The Effect of Functional Endoscopic Sinus Surgery on Pulmonary Functions of Patients with Pulmonary Diseases and Sinusitis

ABSTRACT

Background: Coexistence of upper and lower respiratory diseases is common. This coexistence of sinus disease and pulmonary diseases was first described by Galen in the second century. Since chronic sinusitis and pulmonary diseases are closely related, surgical treatment of chronic sinusitis could improve pulmonary functions and reduces the need for medication. This study was made to assess the efficacy of FESS on pulmonary functions of patients with chronic sinusitis and pulmonary diseases. Methods: The study was conducted in the Department of ENT of a tertiary care centre. Pulmonary function tests Included forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1) and mid expiratory phase of the forced expiratory flow (FEF 25%-75%) were observed of each patients before and after FESS using a spirometer. Results: Scoring results for COPD before and after FESS were shown in Table 5, the score for mild, moderate and severe COPD were 44.4%, 33.3%, 22.2%; and improved postoperatively to 11.1%, 16.6%,11.1% respectively. Scoring results for asthma before and after FESS are the score for mild, moderate and severe asthma were 27.08%,50%, 22.9%; and improved postoperatively to 8.3%, 25%, 29.1% respectively. The mean of spirometric parameters before and after FESS shows an improvement as follows The FVC was improved from72 ± 3.78 to 82 ± 4.12, FEV1 from 70 ± 4.08 to 89 ± 4.56 and FEF 25-75% from 76 ± 2.92 to 88 ± 2.65 with statistical significance for all parameters p <0.001. Conclusion: Findings of the current study suggest that FESS is effective in improving pulmonary functions in patients suffering from pulmonary diseases as well as sinusitis with or without nasal polyp. Therefore, we strongly suggest that surgery for the sinusitis earlier in the course of the disease gives a far better outcome and could be beneficial for the pulmonary diseases.