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Ryu, Kwon, Koh, Lee, Cho, and Kim: Changes in Clinical Characteristics of the Patients Who Received Endoscopic Sinus Surgery according to 10 Year Temporal Difference: A Retrospective Observational Study
Original Article

J Rhinol 2016;23(2):81-84.

Published online: 10 January 2016

DOI: https://doi.org/10.18787/jr.2016.23.2.81

Changes in Clinical Characteristics of the Patients Who Received Endoscopic Sinus Surgery according to 10 Year Temporal Difference: A Retrospective Observational Study

In Yong Ryu, MD, Chul Kwon, MD, Tae Kyung Koh, MD, Kun Hee Lee, MD, Joong Saeng Cho, MD, Sung Wan Kim, MD

Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Korea

교신저자：김성완, 02447 서울 동대문구 경희대로 23 경희대학교 의과대학 이비인후과학교실 Tel: +82-2-958-8474, Fax: +82-2-958-8470, E-mail: drkimsw@hanmail.net

Received 17 March 2016       Revised 18 May 2016       Accepted 22 June 2016

Copyright © 2016 Journal of Rhinology

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) was introduced to Korea in the 1980s and has since developed rapidly. There have been many changes in ESS over this period. Thus, in this paper, we explore trends in the clinical characteristics of ESS.

Subjects and Method

We retrospectively reviewed patients who underwent the ESS at 000 Hospital performed by a single surgeon at a 10-year interval. By comparing 106 patients who underwent ESS in 2003 and 108 patients who underwent ESS in 2013, we investigated changes in ESS in terms of the target group of surgical indications, CT scores, range of operation and complications.

Results

With regard to surgical indications, the proportion of patients who underwent surgery due to nasal polyps in 2013 (32.4%) was lower than in 2003 (59.4%), while the proportion of patients undergoing fungal sinusitis surgery in 2013 (13.9%) was higher than in 2003 (0.0%). In terms of preoperative CT evaluation, Lund-Mackay scores for the maxillary sinus, ethmoid sinus, and ostiomeatal unit were lower in 2013 than in 2003. The proportion of ESS performed only in the maxillary sinus in 2013 (20.0%) was higher than in 2003 (10.0%).

Conclusion

According to this study, the range and extent of sinusitis was favorable in 2013 compared to in 2003. The group of patients requiring treatment for only maxillary sinus disease accounted for a larger proportion of patients in 2013 than in 2003.

Keywords: Endoscopic sinus surgery, Change, Fungal, Polyp, Indication.

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Fig. 1.
Lund-Mackay scoring system of endoscopic sinus surgery in 2013 and in 2003. Ms: Maxillary sinus, Ant-Es: Anterior Ethmoid sinus, Post-Es: Posterior Ethmoid sinus, Ss: Sphenoid sinus, Fs: Frontal sinus, OMU: Ostiomeatal Unit. *: ＜0.05.
jr-23-81f1.tif
Table 1.
Demographics of endoscopic sinus surgery in 2013 and in 2003
  2003 2013 p-value
Number of patients 106 108 –
M: F 62: 44 53: 55 0.119
Mean age 46.2±17.2 44.8±19.0 0.745
  (29.0–63.4) (25.8–63.8)  
Table 2.
Indications of endoscopic sinus surgery in 2013 and in 2003
Indications 2003 (%) 2013 (%) p-value
Nasal polyposis 59.4* 32.4 ＜0.001
Refractory to medical treatment 17.0 18.5 0.721
Fungal sinusitis – 13.9* ＜0.001
Sinus mucocele 06.5 12.0 0.108
POCC among sinus mucocle 04.7 7.4 0.391
Antrochoanal polyp 02.8 6.5 0.195
Recurrent sinusitis 07.5 3.7 0.247
Tumor 00.9 3.7 0.175
Foreign body removal – 0.9 0.316
CSF leakage – 0.9 0.316
Orbital decompression – – –

* ＜0.05. POCC: post-operative cheek cyst, CRS: chronic rhinosinusitis, CSF: cerebrospinal fluid

Table 3.
Range of endoscopic sinus surgery in 2013 and in 2003
Paranasal sinuses 2003 (%) 2013 (%) p-value
Ms+ Es+ Fs 50.0%* 24.6% ＜0.001
Ms+ Es 32.5%* 23.1% 0.169
Ms only 10.0%* 20.0%* 0.037
Ms+ Es+ Ss – 04.6% 0.060
Ms+ Es+ Fs+ Ss 05.0%* 03.1% 0.471
Ss – 01.5% 0.155
Ms+ Ss – 01.5% 0.155
Es+ Fs – 01.5% 0.155

* : ＜0.05. Ms: Maxillary sinu, Es: Ethmoid sinus, Fs: Frontal sinus, Ss: Sphenoid sinus

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