Objective and Subjective Evaluation of Treatment Outcomes of Chronic Sinusitis: Comparison of Endoscopic Surgery and Conventional Surgery

Lee, Bong Jae; Kim, Hyung Suk

Abstract

Authors aimed to know the efficacy of sinus surgery for the chronic sinusitis in the objective and subjective aspects and to compare the surgical outcomes of endoscopic sinus surgery with those of conventional sinus surgery. Two hundred patients who had undergone sinus surgery, either conventional (100 patients) or endoscopic (100 patients), for chronic medically recalcitrant sinusitis were retrospectively studied by reviewing medical records and radiological films. Questionnaires asking postoperative changes of preoperative symptoms were analyzed to assess the subjective improvement. Normalization of the nose, which was defined as free of pathologic secretions and polyp or polypoid growths on endoscopic examination, could be achieved in 41% of 111 patients who had been followed-up for more than 6 months postoperatively, and there was no significant difference in the rate of normalization between the conventional surgery group (40%) and endoscopic surgery group (43%). Postoperative polyps or polypoid growths were developed in 23% and persistence of mucopurulent secretion was identified in 36%. Overall assessment of patients for the subjective symptoms revealed 77% improvement (64% in conventional group vs. 88% in endoscopic group ; p>0.05), and endoscopic sinus surgery appeared to be superior to conventional sinus surgery in relieving nasal obstruction and headache with statistically significant difference (p<0.05). Among possible prognostic factors for the recurrence of polyps, young age and preexisting nasal polyps were significant. These results suggest that frequent development of polyp or polypoid mucosal changes after operation and persistence of pathologic secretions mandate the surgeons to be considerate in selecting surgical candidates and to explain the patients preoperatively about the possible poor results necessitating additional surgical procedures.