Publication:

Impact of functional endoscopic sinus surgery on pulmonary function, sleep quality, and sinonasal quality of life in sinonasal polyposis patients

Background To compare pulmonary function, sleep quality, and sinonasal quality of life parameters in patients undergoing conservative management and those undergoing post-functional endoscopic sinus surgeries (FESS).

Methods A total of 60 patients were included in the study, 30 in each group i.e. medically managed labelled as Group 1 and surgically managed labelled as Group 2 and the groups were matched evenly taking care of different variables. Lund-Mackay endoscopic score and radiological score pre- and post-operatively were obtained. Spirometry was done 1 week before surgery and at postoperative 6 weeks. Endoscopic sinus surgery was performed under general anaesthesia. Nasal packing was removed 24 hours postoperatively and discharged on post-op day 1. Follow-up was done at the 1st, 3rd, and 6th post-op weeks. SNOT 22, PSQI, and PFT were repeated at the end of 6 weeks.

Results There was significant improvement in PSQI score in medically managed patients but not much difference was seen in SNOT 22 score. A significant difference statistically was seen in both PSQI and SNOT 22 scores of surgically managed patients. Patients managed with maximal medical therapy showed improvement in FEV1/FVC after 6 weeks but it was not significant statistically, whereas patients who underwent surgery had statistically significant improvement in all three values of FEV1, FVC, and FEV1/FVC.

Conclusions By employing pulmonary function tests (PFT), the research unveils objective evidence of underlying lower airway involvement in CRSwNP patients, even in the absence of overt clinical symptoms.