الفهرس 
PARANASAL SINUS ANATOMYOnly 14 pages are availabe for public view
Abstract
Chronic sinusitis is one of the most prevalent chronic
illnesses, affecting persons of all age groups. It is an
inflammatory process that involves the paranasal sinuses and
persists for 12 weeks or longer. It is almost always
accompanied by concurrent nasal airway inflammation and is
often preceded by rhinitis symptoms; thus, the term chronic
rhinosinusitis (CRS) has evolved to more accurately describe
this condition.
CRS may manifest as one of three major clinical
syndromes: CRS without nasal polyps, CRS with nasal polyps,
or allergic fungal rhinosinusitis. These classifications possess a
great deal of therapeutic significance. Patients with
symptomatic CRS have a high prevalence of sleep pathology.
The relationship between sleep dysfunction and quality of life
(QOL) in CRS is likely bidirectional, whereby disability
predicts worse sleep which may influence QOL.
The aim of this study is to investigate the effect of
chronic rhinosinusitis (CRS) on sleep disordered breathing.
This study was conducted on one hundred patients with
chronic rhinosinusitis attended to ENT departments of El-
Maadi Armed Forces Medical Complex, Kobry El-Kobba
Armed Forces Medical Complex and El-Demerdash hospitals.Additional 10 control patients were included in the study.
Patients who were included in the study were divided into 3
groups as follows:
Study group A: included 50 patients suffering from chronic
rhinosinusitis with nasal polyposis +/- septal deviation.
Study group B: included 50 patients suffering from chronic
rhinosinusitis without nasal polyposis.
Study group C: included 10 patients serving as control
group with no sinonasal disorders and no other cause of
sleep apnea.
All of the study groups were subjected to the
following measures preoperative:
1- Complete ENT history taking with particular emphasis on
Epworth Sleepiness Scale questionnaires (ESS).
2- Full ENT examination.
3- Endoscopic examination of the nose and paranasal sinuses.
4- High resolution Sinonasal computed tomograghy (CT) scan.
5- Overnight polysomnography using (Nicolet) device in
Neurology department in El-Maadi armed forces medical
complex.
All these findings were recorded one month
postoperatively for all patients for evaluation.esults obtained from this study could be summarized
as follow:
Comparative study between the 3 groups revealed;
1- Non-significant statistical difference as regards age, gender
and BMI
2- Highly significant increase in ESS score in ”A group”;
compared to B then C groups.
3- Highly significant increase in moderate and severe ESS
categories in ”A group”; compared to other groups
Comparative study between pre and post-operative
measurements revealed;
1- Highly significant increase in post-operative sleep
efficiency, minimal and basal Spo2 measurements in ”A
group”.
2- Highly significant decrease in post-operative snore index
and snore episodic measurements in ”A group”.
3- Non-significant difference regarding (A+H) index
measurements in ”A group”.
from the previous results, it can be concluded that Surgery
decreased snoring and ESS scores,increased sleep efficiency,
minimal and basal Spo2 measurements without changes in the
apnea-hypopnea index and improved sleep quality.