The Role of Functional Endoscopic Sinus Surgery (FESS) in the Management of Chronic Rhinosinusitis
DOI:
https://doi.org/10.12775/QS.2024.24.55363Keywords
chronic rhinosinusitis, CRS, functional endoscopic sinus surgery, FESSAbstract
Chronic rhinosinusitis (CRS) is a persistent inflammatory condition of the nasal and sinus mucosa, affecting over 10% of adults in Europe and the USA. Treatment primarily focuses on symptom management and improving quality of life, with initial approaches including saline irrigations, intranasal corticosteroids, and short-term antibiotics when necessary. When medical therapy fails, Functional Endoscopic Sinus Surgery (FESS) is considered. This minimally invasive procedure has been shown to effectively alleviate symptoms and enhance the quality of life in CRS patients, as demonstrated by various studies.
Aim
This study aims to gather and analyze the current knowledge on chronic rhinosinusitis (CRS), with a specific focus on the surgical treatment known as Functional Endoscopic Sinus Surgery (FESS) and its effectiveness in improving patient outcomes. By reviewing existing literature and clinical studies, this article seeks to provide a comprehensive overview of how FESS impacts the quality of life in CRS patients, the factors influencing its success, and the associated risks and complications.
Methods
The study contains data available in freely accessible databases like PubMed, the National Library of Medicine and Google Scholar. The databases were searched using the keywords such as chronic rhinosinusitis, CRS, functional endoscopic sinus surgery, FESS.
References
Benninger, M. S., Ferguson, B. J., Hadley, J. A., Hamilos, D. L., Jacobs, M., Kennedy, D. W., Lanza, D. C., Marple, B. F., Osguthorpe, J. D., Stankiewicz, J. A., Anon, J., Denneny, J., Emanuel, I., & Levine, H. (2003). Adult chronic rhinosinusitis: definitions, diagnosis, epidemiology, and pathophysiology. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 129(3 Suppl), S1–S32. https://doi.org/10.1016/s0194-5998(03)01397-4
Bachert, C., Marple, B., Schlosser, R.J. et al. Adult chronic rhinosinusitis. Nat Rev Dis Primers 6, 86 (2020) https://doi.org/10.1038/s41572-020-00218-1
Mustafa, Murtaza & Patawari, P. & Hanif, Muhammad & Shimmi, Sadia & Hussain, Ss & Sien, Mm. (2015). Acute and Chronic Rhinosinusitis, Pathophysiology and Treatment. International Journal of Pharmaceutical Science Invention. 4. 30-36.
Jackson, L. L., & Kountakis, S. E. (2005). Classification and Management of Rhinosinusitis and Its Complications. Otolaryngologic Clinics of North America, 38(6), 1143–1153. doi:10.1016/j.otc.2005.07.001
Rosenfeld, R. M., Piccirillo, J. F., Chandrasekhar, S. S., Brook, I., Kumar, K. A., Kramper, M., Orlandi, R. R., Palmer, J. N., Patel, Z. M., Peters, A., Walsh, S. A., & Corrigan, M. D. (2015). Clinical practice guideline (update): Adult Sinusitis Executive Summary. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 152(4), 598–609. https://doi.org/10.1177/0194599815574247
Sedaghat A. R. (2017). Chronic Rhinosinusitis. American family physician, 96(8), 500–506.
