Surgical Treatment of Chronic Sinusitis with Nasal Polyps

Clinical History: Patient referred for evaluation of chronic sinusitis with nasal polyps. She has an extensive history of long term sinus issues that have required two prior surgeries over the past 8 years. The patient presents with symptoms of lack of smell, sinus pressure, and nasal congestion. She has tried various medications including antibiotics(Azithromycin, Amoxicillin, Augmentin), nasal steroid sprays, antihistamines, and oral steroids. Initially she noted relief with these medications, however, over the past year nothing has been effective. The patient has also undergone an extensive allergy workup with injection immunotherapy – again with limited success. Seeking further options, the patient was referred to GNO Snoring and Sinus.

Physical Exam: A nasal endoscopy was performed revealing significant nasal polyps at both left and right nasal passage. An in-office CT Sinus was then performed confirming evidence of significant nasal polyps blocking nasal airflow and sinus drainage. (PreOp CT Scan). This resulted in an accurate diagnosis of chronic sinusitis with nasal polyposis.

Treatment: The patient received preoperative medical treatment with antibiotics and steroid taper followed immediately by surgical treatment of her chronic sinusitis with nasal polyposis.

Before:

ProOp CT Scan: (10/2016)

After:

Treatment: Sinus Surgery – (11/2016)
PostOp CT Scan: (4/2017)

Summary: Following surgical correction of her chronic sinusitis with nasal polyposis, the patient noted a significant decrease in sinus pressure and regained her ability to smell. There was noted improvement in nasal breathing as well. This is evident from the clearance of polyps noted in the PostOp Image.

It is important to note that her PostOp CT Scan was performed 5 months after surgery – therefore, no polyps had recurred. This is due to both successful surgery as well as the patient maintaining proper medical therapy with various sprays and oral medications. Nasal polyps are an allergic manifestation and surgery is only part of the treatment. Ultimate treatment success comes from the patient’s ability to remain compliant with allergy treatment and follow up for routine visits to prevent polyp recurrence. In essence, success is a team effort.

With an accurate diagnosis, proper treatment is provided resulting in improved clinical symptoms.

To learn more about the various medical and surgical treatment options available at GNO Snoring and Sinus, please contact us to learn more.