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Inicio Acta Otorrinolaringológica Española Usefulness of endonasal mucoplasty in the surgical treatment of chronic rhinosin...
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Vol. 72. Issue 4.
Pages 256-261 (July - August 2021)
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Vol. 72. Issue 4.
Pages 256-261 (July - August 2021)
Brief communication
Usefulness of endonasal mucoplasty in the surgical treatment of chronic rhinosinusitis with nasal polyps. Prospective study
Utilidad de la mucoplastia endonasal en el tratamiento quirúrgico de la rinosinusitis crónica con pólipos nasales. Estudio prospectivo
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Ramón Moreno-Lunaa,
Corresponding author
ramoluorl@gmail.com

Corresponding author.
, Jaime González-Garcíaa, José Palacios-Garcíaa, Juan Manuel Maza-Solanoa, Alfonso del Cuvillo Bernalb, Serafín Sánchez-Gómeza
a Unidad de Rinología y Base de Cráneo, Hospital Universitario Virgen Macarena, Sevilla, Spain
b Unidad de Rinología, Hospital Universitario de Jerez, Jerez (Cádiz), Spain
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Table 1. Baseline data.
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Abstract

Chronic Rhinosinusitis with Nasal Polyps (CRScPN) is a disease with great impact on health. The surgical option using endoscopic nasosinus surgery is the therapeutic alternative when control of the disease is not achieved with medical treatment. Extensive endoscopic approaches are being postulated as a possible best surgical treatment option in certain phenotypes of CRScPN. Endonasal mucoplasty associated with these approaches has been shown to be a complementary technique that improves both healing and mucosal oedema in patients with CRScPN in the short term. The aim of our study was to analyse the results of endonasal mucoplasty associated with a complete ethmoid-sphenoidotomy plus grade III frontal sinusotomy in the treatment of CRScPN in the medium term. For this purpose, a prospective case-control study (10/10) was carried out on patients with CRScPN. In the case group, endonasal mucoplasty in the left nostril was associated with surgery, and the control group was not. The assessment of quality of life at one year after surgery, as measured by the mean difference in SNOT-22 (mean [SD]), in the case group was significantly better than in the control group, (45.9 [19.6]–26.6 [16.05], P = 0.027). The endoscopic improvement in healing and mucosal oedema, measured by the Modified Lund-Kennedy scale, showed relevant improvements, when comparing both pits, but without reaching significance (P = 0.29). Endonasal mucoplasty promotes short-term healing, improving the quality of life in the medium term (one year) of patients treated with extensive endoscopic breast resections.

Keywords:
Chronic sinusitis
Nasal polyps
Endoscopic sinus surgery
Mucosal grafts
Resumen

La Rinosinusitis Crónica con Pólipos Nasales (RSCcPN) es una enfermedad con gran impacto sobre la salud. La opción quirúrgica mediante cirugía endoscópica nasosinusal es la alternativa terapéutica cuando no se alcanza el control de la enfermedad con el tratamiento médico. Los abordajes endoscópicos extensos se están postulando como posible mejor opción de tratamiento quirúrgico en ciertos fenotipos de RSCcPN. La mucoplastia endonasal asociada a estos abordajes ha demostrado ser una técnica complementaria que mejora tanto la cicatrización como el edema mucoso en pacientes con RSCcPN a corto plazo. El objetivo de nuestro estudio ha consistido en analizar los resultados de las mucoplastia endonasal asociada a una etmoido-esfenoidotomía completa más sinusotomía frontal grado III en el tratamiento de RSCcPN a medio plazo. Para ello se realizó un estudio prospectivo de casos y controles (10/10) en pacientes con RSCcPN. En el grupo de casos se asoció a la cirugía una mucoplastia endonasal en la fosa nasal izquierda, y el grupo control no. La evaluación de la calidad de vida al año de la intervención quirúrgica, medida mediante la diferencia de medias de SNOT-22 (media [DE]), en el grupo de casos fue significativamente mejor frente al grupo control, (45,9[19,6]–26,6[16,05], p = 0,027). La mejoría endoscópica de la cicatrización y edema mucoso, medido mediante la escala de Lund-Kennedy Modificada, mostró mejorías relevantes, al comparar ambas fosas, pero sin alcanzar la significación (p = 0,29). La mucoplastia endonasal favorece la cicatrización a corto plazo, mejorando la calidad de vida a medio plazo (un año) de los pacientes tratados con resecciones extensas endoscópicas de los senos.

Palabras clave:
Sinusitis crónica
Pólipos nasales
Cirugía endoscópica nasosinusal
Injertos mucosos

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