Correlation Between Lund-Mackay Ct Scores Before and after Surgery for Nasal Polyposis, An Evaluation of Medical and Surgical Treatment in Nasal Polyposis

Abstract

Objective: To determine the efficacy of functional endoscopic sinus surgery on treating nasal polyps in terms of improvement in the Lund-MacKay score.

Study Design: Quasi-experimental study.

Place and Duration of Study: Department of ENT, Combined Military Hospital, Rawalpindi Pakistan, Jul 2021 to Jan 2022.

Methodology: Seventy patients suffering from chronic rhino-sinusitis were included in this study. All patients were assessed before and three weeks after treatment using the Lund-MacKay computed tomography score. Group-A patients received management with a hybrid therapy using functional endoscopic sinus surgery and drug therapy, while Group-B patients received conservative management alone.

Results: The majority of the patients in our sample were males 43(61.4%), a mean duration of complaints of 6.47±1.91 months.Hybrid therapy showed a significantly higher improvement in relieving nasal obstruction when compared to conservative management alone (p=0.033). Conservative management appeared to be more effective in relieving nasal discharge and headache, although this did not approach statistical significance (p=0.11 and 0.43, respectively). Facial pain and olfactory function showed a greater improvement with hybrid therapy, which was not statistically significant (p=0.097 and 0.131, respectively).The Lund-MacKay computed tomography scores with conservative and hybrid therapy were 13.91±4.11 and 11.17±4.17 at the end of treatment (p=0.007), demonstrating that hybrid therapy was superior.

Conclusion: Functional Endoscopic Sinus Surgery combined with limited medical therapy is superior to pure medical therapy in terms of improvement in Lund-MacKay CT scores and relief in symptoms of nasal obstruction.