Browsing by Subject "Endoscopic sinus surgery"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    A Systematic Classification of Surgical Approaches for the Sphenoid Sinus: Establishing a Standardized Nomenclature for Endoscopic Sphenoid Sinus Surgery
    (Korean Society of Otorhinolaryngology-Head and Neck Surgery, 2025) Park, Marn Joon; Fischer, Jakob L.; Ramakrishnan, Vijay R.; Welch, Kevin C.; Kim, Dong-Young; Won, Tae-Bin; Cho, Jae Hoon; Mun, Sue Jean; Lee, Jivianne T.; Beswick, Daniel M.; Wang, Marilene B.; Suh, Jeffrey D.; Otolaryngology -- Head and Neck Surgery, School of Medicine
    The sphenoid sinus presents significant challenges during endoscopic sinus surgery. It is essential that surgeons employ strategies that effectively address sphenoid pathology while minimizing surgical risks and optimizing outcomes. Although nomenclature for maxillary and frontal sinus surgery is well established, there is currently no standardized nomenclature for sphenoid sinus surgery. We present a comprehensive review of techniques for accessing the sphenoid sinus and propose a common surgical classification system to better define and categorize these approaches. Each technique is classified based on surgical extent, anticipated operation time, complexity, potential complications, and expected wound healing, aligning with established standards in the literature. The proposed sphenoidotomy types are as follows: type I, sphenoid ostial dilation; type IIa, transnasal sphenoidotomy (sphenoidotomy without ethmoidectomy); type IIb, transethmoidal sphenoidotomy (sphenoidotomy with ethmoidectomy); type III, bilateral, common cavity sphenoidotomy, or "sphenoid drill-out;" type IV, transpterygoid approach, to expose the lateral sphenoid sinus recess; and type V, sphenoid nasalization, completely removing the sphenoid sinus floor. By standardizing the nomenclature for these techniques, we aim to enhance consistency in terminology for teaching, surgical planning, clinical research, and interdisciplinary communication in sphenoid sinus surgery.
  • Thumbnail Image
    Item
    Disease control after surgery for chronic rhinosinusitis: Prospective, multi-institutional validation of the Sinus Control Test (SCT)
    (Wiley, 2021) Little, Ryan E.; Schlosser, Rodney J.; Smith, Timothy L.; Storck, Kristina A.; Alt, Jeremiah A.; Beswick, Daniel M.; Mace, Jess C.; Mattos, Jose L.; Ramakrishnan, Vijay R.; Soler, Zachary M.; Otolaryngology -- Head and Neck Surgery, School of Medicine
    Background: The Sinus Control Test (SCT) is a 4-question, patient-reported questionnaire that assesses disease control in chronic rhinosinusitis (CRS). This prospective, multicenter study examines SCT outcomes following endoscopic sinus surgery (ESS), further validating its use as a control instrument for CRS. Methods: Adults with CRS undergoing ESS were prospectively enrolled from 5 centers across North America. The SCT was administered at baseline and once 6 months after surgery. Quality of life and disease burden were evaluated using the 22-item Sino-Nasal Outcome Test (SNOT-22) and Lund-Kennedy endoscopy scores. Linear regression was used to determine whether specific demographic, comorbidity, or disease severity measures were independently associated with changes in SCT scores postoperatively. Results: A total of 218 patients, 111 females (50.9%) and 107 males (49.1%), were enrolled, with mean ± standard deviation age of 50.1 ± 15.6 years. Mean SCT score improved from 8.9 ± 3.5 to 4.3 ± 3.7 postoperatively (p < 0.001). Preoperatively, 21.6% were uncontrolled, 71.5% partially controlled, and 6.9% controlled. Postoperatively, 6.0% were uncontrolled, 42.6% partially controlled, and 51.4% controlled (p < 0.001). Change in SCT score correlated independently with change in SNOT-22 (r = 0.500, p < 0.001) and endoscopy scores (r = 0.310, p < 0.001). Endoscopy scores did not correlate with control status among patients with CRS without nasal polyposis (CRSsNP) nor between uncontrolled and partially controlled patients. Demographics and comorbidities were not associated with changes in SCT. Conclusion: Improvement in disease control following ESS as measured by the SCT correlated with improvements in SNOT-22 and endoscopy scores. The SCT is an easily administered instrument that provides information complementary to existing patient-reported and objective measures of disease severity.