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Endoscopic Sinus Surgery Effective In HIV Patients

SAN FRANCISCO -- April 26, 1999 -- University of California-San Francisco researchers prove that surgical intervention for sinus problems enhances quality of life in patients with immune deficiency disorder.

Despite the significant advances in the treatment of patients with HIV and AIDS, there remains a prevalence of sinusitis in at least 65 percent of these patients. The treatment of this debilitating disorder has been thwarted by recurrent infections and an increased incidence of tolerance to antibiotics. New research now shows that endoscopic sinus surgery is an effective treatment for these patients.

A new study by otolaryngologist -- head and neck surgeons -- provides strong evidence that endoscopic sinus surgery alleviates the sinus disorder symptoms often seen in HIV patients.

The research study was carried out by Saurabh B. Shah MD, Nadim B. Bikhazi MD, Kenneth Yu MD, and Kelvin C. Lee MD, all from the Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, CA. The results of their findings were presented on Monday, April 26, at the annual meeting of the American Rhinologic Society, being held in Palm Desert, CA.

The researchers identified 41 patients diagnosed as seropositive with HIV and suffering from chronic sinusitis or recurrent acute sinus infections. All of the patients had undergone medical management for their sinus condition; despite aggressive medical therapy, the condition remained. Accordingly, endoscopic surgery was recommended for each.

The researchers found statistically significant improvements following surgical intervention. Specifically, they found a reduction in the number of sinusitis episodes following the surgical intervention. Additionally, endoscopic sinus surgery appeared to have reduced the post-operative antibiotic requirements, a necessity among a population with resistant organisms, such as the aerobic bacteria, Pseudomonas.

The researchers caution that the standards of success applied to HIV-positive patients differ from similar criteria applied to immunocompetent patients. Many HIV-patients have major problems with nasal congestion and drainage. This may be due to hyper-allergic decreased cellular immunity. Because of this, many HIV patients will, after surgery, continue to note nasal congestion and drainage despite improvement on CT scans.

This study demonstrates that endoscopic sinus surgery, despite the prevalence of sinusitis symptoms, is effective in reducing outpatient visits for HIV patients and reducing the reliance on antibiotics.

Thanks to The Doctor's Guide to the Internet™ for the article


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