Practice Patterns in Endoscopic Sinus Surgery: Survey of the Korean Rhinologic Society

Yong Jung Gi; Hun-Jong Dhong; Yong-Jin Park

doi:10.18787/jr.2015.22.2.82

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Gi, Dhong, and Park: Practice Patterns in Endoscopic Sinus Surgery: Survey of the Korean Rhinologic Society

Original Article

J Rhinol 2015;22(2):82-88.

Published online: 10 January 2015

DOI: https://doi.org/10.18787/jr.2015.22.2.82

Practice Patterns in Endoscopic Sinus Surgery: Survey of the Korean Rhinologic Society

Yong Jung Gi, MD, PhD¹, Hun-Jong Dhong, MD, PhD², Yong-Jin Park, MD, PhD^3,

¹ Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon;

² Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Seoul Hospital, Sungkyunkwan University School of Medicine, Seoul;

³ Department of Otorhinolaryngology-Head and Neck Surgery, St. Vincent's Hospital, The Catholic University of Korea, College of Medicine, Seoul, Korea

교신저자：박용진, 16247 경기도 수원시 팔달구 중부대로 93 가톨릭대학교 의과대학 성빈센트병원 이비인후과학교실 Tel: +82-31-249-8209, Fax: +82-31-257-3752, E-mail: yp@catholic.ac.kr

Received 8 June 2015 Revised 24 June 2015 Accepted 12 August 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background and Objectives

Endoscopic sinus surgery (ESS) has become the standard treatment modality in chronic rhinosinusitis. However there is no uniform treatment protocol regarding preoperative, intraoperative, and postoperative care. The objectives of this study are to identify and report the practice patterns of ESS in South Korea.

Materials and Method

A series of eight surveys were sent to the board members of the Korean Rhinologic Society via e-mail between August 2013 and September 2014. Responses to questions regarding detailed practice patterns were recorded anonymously.

Results

The average number of replies to each survey was 41.5. Routine antibiotics were prescribed just before computed tomography by 46.9% of the respondents, and the mean duration of antibiotics treatment was 1.90 weeks. A routine preoperative olfactory test was conducted by 64.3% of respondents, and allergy tests were conducted by 82.2%. General anesthesia was pre-ferred by 76.8%, and the mean hospitalization period was 3.12 days. The mean rotation speed used for a microdebrider was 3,054 rpm, and 3,000 rpm was selected by 51.6% of the respondents. In addition, 74.2% of respondents reported that they operate the foot switch themselves. Finally, an absorbable pack was preferred after ESS.

Conclusion

The current study was the first nationwide survey on practice patterns in endoscopic sinus surgery in Korea, and the data reflects the opinions of expert sinus surgeons.

Keywords: Sinusitis, Paranasal sinuses, Preoperative care, Intraoperative, Postoperative, Endoscopic sinus surgery.

References

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Fig. 1.

A: Duration of antibiotics treatment before preoperative computed tomography (CT). B: CT scan time before endoscopic sinus surgery. Horizontal bar indicates median value and vertical bar indicates interquartile range.

Fig. 2.

The difference in duration of hospital stay between training (referral) hospital and private hospital when doing bilateral endoscopic sinus surgery involving whole sinuses. There was a significant difference between two groups (p＜0.001, Mann-Whitney U test). Horizontal bar indicates median value and vertical bar indicates interquartile range. H: Hospital.

Fig. 3.

The distribution of first outpatient visit day after endoscopic sinus surgery. Horizontal bar indicates median value and vertical bar indicates interquartile range. Postop OPD visit: post-op-erative first outpatient department visit.

Fig. 4.

The distribution of rotation speed when microdebrider is used as oscillation mode in endoscopic sinus surgery. Horizontal bar indicates median value and vertical bar indicates interquartile range.

Fig. 5.

The difference of packing removal time between Nasopore and Merocel after endoscopic sinus surgery. There was a significant difference between two groups (p＜0.001, Mann-Whit-ney U test). Horizontal bar indicates median value and vertical bar indicates interquartile range.

Fig. 6.

The difference in time when patient starts sinus irrigation after removal of nasal packing between non-absorbable and absorbable packing material. Statistical analysis was not carried out because the meaning of “ removal” is different in non-absorbable and absorbable material.

Fig. 7.

A: Sinus irrigation frequency after endoscopic sinus surgery. B: The amount of solution which was used during sinus irrigation each time. Horizontal bar indicates median value and vertical bar indicates interquartile range.

Table 1.

Subjects of “consensus paper on endoscopic sinus surgery”

No	Time	No. of respondents	Subject
1	Aug. 2013	50	Packing material
2	Sep. 2013	39	Packing material (time of removal)
3	Nov. 2013	37	Sinus irrigation (when the patient start irrigation?)
4	Jan. 2014	40	Sinus irrigation (additive chemical)
5	Mar. 2014	31	Microdebrider
6	May. 2014	32	Preoperative CT scan
7	Aug. 2014	56	Preoperative test (allergy and olfaction)
8	Sep. 2014	56	Hospital stay and anesthesia

No: Number

Table 2.

Difference in surgical practice pattern

	Bilateral surgery; at the same time	Unilateral surgery; sequential procedure
Training (referral) hospital	44	1	45
Private clinic	2	9	11
	46	10

Table 3.

Packing materials in endoscopic sinus surgery

Material	Practice experience (year)
Material	–5	–10	–15	–20	–25	26-
Nasopore	8	15	9	1	5	1	39
Merocel	5	13	8	2	5	4	37
Gauze	2	2	4	1	1	1	11
Cutanplast	1	4	1	0	1	0	7
Surgicel	0	1	1	0	0	0	2
Stammberger gel	0	2	0	0	0	0	2
Gelfoam	0	0	1	0	0	0	1
No packing	0	1	0	0	0	0	1
	16	38	24	4	12	6	100 (%)

All respondents were requested to select two packing materials. In case that only one material was selected, double weight was put to the answer

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