Gregurić, T., Prokopakis, E., Vlastos, I., Doulaptsi, M., Cingi, C., Košec, A., Zadravec, D., & Kalogjera, L. (2021). Imaging in chronic rhinosinusitis: A systematic review of MRI and CT diagnostic accuracy and reliability in severity staging. Journal of neuroradiology = Journal de neuroradiologie, 48(4), 277–281. https://doi.org/10.1016/j.neurad.2021.01.010
Pynnonen, M. A., Mukerji, S. S., Kim, H. M., Adams, M. E., & Terrell, J. E. (2007). Nasal saline for chronic sinonasal symptoms: a randomized controlled trial. Archives of otolaryngology--head & neck surgery, 133(11), 1115–1120. https://doi.org/10.1001/archotol.133.11.1115
Fokkens, W. J., Lund, V. J., Mullol, J., Bachert, C., Alobid, I., Baroody, F., Cohen, N., Cervin, A., Douglas, R., Gevaert, P., Georgalas, C., Goossens, H., Harvey, R., Hellings, P., Hopkins, C., Jones, N., Joos, G., Kalogjera, L., Kern, B., Kowalski, M., … Wormald, P. J. (2012). EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists. Rhinology, 50(1), 1–12. https://doi.org/10.4193/Rhino12.000
Orlandi, R. R., Kingdom, T. T., Hwang, P. H., Smith, T. L., Alt, J. A., Baroody, F. M., Batra, P. S., Bernal-Sprekelsen, M., Bhattacharyya, N., Chandra, R. K., Chiu, A., Citardi, M. J., Cohen, N. A., DelGaudio, J., Desrosiers, M., Dhong, H. J., Douglas, R., Ferguson, B., Fokkens, W. J., Georgalas, C., … Kennedy, D. W. (2016). International Consensus Statement on Allergy and Rhinology: Rhinosinusitis. International forum of allergy & rhinology, 6 Suppl 1, S22–S209. https://doi.org/10.1002/alr.21695
Carr T. F. (2016). Complications of sinusitis. American journal of rhinology & allergy, 30(4), 241–245. https://doi.org/10.2500/ajra.2016.30.4322
Homsi MT, Gaffey MM. Sinus Endoscopic Surgery. [Updated 2022 Sep 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK563202/
Pradhan, B., & Thapa, N. (2006). Functional Endoscopic Sinus Surgery (FESS). JNMA; journal of the Nepal Medical Association, 45(164), 337–341.
FESS Procedures - Frequently Asked Questions | Medtronic. (b. d.). Medtronic | Startseite | Engineering the Extraordinary. https://www.medtronic.com/us-en/patients/treatments-therapies/sinus-surgery/functional-endoscopic-sinus-surgery/frequently-asked-questions.html
Khalil H, Nunez DA. Functional endoscopic sinus surgery for chronic rhinosinusitis. Cochrane Database of Systematic Reviews 2006, Issue 3. Art. No.: CD004458. DOI: 10.1002/14651858.CD004458.pub2. Accessed 04 August 2024.
Behiry, E., Elshazly, H., Abdel-Shafy, I., & Adel Hussein, H. (2019). Evaluation of quality of life after Functional Endoscopic Sinus Surgery (FESS) in chronic rhinosinusitis patients in Menoufia Governorate. Egyptian Journal of Ear, Nose, Throat and Allied Sciences, 20(3), 131–136. https://doi.org/10.21608/ejentas.2019.12297.1106
Laababsi, Rabii*; bushra, Abdulhakeem; Elkrimi, Zineb; Allouane, Amine; Rouadi, Sami; Abada, Reda; Roubal, Mohammed; Mahtar, Mohammed. Quality of life outcomes of patients with chronic rhinosinusitis after functional endoscopic sinus surgery, prospective cohort study. Annals of Medicine & Surgery 40():p 9-13, April 2019. | DOI: 10.1016/j.amsu.2019.03.001
Plath MM, Sand M, Gruchlik MP, et al. [Short-term quality of life assessment after sinus surgery for chronic rhinosinusitis]. Laryngo- Rhino- Otologie. 2024 May. DOI: 10.1055/a-2306-2702. PMID: 38754449.
Wardas, P., Markowski, J., Piotrowska-Seweryn, A., Ślaska-Kaspera, A., Łatacz, B., & Kołodziej, W. (2014). Impact of rhinosinusitis symptoms on patients’ self-esteem before and after FESS. Otolaryngologia Polska, 68(6), 293–297. doi:10.1016/j.otpol.2014.05.001
Damm, M., Quante, G., Jungehuelsing, M., & Stennert, E. (2002). Impact of Functional Endoscopic Sinus Surgery on Symptoms and Quality of Life in Chronic Rhinosinusitis. The Laryngoscope, 112(2), 310–315. doi:10.1097/00005537-200202000-00020
Netkovski, J., & Sirgovska, B. (2006). The impact of functional endoscopic sinus surgery on symptoms in chronic rhinosinusitis. Prilozi, 27(2), 167–174.
