Retrospective study of full-house functional endoscopic sinus surgery for revision endoscopic sinus surgery

Abstract

<h4>Background</h4>Outcomes for revision endoscopic sinus surgery (RESS) are rarely reported in relation to technique. Our goal was to document the outcome of full-house functional endoscopic sinus surgery (FESS) (FHF) (complete sphenoethmoidectomy with Draf IIA frontal sinusotomy) for treatment of this recalcitrant group.<h4>Methods</h4>Twenty-one patients with chronic sinusitis having had at least 1 previous sinus surgery (mean, 2.14) underwent FHF, followed by postoperative nasal douching and oral antibiotics for 12 weeks. After a minimum 6 months of follow-up, patients were asked to complete a 5-item Patient Response Score (PRS) (graded on a 6-point scale from 1 = completely improved to 6 = much worse). Objective measures collected included computed tomography (CT) Lund MacKay score (L-M score, LMS), and endoscopic findings: mucosal swelling (MS) and mucopus (MP) (graded on a 4-point scale from 0 = none to 3 = severe).<h4>Results</h4>Patients were divided into 3 subgroups based on months of follow up from surgery: 6-12, 12-18, and 18-24. There was no statistical difference in any outcome based on length of follow up. Mean symptom outcome was reported as much improved (PRS = 1.9 ± 0.1). Both mucosal swelling and mucopus improved dramatically (2.48 vs 0.29, p < 0.001; 2.52 vs 0.29, p < 0.001, respectively). LMS also improved dramatically (11.52 vs 2.1, p < 0.001). Presence of nasal polyps did not affect any subjective or objective outcome.<h4>Conclusion</h4>Marked improvements in symptoms and mucosal findings were consistently obtained with FHF between 6 and 24 months postoperatively.