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European Archives of Oto-Rhino-Laryngology

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01-05-2019 | Sinus Surgery | Rhinology

The effects of endoscopic sinus surgery on pulmonary function in chronic rhinosinusitis patients with asthma: a systematic review and meta-analysis

Authors: Yujie Cao, Haiyu Hong, Yueqi Sun, Yinyan Lai, Rui Xu, Jianbo Shi, Fenghong Chen

Published in: European Archives of Oto-Rhino-Laryngology | Issue 5/2019

Abstract

Purpose

Evidences showed improvements in clinical asthma outcomes following endoscopic sinus surgery (ESS) in chronic rhinosinusitis (CRS) patients with asthma. However, pulmonary function benefits have remained controversial up to date. The goal of this study was to conduct a systematic review and meta-analysis to investigate the effects of ESS on pulmonary function tests in CRS patients with asthma.

Methods

Pubmed, Embase and Cochrane Library were searched up to March 2018 to obtain relevant studies. The researches that evaluated the effects of ESS on pulmonary function in CRS patients with asthma and had at least one parameter of pulmonary function tests before and after surgery were included in the study.

Results

A total of 13 studies containing 421 patients satisfied the eligibility after judgment by 2 reviewers. These included three RCTs and ten case series. The heterogeneity in parameters of spirometry and difference in data presented forms across studies along with the lack of standard deviation of some data make it difficult to synthesize results. If data were unavailable for meta-analyses, descriptive statistics were used to report study outcomes. After qualitative and quantitative analysis, the weighted mean change after ESS in forced expiratory flow between 25% and 75% of vital capacity (FEF25–75%) was 0.21 L/s (95% CI 0.12–0.30); eight of ten studies supported that forced expiratory volume at 1 s (FEV1) improved after ESS; five of six studies supported that peak expiratory flow (PEF) improved after ESS. However, strength of evidence is generally low to insufficient.

Conclusion

A generally low-quality evidence supports the association between ESS and improvements in FEF25–75%, FEV1 and PEF. A few studies met inclusion criteria for meta-analysis, which indicates the need for more high-quality studies to determine the effect of ESS.

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Title: The effects of endoscopic sinus surgery on pulmonary function in chronic rhinosinusitis patients with asthma: a systematic review and meta-analysis
Authors: Yujie Cao
Haiyu Hong
Yueqi Sun
Yinyan Lai
Rui Xu
Jianbo Shi
Fenghong Chen
Publication date: 01-05-2019
Publisher: Springer Berlin Heidelberg
Keywords: Sinus Surgery
Pulmonary-Function Tests
Rhinosinusitis
Bronchial Asthma
Spirometry
Published in: European Archives of Oto-Rhino-Laryngology / Issue 5/2019
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-019-05337-4

At a glance: The STEP trials

Springer Medicine

The effects of endoscopic sinus surgery on pulmonary function in chronic rhinosinusitis patients with asthma: a systematic review and meta-analysis

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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