Irman, S., Nursiah, S., Sofyan, F., & Ashar, T. (2017). The Role of Functional Endoscopic Sinus Surgery (FESS) to Improve Olfactory Function in Chronic Rhinosinusitis Patients Without Polyps. Bali Medical Journal, 6, 641-644.
Saedi, B., Sadeghi, M., Yazdani, N., & Afshari, A. (2012). Effectiveness of FESS in Smell Improvement of Sinusitis Patients. Indian Journal of Otolaryngology and Head & Neck Surgery, 65(S2), 283–287. doi:10.1007/s12070-011-0439-8
Anne, J., Sreedharan, S., Dosemane, D., Shenoy, V., Kamath, P. M., & Zubair, S. M. (2022). Predictors of Surgical Outcomes After Functional Endoscopic Sinus Surgery in Chronic Rhinosinusitis. Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 74(Suppl 2), 835–841. https://doi.org/10.1007/s12070-020-01855-4
Rasouli , A. A., Rahimi, G. F., Hameedi, A., Safi, A. B., & Zhaisakova , D. (2023). Complications and Risk Factors for Eye in Adult Patients Undergoing Functional Endoscopic Sinus Surgery for Chronic Rhinosinusitis. NUIJB, 2(03), 01–10.
Hemmi, T., Nomura, K., Kobayashi, Y., Numano, Y., Ikeda, R., Sugawara, M., & Katori, Y. (2024). Epidemiology of postoperative bleeding after endoscopic nasal and sinus surgery and factors associated with bleeding. European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 281(4), 1843–1847. https://doi.org/10.1007/s00405-023-08377-z
Shah, S. J., Hawn, V. S., Zhu, N., Fang, C. H., Gao, Q., Akbar, N. A., & Abuzeid, W. M. (2022). Postoperative Infection Rate and Associated Factors Following Endoscopic Sinus Surgery. The Annals of otology, rhinology, and laryngology, 131(1), 5–11. https://doi.org/10.1177/00034894211007240
Stępiński, M. J., & Banaszewski, J. (2023). Intranasal Synechiae as Complications of Rhinosurgical Treatment-A Review of Current Knowledge. Journal of clinical medicine, 12(21), 6831. https://doi.org/10.3390/jcm12216831
Aliyeva, A., Mammadova, G., & Yagiz, O. (2023). Ophthalmological complications during endoscopic sinus surgery: A comprehensive review, 2, 1-7. https://doi.org/10.31579/2835-7957/022
Ilieva, K., Evens, P. A., Tassignon, M. J., & Salu, P. (2008). Ophthalmic complications after functional endoscopic sinus surgery (FESS). Bulletin de la Societe belge d'ophtalmologie, (308), 9–13.
Bhatti, M. T., & Stankiewicz, J. A. (2003). Ophthalmic complications of endoscopic sinus surgery. Survey of Ophthalmology, 48(4), 389–402. doi:10.1016/s0039-6257(03)00055-9
Han, J. K., & Higgins, T. S. (2010). Management of orbital complications in endoscopic sinus surgery. Current opinion in otolaryngology & head and neck surgery, 18(1), 32–36. https://doi.org/10.1097/MOO.0b013e328334a9f1
May, M., Levine, H. L., Schaitkin, B., et al.: Complications of Endoscopic Sinus Surgery. In: Endoscopic Sinus Surgery. (Chap. 7). H. L. Levine and M. May (Eds.). Thieme Medical Publishers, New York, 1993.
Krings, J. G., Kallogjeri, D., Wineland, A., Nepple, K. G., Piccirillo, J. F., & Getz, A. E. (2014). Complications of primary and revision functional endoscopic sinus surgery for chronic rhinosinusitis. The Laryngoscope, 124(4), 838–845. https://doi.org/10.1002/lary.24401
Khademi, S., Kazemi, A., Divanbeigi, R., & Afzalzadeh, M. (2022). A review of the revisions and complications management procedure in sinus surgery. Journal of family medicine and primary care, 11(3), 887–895. https://doi.org/10.4103/jfmpc.jfmpc_897_21
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Julia Hamerska, Laura Hamerska, Julia Lipska, Joanna Antczak, Anna Kajka, Urszula Fenrych, Karolina Wojtczak, Olga Skupińska, Bogumił Bocianiak, Damian Ruta
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 73
Number of citations: 0
