergic patients not receiving immunotherapy.
    • Allergic patients on immunotherapy performed similarly to nonallergic patients, except for a higher recurrence of polyps in the allergic group.
    • Preoperative polyp prevalence was similar between groups, but recurrence was higher in allergic patients.
    • Approximately 40% of allergic patients discontinued preoperative immunotherapy post-surgery due to symptom resolution.

    Conclusions:

    • Immunotherapy does not provide a statistically significant benefit for middle meatotomy patency, synechiae formation, or polyp recurrence after FESS.
    • Despite lack of statistical significance, immunotherapy appears beneficial for allergic chronic sinusitis patients undergoing FESS.
    • Allergic patients may experience symptom resolution post-surgery, leading to discontinuation of immunotherapy.