Clin Exp Otorhinolaryngol.  2014 Dec;7(4):302-306. 10.3342/ceo.2014.7.4.302.

Surgical Management of Rhinosinusitis in Onco-Hematological Patients

• Di Girolamo S
• Mazzone S
• Di Mauro R
• Giacomini
• Cantonetti M

• KMID: 2278371
• DOI: http://doi.org/10.3342/ceo.2014.7.4.302

Abstract

OBJECTIVES
In onco-hematological diseases, the incidence of paranasal sinuses infection dramatically increase and requires a combination of medical and surgical therapy. Balloon dilatation surgery (DS) is a minimally invasive, tissue preserving procedure. The study evaluates the results of DS for rhinosinusitis in immunocompromised patients.
METHODS
A retrospective chart review was conducted in 110 hematologic patients with rhinosinusitis. Twenty-five patients were treated with DS technique and 85 patients with endoscopic sinus surgery (ESS). We considered the type of anesthesia and the extent of intra- and postoperative bleeding. Patients underwent Sino-Nasal Outcome Test (SNOT-20) to evaluate changes in subjective symptoms and global patient assessment (GPA) questionnaire to value patient satisfaction.
RESULTS
Local anesthesia was employed in 8 cases of DS and in 15 of ESS. In 50 ESS patients, an anterior nasal packing was placed and in 12 cases a repacking was necessary. In the DS group, nasal packing was required in 8 cases and in 2 cases a repacking was placed (P=0.019 and P=0.422, respectively). The SNOT-20 change score showed significant improvement of health status in both groups. However the DS group showed a major improvement in 3 voices: need to blow nose, runny nose, and facial pain/pressure. The 3-month follow-up GPA questionnaire showed an higher satisfaction of DS group.
CONCLUSION
Balloon DS represents a potentially low aggressive treatment and appears to be relatively safe and effective in onco-hematologic patients. All these remarks may lead the surgeon to consider a larger number of candidates for surgical procedure.

Keyword

Rhinosinusitis; Balloon sinuplasty; Oncohematological disease

MeSH Terms

Anesthesia
Anesthesia, Local
Dilatation
Follow-Up Studies
Hemorrhage
Humans
Immunocompromised Host
Incidence
Nose
Paranasal Sinuses
Patient Satisfaction
Retrospective Studies
Voice
Surveys and Questionnaires

Figure

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  Fig. 1 Changes in Sino-Nasal Outcome Test (SNOT-20) results between 2 groups.

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  Fig. 2 Global patient assessment outcome between 2 groups.

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