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Endoscopic Sinus Surgery in Patients Infected With HIV
Author(s) -
Friedman Michael,
Landsberg Roee,
Tanyeri Hasan,
Schults Roman A.,
Kelanic Stephen,
Caldarelli David D.
Publication year - 2000
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-200010000-00006
Subject(s) - medicine , contraindication , surgery , sinusitis , sinus (botany) , functional endoscopic sinus surgery , human immunodeficiency virus (hiv) , botany , alternative medicine , pathology , biology , genus , family medicine
Objectives To be able to plan appropriate surgical treatment for patients with HIV infection who have sinusitis refractory to medical therapy. Design We retrospectively reviewed the charts of 186 patients with HIV who required surgical treatment for sinusitis between 1987 and 1998. One hundred sicharts provided the necessary information and an adequate follow‐up to be included in the study. Collected data included preoperative and postoperative symptoms, radiographic staging, CD4 count at the time of surgery when available, and type and e‐tent of surgery. Results Surgical treatment evolved over the 12 years from limited surgery to standard endoscopic sinus surgery (ESS). Eighteen patients had invasive fungal disease or complications of sinusitis requiring radical surgery. Thirty‐six patients were treated with minimal procedures to address involved sinuses only. These patients were treated between 1987 and 1991. Recurrent disease or further complications occurred in 80.6% of the patients in this group. Since 1992, 52 patients were treated with standard ESS following the same indications for HIV− patients. This group had an improvement of symptoms in 75% of the cases, a rate comparable to the success rate in HIV− patients. Conclusions HIV+ patients undergoing standard ESS enjoy a satisfactory success rate. HIV+ patients with surgical indication for endoscopic sinus surgery should be treated as non‐HIV+ patients. Apparently, low CD4 count (< 100) does not serve as a contraindication for definitive surgery.